United Benefit Advisors Insight and Analysis Blog

HHS Releases Bulletin that Extends Grandmothered Plans Through 2020

Posted by: Karen Hsu    Apr 25, 2019 2:58:31 PM

shutterstock_245503777As background, in the fall of 2013, the Department of Health and Human Services (HHS) announced a transitional relief program that allowed state insurance departments to permit early renewal at the end of 2013 of individual  and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act (ACA) and for the policies to remain in force until their new renewal date in late 2014.

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Topics: compliance

Status of Court Case Challenging ACA Constitutionality

Posted by: Karen Hsu    Apr 16, 2019 2:52:00 PM

shutterstock_754468558As background, in February 2018, twenty states filed a lawsuit asking the U.S. District Court for the Northern District of Texas (Court) to strike down the Patient Protection and Affordable Care Act (ACA) entirely. The lawsuit came after the U.S. Congress passed the Tax Cuts and Jobs Act in December 2017 that reduced the individual mandate penalty to $0, starting in 2019.

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Topics: compliance

Top Five Compliance Assessment Surprises

Posted by: Bob Bentley    Feb 23, 2017 9:30:00 AM

Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.

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Topics: compliance, ACA, COBRA, Affordable Care Act, Albers & Company, benefits compliance, Department of Labor audit, USERRA, life insurance, compliance assessment, Bob Bentley, benefits notices

Interim Final Regulation on Maximum Civil Monetary Penalties

Posted by: Danielle Capilla    Dec 29, 2016 10:30:00 AM

The Department of Health and Human Services (HHS) recently issued interim final regulations that adjust for inflation the maximum civil monetary penalties (CMP) that fall under HHS's jurisdiction. The regulations reflect changes required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 (the Act).

Adjustments under the Act were effective on August 1, 2016, and HHS's CMP adjustment regulations were effective on September 6, 2016. HHS issued its regulations for immediate implementation, without the notice and comment procedures that normally accompany new regulations.

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Topics: compliance, ACA, HIPAA, group health insurance, Danielle Capilla, Affordable Care Act, monetary penalties

State Guide to COBRA Supplemental Requirements

Posted by: Danielle Capilla    Nov 22, 2016 10:30:00 AM

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal requirement of group health plans to provide COBRA continuation coverage to participants who lose coverage due to a qualifying event, when the employer had 20 or more full time employees. Over the years, many states enacted additional requirements similar to COBRA, either for small employers, or in addition to the federal COBRA requirements. UBA has created a chart to outline each state’s specific continuation laws. For a sampling of the types of laws employers need to be aware of, consider these seven states (and view our full Compliance Advisor with the detail on all 50 states)

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Topics: compliance, COBRA, Danielle Capilla, COBRA continuation coverage, group benefit plans

HIPAA Phase 1 Audits

Posted by: Danielle Capilla    Aug 26, 2016 10:30:00 AM

The Health Insurance Portability and Accountability Act (HIPAA) established national standards to secure and protect the privacy of health information. The Health Information Technology for Economic and Clinical Health Act (HITECH) requires the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) to conduct audits of covered entities and business associates in order to ensure compliance with the HIPAA Privacy, Security, and Breach Notification Rules.

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Topics: compliance, HIPAA, Danielle Capilla, covered entities, HIPAA audit, business associates

How to Complete the IRS/SSA/CMS Data Match Report

Posted by: Danielle Capilla    Jul 26, 2016 10:30:00 AM

Data Match is a program coordinated by the Internal Revenue Service (IRS), Centers for Medicare & Medicaid Services (CMS), and the Social Security Administration (SSA) to identify Medicare beneficiaries who received Medicare benefits with Medicare as the primary payer when Medicare should have been the secondary payer. We recently covered background on this program in a previous blog posting. Employers are required to complete the Data Match report within 30 days of receipt of the Data Match Personal Identification Number (PIN), unless an extension has been requested and approved. The letter directs employers to the Data Match Secure Website, where the questionnaire can be accessed after entering the employer identification number and PIN.

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Topics: compliance, Medicare, Danielle Capilla, IRS-SSA-CMS Data Match Program

Shining a Light on HIPAA Compliance for Health and Welfare Plans

Posted by: Elizabeth Kay    Jun 7, 2016 5:43:27 PM

With the passage of the Affordable Care Act (ACA), the federal government became much more involved in what had always been a heavily regulated, but predominately private industry. What many people have forgotten is that the ACA was not the first legislation to be passed that involved private and employer-sponsored health and welfare plans.

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Topics: compliance, HIPAA, health plan compliance, Elizabeth Kay, PHI, health and welfare plans, protected health information, business associate agreement

Top 8 Free (!) UBA Healthcare Cost and Compliance Resources for Employers

Posted by: Bill Olson    Jan 12, 2016 12:00:00 PM

UBA offers a comprehensive library of ACA Advisors and white papers to help employers navigate health care cost and compliance. Every year we look at the documents most accessed by employers and remind our audience of these helpful, free resources. Here’s what was most in demand in 2015.

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Topics: compliance, ACA, health plan benchmarking, UBA Health Plan Survey, Don't Roll the Dice on Department of Labor Audits, cafeteria plan, Affordable Care Act, annual benefit limits, white paper, health care cost, account-based plans

PCORI Fees Due July 31 for Many Health Plans. How Much Do You Owe?

Posted by: Danielle Capilla    Jun 16, 2015 12:00:00 PM

PPACA created a private non-profit corporation called the Patient-Centered Outcomes Research Institute (PCORI). The Institute's job is to research the comparative effectiveness of different types of treatment for certain diseases, and to share its findings with the public and the medical community. The goal is to improve quality of treatment and reduce unnecessary spending. The Patient-Centered Outcomes Research Institute (PCORI) fee is to support this research and applies from 2012 to 2019.

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Topics: compliance, PPACA Affordable Care Act, PCORI, group health insurance, Danielle Capilla, PPACA fees