Employer Disclosure Reporting and Obligations: A Guide for 2021

Employer Disclosure Reporting and Obligations: A Guide for 2021

As calendar-year plans look forward to the 2021 Plan Year, which runs from January 1, 2021 through December 31, 2021, now is a good opportunity to review the ongoing ERISA notice and reporting obligations, including their respective deadlines! It’s always good to plan ahead and these obligations help to ensure that your benefit plans maintain compliance. In this blog, we’ll be discussing important employer disclosure reporting and obligations and providing a quick reference for when these are due!

Notice for Employers and Open Enrollment

Prior to the start of each Plan year: Certain required notices are often included within the open enrollment materials for convenience as well as compliance. One such notice is the Summary of Benefits and Coverage (SBC) & Uniform Glossary. For fully-insured plans, a carrier provides these within their enrollment documents. Boon prepares and provides these materials for plan sponsors to distribute for self-funded plans.

Other required annual notices that are often included within the enrollment booklet that Boon provides, include:

  • HIPAA Notice of Special Enrollment Rights
  • HIPAA Preexisting Conditions Exclusions NoticeHealthCare Reform limited the impact of pre-existing condition exclusions, but this notice may still be relevant for excepted benefits (e.g. dental, vision).
  • COBRA Initial Notice
  • GINA Notice of Research Exception
  • Women’s Health & Cancer Rights Act (WHCRA) Notice
  • Newborns’ & Mothers’ Health Protection Act (NMHPA) Notice
  • Mental Health Parity & Addiction Equity Act (MHPAEA) Disclosure
  • Statement of grandfathered status.
  • Patient Protections ‘Providers Choice’ Notice

HIPAA Notices to Watch

The HIPAA Notice of Privacy Practices informs plan participants of their HIPAA Privacy Rights, the plan’s privacy obligations, and the contact information for filing complaints. For fully-insured plans, the carriers often include this notice within the annual enrollment packet, because it is required at time of enrollment. Plan Sponsors of self-funded plans may want to do the same.

Upon enrollment in a plan, newly covered participants should receive the Summary Plan Description (SPD) within 90 days of the start of coverage. Boon provides the employers with these documents as well. In addition to the requirement that newly covered participants be given an SPD, an updated SPD should be provided to all participants every 5 years (or every 10 years if no document changes). The SPD must also include the following notices:

  • Internal claims & appeals and External Review notice
  • Address the Qualified Medical Child Support Order (QMCSO)
  • Newborns’ & Mothers’ Health Protection Act (NMHPA) Notice
  • Mental Health Parity & Addiction Equity Act (MHPAEA) Disclosure
  • Statement of grandfathered status

Employer Disclosure Reporting and Obligations

Maintaining compliance and properly reporting for your benefit plans is a year-round effort! Starting in January and rolling into the enrollment season, there are several deadlines to be mindful of. Here’s your calendar of employer disclosure reporting, and obligations, at a glance:

On or before January 31st of each year, all employers must provide the IRS Form W-2 Reporting that includes the aggregate cost of applicable employer-sponsored coverage provided to employees. Note that this is solely for informational purposes and not included within the employee’s taxable income.

On or before January 31st of each year, an employer must provide employees the Form 1095-B, 1094-B or Form 1095-C, 1094-C, as applicable.

On or before February 28th (or March 31st if filing electronically), employers must provide to the IRS the Form 1095-B, 1094-B or Form 1095-C, 1094-C, as applicable.

On or before February 28th, an employer must send CMS via online disclosure the Medicare Part D Creditable/Non-Creditable Coverage status.

On or before July 31st, employers must submit to the DOL the Form 5500, unless they satisfy the small employer plan exception. Employers can request an extension.

On or before September 30th, the employer must provide plan participants the Summary Annual Report (SAR). The SAR must be provided within 9 months after the end of the plan year, or 2 months after the due date for the Form 5500 filing with the DOL (if an extension for the Form 5500 was filed).

On or before October 15th, the Medicare Part D- Creditable Coverage Notice must be provided to Part D eligible participants who are covered by, or who apply for, coverage under the group health plan. It is generally accepted best practice to send the Medicare Part D coverage notice to all participants.

Though not required to be included at an annual basis, the Notice of Coverage Options must be provided to each new employee at the time of hire or within 14 days of an employee’s start date.  This notice provides information about the Marketplace Exchange – provides information to employees about the employer’s coverage, the Marketplace/Exchange, and available federal subsidies.

Your Compliance is Our Priority

Though not an exhaustive list, this is hopefully a good reminder of the importance to maintain compliance with the health and welfare benefits offered to eligible employees. If you ever have questions about your ongoing compliance obligations, please reach out to your Boon Account Manager. We can provide helpful guidance, backed with decades of experience!

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