Category: Articles

  • New Simplified Rules for Medicare Part D Creditable Coverage—What HR Professionals Need to Know in 2025

    —

    by

    admin
    in

    A New Era of Simplicity for Creditable Coverage Notices In the first and second quarters of 2025, the Centers for Medicare & Medicaid Services (CMS) finalized changes to how employer-sponsored group health plans determine if their prescription drug coverage is “creditable” for Medicare Part D purposes. For HR professionals, this marks a shift to simplified…

  • Compliance Q&A: Rehire Rules After the Affordable Care Act

    —

    by

    admin
    in

    Question My company is an Applicable Large Employer using the look-back measurement method to determine full-time status of our employees. One of our full-time employees left the company to pursue another career. Four months later, he returned to the company as a part-time employee. Do I need to offer him health insurance coverage? Summary In…

  • Compliance Q&A: High-Cost Claimants: ADA, ACA, HIPAA and ERISA

    —

    by

    admin
    in

    Question We are examining various health coverage and plan design options in order to save money. One employee, a hemophiliac, has experienced high claims and requires expensive, ongoing treatment. Our reinsurance carrier has imposed a laser at $500,000 for this employee, which is a significant financial burden. May we offer this high-cost claimant cash to…

  • Compliance Q&A: Short Plan Year

    —

    by

    admin
    in

    Question We are an applicable large employer (ALE) and we currently operate medical plans and other benefits on a plan year ending March 31st (current plan year ending March 31, 2026). We want to amend our plan year to a calendar year plan so that our employees can better understand the timing and election of…

  • Compliance Q&A: Classing Out Executive Benefits

    —

    by

    admin
    in

    Question Our company would like to reward our executive team for their hard work in turning around the company’s recent financial difficulties and making the company profitable again. We would like to pay a greater portion of the premiums for our group health plan for our executives than we pay for our rank-and-file employees. Can…

  • Understanding Indemnification Language When Using Standard Industry Forms

    —

    by

    admin
    in

    For contractors entering into agreements, it is crucial to understand the contractual language that applies to the Indemnification language, in particular, can often be ambiguous. And that can leave contractors vulnerable to losses resulting from a subcontractor’s work that damages a project. Many contractors use standard AIA contracts, but we must be aware that these…

  • Compliance Q&A: Interns and Offers of Coverage

    —

    by

    admin
    in

    Question I have hired a couple of interns. They’re scheduled to work full-time hours but they’re only going to be with us for about four months. Am I at risk of any Affordable Care Act (ACA) “Pay or Play” penalties if I decide not to offer these interns health coverage? Summary If the employer is…

  • The Vital Role of Occupational Health Nurses in the Workplace

    —

    by

    admin
    in

    When we think of nurses, we often envision compassionate caregivers in hospitals. However, this image overlooks a crucial segment of nursing professionals known as Occupational Health Nurses (OHNs). These registered nurses help prevent and manage work-related injuries and illnesses and play a vital role in promoting employee health and safety across the workplace.   According…

  • Consider a Single Parent Captive in a Soft Insurance Market

    —

    by

    admin
    in

    The insurance market began to show signs of softening in 2024 and has continued to do so into 2025. We are experiencing decelerating rate increases for Property insurance, and Workers’ Compensation has continued to remain favorable for buyers. While Umbrella and Auto Liability remain challenging in some segments, the broader trend is one of selective…

  • Compliance Q&A: 2026 ACA Affordability Safe Harbors

    —

    by

    admin
    in

    Question I am an Applicable Large Employer (ALE) sponsoring a calendar year health insurance plan. I don’t know how much I should contribute to the cost of my employees’ health care. I want to avoid “pay-or-play” penalties, but I can’t afford to contribute more than the minimum required amount. What IRS affordability “safe harbor” works…