Benefits, Health Care Reform, Reporting Requirements

2019 Q4 Deadlines and Reminders for Group Health Plan Sponsors

With the year nearly half over, it is time to remember important employee benefits dates. See below for those dates for calendar year plans.

July 31 – Form 5500 is due (unless an extension is requested) for calendar year ERISA plans that had at least 100 employee participants on the first day of the plan year (or that held plan assets in a trust even if had fewer than 100 participants).

July 31 – Sponsors of self-funded major medical plans must pay the PCORI Fee by filing IRS Form 720. For insured plans, the carrier pays the PCORI fee. Read More About PCORI

September 30Date by which insurers must pay Medical Loss Ratio (MLR) rebates to policyholders, for the 2018 reporting year.  Employers who sponsor ERISA plans and who receive MLR rebates that are in part “plan assets” must pay the appropriate rebate amount to participants or for benefit improvements within three months of receipt of the MLR rebate from the carrier, or must establish a trust to hold the rebate as plan assets.

September 30 – Summary Annual Report (SAR)  – Date by which Plan administrator must distribute SARs to plan participants, if Form 5500 was filed July 31.  SAR must be furnished within 2 months after Form 5500 is filed.

October 15 – Form 5500 –  Date by which plan sponsors of calendar year ERISA plans must file Form 5500, if filed for an extension by or before the original deadline of July 31.

October 15 – Medicare Part D notice –  Date by which plan sponsors must send Medicare Part D notices to Medicare-eligible participants, informing them whether employer-sponsored prescription drug coverage is creditable or non-creditable.

October 31 – Plan sponsors of self-funded group health plans and/or cafeteria (Code §125) plans may wish to have nondiscrimination testing done, so plan sponsor can make adjustments (if needed) before year-end.   (This is a suggested date, not a required date. Code §125 regulations require that nondiscrimination testing be done on the last day of the plan year.)

November 1  – Open enrollment begins in the Health Insurance Marketplaces (Exchanges).  Eligible individuals can enroll or renew enrollment for 2020, and some may qualify for subsidies.  Open enrollment period in the federal Marketplace (healthcare.gov) is November 1, 2019 – December 15, 2019.  State-run marketplaces may have longer enrollment periods.

November 15- December 15 –  Special one-month enrollment period each year, during which small group health insurers must offer and write new coverage for small employers who do not meet the insurer’s minimum participation requirements.  Insurers are not required to renew existing plans that do not meet minimum participation rules, although apparently insurers generally do apply this to renewals to avoid having to swap their current small groups with other insurers.

December 15 – Summary Annual Report (SAR)  – Date by which Plan administrator must distribute SARs to plan participants, if Form 5500 was filed October 15 (on extension).  SAR must be furnished within 2 months after Form 5500 is filed.

December 15  Date by which individuals must enroll in Marketplace/Exchange coverage for it to be effective January 1, 2020.

December 31  – Date by which ERISA plan sponsors who received MLR rebates on September 30 must pay the plan’s portion of the rebate amount (“plan assets”) to participants or use it for benefit improvements, or employer must establish a trust to hold the rebate as plan assets.

December 31 – Code §125 regulations require that nondiscrimination testing be done on the last day of the plan year, which is December 31 for calendar-year plans. Many employers test around October 31 so they can make any necessary adjustments and then do not re-test again on December 31. If IRS subsequently audited and questioned compliance, employer might need to re-run the test as of December 31 to prove plan complied with nondiscrimination requirements on that date.

December 31  – Just a reminder that, as of December 31, employers have all the information they need to calculate whether they are “applicable large employers” (ALEs) in 2020 – because 2020 status is based on number of employees each month in 2019.  Also, ALEs (and small employers who sponsor self-funded group health plans) have all the data they need for 2019 information reporting (Forms 1094-B or C and 1095-B or -C).

 

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