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Medical Loss Ratio (MLR) Rebates

Employers with fully insured health plans that receive MLR rebates Employers that receive rebates should consider their legal options for using the rebate. Any rebate amount must be used for the exclusive benefit of the plan’s participants and beneficiaries within 3 months of receiving the rebate to avoid ERISA trust requirements. Penalty for each violation […]

Summary Annual Report (SAR) to participants

Group health plans that are subject to the Form 5500 filing and have not extended the deadline via a Form 5558 Employers that are required to file a Form 5500 must provide participants with a summary of the information in the Form 5500, called a summary annual report (SAR). The plan administrator must provide the […]

Medicare Part D Notices to participants

Group health plans that provide Rx coverage to Individuals eligible for Medicare Part D Employers must notify Medicare Part D-eligible individuals by Oct. 15th of each year about whether the Rx coverage is creditable or non-creditable as discussed above. No specific penalty for employers. Potential penalty for individuals who do not maintain creditable coverage.