Compliance Bulletin | September 2023

Welcome to the September 2023 edition of the Baldwin Bulletin, a compliance newsletter by the Baldwin Regulatory Compliance Collaborative (BRCC).

The Baldwin Bulletin serves as a monthly guide to important regulatory developments, legal news, and employee benefits-related industry happenings designed to keep you abreast of the latest developments.

This month’s issue focuses on important compliance deadlines that will apply this year, in addition to providing employers with information regarding certain hot-button compliance issues significantly impacting employers over the next several months.

Upcoming 2023 Compliance Deadlines. For information regarding upcoming compliance deadlines for employer-sponsored group health plans, including our compliance timeline explaining key compliance deadlines during September – December 2023. Read more here.

Medicare Part D Annual Disclosure Due October 13. Employers that offer prescription drug coverage must provide notices of “creditable” or “non-creditable” coverage to Medicare-eligible employees or covered dependents at least annually, typically before the beginning of each year’s Medicare Part D annual enrollment period.   Read more here.

2024 Play or Pay Affordability Percentage Released. The IRS has released Revenue Procedure 2023-29, announcing that the affordability percentage for the 2024 plan year has decreased to 8.39% from 9.12 % in 2023. The affordability percentage is the maximum permitted employee contribution percentage to satisfy the employer mandate’s affordability requirements under the Affordable Care Act.  Read more here.

Mental Health Parity Opt-Out Provisions to Sunset. Plan sponsors of self-insured, non-Federal governmental group health plans may no longer elect to opt-out of the provisions under the Public Health Service Act related to the Mental Health Parity and Addiction Equity Act.   Read more here.

Increased Regulation of PBMs. State legislatures have increasingly been active in regulating the role of pharmacy benefit managers with respect to the provision of health care benefits.  Read more here.

2024 San Francisco Health Care Security Ordinance Spending Requirements. The employer expenditure rates to comply with the San Francisco Health Care Security Ordinance for 2024 have been released. Read more here.

UHC HIPAA Non-Compliance Settlement. A voluntary resolution agreement was recently entered into between the Office of Civil Rights (OCR) and UnitedHealthcare Company, that resulted in an $80,000 settlement payment and a one-year corrective action plan. This was the first of its kind directed at a specific health plan, illustrating that the Department of Health and Human Services, and its enforcement arm, the OCR, is taking HIPAA compliance seriously. Read more here.

IRS Reminder Regarding Use of Educational Assistance Programs to Pay Employees’ Student Loans. The IRS has issued a reminder to inform both employers and employees that educational assistance programs sponsored by employers may include reimbursement of employee student loans. Read more here.

Question of the Month. Our “Question of the Month” concerns whether employers can charge more for older dependent children. Read more here.