The fourth quarter is often the busiest time of year in the employee benefits business, with preparations for annual open enrollment adding extra tasks to HR teams’ day-to-day operations. To help you meet deadlines while planning for the enrollment season, Lockton’s Compliance Consulting team has prepared the following guide to assist with reporting and disclosure requirements.
Our fourth quarter guide is categorized by federal and state deadlines, in chronological order.
Deadlines may or may not be applicable to your group, depending on employer and plan characteristics.
Here are potential action items for the fourth calendar quarter (through Dec. 31, 2023).
STANDARD FEDERAL DEADLINES
Oct. 2 or Dec. 15 if Form 5500 was filed under an extension (for a non-calendar year plan, see NOTES) - Distribute summary annual reports (SARs).
The Oct. 2 - deadline applies to certain calendar-year ERISA plans that filed Form 5500 on or before July 31, 2022.
For non-calendar year plans, the SAR deadline is nine months after close of the plan year or two months after the plan’s extended 5500 deadline.
The SAR should be distributed to participating employees and former employees, COBRA beneficiaries and alternate recipients under QMCSOs.
A totally unfunded welfare plan (i.e., a plan that pays benefits solely from employer general assets and not through insurance, a trust, or other separate account) is not required to furnish SARs, regardless of its size.
If, however, your self-insured plan is funded (even partially), then SARs must be provided. SAR language is rather standard. The disclosure may be supplied electronically in accordance with Department of Labor (DOL) requirements.
Oct. 2 - Distribute notice of Qualifying Small Employer Health Reimbursement Arrangement (QSEHRA) - for employers offering calendar year QSEHRAs.
Applies to small employers (not subject to the ACA employer mandate) who sponsor a QSEHRA, in lieu of any other group medical coverage, that reimburses employees for individual market medical insurance premiums on a tax-free basis.
The notice must be provided to each “eligible employee” regardless of enrollment status and must include the employee’s maximum HRA benefit for the year, among other information. The notice is due at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the QSEHRA.
A model notice is available from your Lockton account service team.
Oct. 2 - Distribute notice of Individual Coverage Health Reimbursement Arrangement (ICHRA) For employers offering calendar year ICHRAs.
Applies to employers of any size who offer an ICHRA, in lieu of any other traditional group medical coverage, that reimburses employees for individual market medical insurance premiums or Medicare premiums.
The notice must be provided to each “eligible employee” regardless of enrollment status. It must include information about the benefits provided by the IHCRA and the effect of the ICHRA coverage on the ability to qualify for federal subsidies in an individual market.
The notice is due, generally speaking, at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the ICHRA.
A model notice Is available from your Lockton account service team.
Oct. 2 - Submit Medicare Part D subsidy application to CMS to obtain Part D subsidy for 2023 plan year. For calendar year retiree drug plans.
Applies to ERISA and non-ERISA plans seeking federal subsidies for providing retiree drug coverage. Generally, the application deadline is 90 days prior to the beginning of the plan year. An extension of approximately 30 days can be requested from the Center for Medicare & Medicaid Services (CMS) prior to the application deadline.
Oct. 13 - Distribute notices of creditable and/or non-creditable coverage. If not provided in the previous 12 months.
Provide this notice to employees, retirees and dependents enrolled in Medicare and also enrolled (or seeking enrollment in) the employee’s group medical plan.
Most employers supply these notices at open enrollment, and such notices are deemed given for the next 12 months unless there’s a material change in the creditable or non-creditable nature of the coverage. Thus, if distributed in enrollment packets during the previous 12 months (and there’s no material change in the Rx coverage), the mid-October deadline may be ignored.
These notices may be combined with other notices but must be "conspicuous.” There must be a text box atop the packet noting in 14-point font that the packet includes a Medicare Part D notice.
The notice may be mailed or hand-delivered; electronic distribution is possible, but special consent rules apply.
Oct. 16 (if a non-calendar year plan) - File Form 5500 for the prior calendar year plan year, if filing under an extension from a July 31 deadline.
Applies to ERISA plans.
Form 5500 extensions are available by filing a Form 5558 with the DOL on or before the filing’s initial due date. Calendar year plans with a July 31, 2023 deadline for 2022 Forms 5500 and that obtained a 2-1/2 month extension via Form 5558 should file by Oct. 16, 2023.
Dec. 15 - Distribute summary annual reports (SARs), if Form 5500 for a calendar year plan was filed under an extension.
This applies to calendar-year ERISA plans that filed Form 5500 under an extension.
For non-calendar year plans, the SAR deadline is two months after the plan’s extended 5500 deadline.
See the Oct. 2 deadline above for more information on SARs.
Dec. 31 - Submit to CMS the gag clause prohibition attestation (GCPCA).
Under the Transparency provision of the Consolidated Appropriations Act of 2021 (CAA), plans and issuers must annually submit to CMS an attestation that the plan or issuer is in compliance with the gag clause prohibition.
The first gag clause prohibition attestation is due no later than Dec. 31, 2023, covering the period beginning Dec. 27, 2020, or the effective date of the group health plan coverage (if later), through the date of attestation. Subsequent attestations, covering the period since the last preceding attestation, are due by Dec. 31 of each year thereafter.
Attestations are collected by CMS via the online portal (opens a new window).
Dec. 31 - Distribute annual Women's Health and Cancer Rights Act notice. For calendar year plans.
Applies to ERISA and non-ERISA plans. Self-insured state and local governmental plans may opt out.
Notice must be provided to participants (employees and retirees), COBRA and other beneficiaries receiving benefits and alternate recipients under QMCSOs. This notice is typically distributed at initial enrollment and then annually, prior to each plan year.
Including this notice in the annual enrollment packet is appropriate and typical, as long as the notice is "prominent." Electronic disclosure is permitted, in accordance with DOL requirements.
Dec. 31 - Distribute notice of premium assistance under Medicaid or the Children's Health Insurance Program (CHIP). For calendar year plans.
Applies to ERISA and non-ERISA plans.
The notice must be provided to each employee, regardless of eligibility or enrollment status, and is best provided as a separate document, even if offered with enrollment materials. It should be provided by the last day of the plan year preceding the year to which the notice relates.
A model notice is available through your Lockton account service team and is updated periodically by federal authorities.
First day of open enrollment - Distribute the Summary of Benefits and Coverage (SBC).
Applies to ERISA and non-ERISA plans.
The SBC must be provided to benefit eligible employees at open enrollment if employees must make affirmative benefit elections. If employees do not need to make affirmative benefit elections (automatic re-enrollment), the SBC must be provided 30 days prior to the beginning of the plan year.
First day of open enrollment - Michelle’s Law notice.
Applies to ERISA and non-ERISA plans.
The notice must be provided at open enrollment if the plan covers full-time students beyond age 26.
SELECT STATE AND LOCAL DEADLINES
Oct. 30 - Make San Francisco HCSO contributions for prior calendar quarter.
For employers subject to the San Francisco Healthcare Security Ordinance.
Quarterly contributions, if due for the quarter ending Sept. 30, are due by Oct. 30. Self-funded employers have the option of utilizing an annual true-up method in lieu of quarterly contributions. The true-up contributions are due in February of each year, for the prior year.
Nov. 15 – Dec. 15 - File Massachusetts Health Insurance Reporting Disclosure (HIRD) form.
Applies to any employer that reported six or more employees in any Massachusetts unemployment wage report during the past 12 months. The employer must file the HIRD form through the Massachusetts Department of Revenue web portal, MassTaxConnect.
The disclosure is made during the filing period of Nov. 15 – Dec. 15, annually.
Not legal advice: Nothing in this alert should be construed as legal advice. Lockton may not be considered your legal counsel and communications with Lockton's Compliance Consulting group are not privileged under the attorney-client privilege.