Broker Check

Key Deadlines

June 1, 2024—Submit Your Health Plan’s Prescription Drug Data Collection Report

Confirm that your health plan’s annual prescription drug data collection report is submitted to CMS by June 1, 2024. A transparency law requires employer-sponsored health plans and health insurance issuers to annually report information about prescription drug spending to the federal government. This reporting process is referred to as the “prescription drug data collection” (or “RxDC report”). Most employers rely on third parties, such as issuers, third-party administrators (TPAs) or pharmacy benefit managers, to prepare and submit the RxDC report for their health plans.

 

June 4, 2024—File EEO-1 report with the EEOC

Private sector employers with 100 or more employees and federal contractors with 50 or more employees meeting certain criteria must submit demographic workforce data to the EEOC each year as part of the EEO-1 data collection. The deadline for filing the 2023 EEO-1 report is June 4, 2024.


Key Deadlines

July 31, 2024—File Form 941, Employer’s Quarterly Federal Tax Return

 File Form 941 with the IRS by July 31, 2024, to report the federal income tax, Social Security tax and Medicare tax you withheld from your employees’ pay during the second quarter of 2024 (April, May and June). If your company timely deposited all taxes when they were due, the filing deadline is extended to Aug. 10, 2024. However, since Aug. 10, 2024, is a Saturday, the extended deadline is the next business day, which is Aug. 12, 2024.

 

July 31, 2024—Report and Pay PCORI Fees (Self-insured Health Plans Only)

If you have a self-insured health plan, report and pay fees to fund the Patient-Centered Outcomes Research Institute (PCORI) by July 31, 2024. Employers use IRS Form 720 to report and pay PCORI fees. PCORI fees for plan years ending in 2023 are due by July 31, 2024.

 

July 31, 2024—File Form 5500 for the 2023 Plan Year (Calendar-year Plans Only)

File Form 5500 with the DOL by July 31, 2024, for your ERISA-covered employee benefit plans that operate on the calendar year unless a reporting exemption applies. Form 5500 must be filed by the last day of the seventh month following the end of the plan year. For calendar-year plans, this deadline is July 31. An automatic extension of 2.5 months may be requested by filing IRS Form 5558 by the due date. Small welfare benefit plans (fewer than 100 participants) that are fully insured, unfunded, or a combination of insured/unfunded are generally exempt from the Form 5500 filing requirement.

Key Deadlines

Sept. 30, 2024—Provide SAR to Plan Participants (Calendar-year Plans Only)—If Form 5500 Deadline Was Not Extended

 Provide a summary annual report (SAR) to plan participants by Sept. 30, 2024, for calendar-year plans if the employee benefit plan’s Form 5500 deadline was not extended. The SAR must be provided within nine months of the close of the plan year unless the plan’s Form 5500 deadline was extended. Plans exempt from the annual 5500 filing requirement are not required to provide an SAR. Unfunded welfare plans are also generally exempt from the SAR requirement.

 

Sept. 30, 2024—Watch for MLR Rebates (Fully Insured Health Plans Only)

Employers with insured health plans might receive rebates if their issuers did not meet their medical loss ratio (MLR) percentage for 2023. Rebates must be provided by Sept. 30 following the end of the MLR reporting year. Employers who receive rebates should consider their legal options for using the rebate. Any rebate amount that qualifies as a plan asset under ERISA must be used for the exclusive benefit of the plan’s participants and beneficiaries. Also, as a general rule, plan sponsors should use the plan asset portion of the rebate within three months of receiving it to avoid ERISA’s trust requirements.

GET READY FOR OPEN ENROLLMENT

Employers with calendar year plans should start preparing for open enrollment for the plan year starting Jan. 1, 2025. This process should include reviewing your company’s benefit offerings, working with vendors to make any benefit adjustments, updating benefit limits for 2025 and preparing employee communications. If your company is an ALE, you also may need to adjust employee contributions based on the ACA’s affordability percentage for plan years beginning in 2025.

In addition, you should consider providing the following benefit notices in connection with open enrollment:

  • Summary of Benefits and Coverage (SBC): Group health plans and health insurance issuers are required to provide an SBC to applicants and enrollees each year at open enrollment or renewal time. Federal agencies have provided a template for the SBC, which health plans and issuers are required to use.
  • Children’s Health Insurance Plan (CHIP) Annual Notice: If your group health plan covers residents in a state that provides a premium subsidy under a Medicaid plan or CHIP, send an annual notice about the available assistance to all employees residing in that state. The annual CHIP notice can be provided at any time during the year, but it is often included with the plan’s open enrollment materials. The DOL has a model notice that employers may use. The DOL updates this model notice frequently, so ensure you use the most current version.
  • Women’s Health and Cancer Rights Act (WHCRA) Notice: Group health plans must provide a notice about the WHCRA’s coverage requirements at the time of enrollment and annually after enrollment. The annual WHCRA notice can be provided at any time during the year, but it is often included with the plan’s open enrollment materials. Employers who redistribute their summary plan descriptions (SPDs) each year can satisfy the annual notice requirement by including the WHCRA notice in their SPDs. Model language is available in the DOL’s model notice guide.
  • SPD: An SPD must be provided to new plan participants within 90 days of the date their coverage begins. Employers may include the SPD in their open enrollment materials to make sure employees newly enrolled employees receive the SPD on a timely basis. Also, an employer should include the SPD with its enrollment materials if it includes notices that are required to be provided at the time of enrollment, such as the WHCRA notice.
  • COBRA General Notice: Group health plans must provide a written General Notice of COBRA Rights to covered employees within 90 days after their health plan coverage begins. Employers may include the General Notice in their open enrollment materials to ensure that employees who newly enroll during open enrollment receive the notice on a timely basis. The DOL has a COBRA Model General Notice that employers may use.
  • HIPAA Privacy Notice (self-insured health plans only): The HIPAA Privacy Rule requires self-insured health plans to maintain and provide their own privacy notices. Self-in - sured health plans are required to send the privacy notice at certain times, including to new enrollees at the time of enrollment. Thus, the privacy notice should be included with the plan’s open enrollment materials. Also, at least once every three years, health plans must either redistribute the privacy notice or notify participants that the privacy notice is available and explain how to obtain a copy. The Department of Health and Human Services (HHS) has model privacy notices for employers to use.
  • Special Enrollment Rights Notice: At or before enrollment, a group health plan must provide each eligible employee with a notice of their special enrollment rights under HIPAA. This notice is often included in the plan’s SPD or benefits booklet provided by the issuer or TPA.
  • Notice of Patient Protections: If a health plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of patient protections whenever the SPD or similar description of benefits is provided to a participant. This notice is often included in the SPD or benefits booklet provided by the issuer or TPA (or otherwise provided with enrollment materials). The DOL has provided a model notice for employers to use.

Grandfathered Plan Notice: Companies with grandfathered health plans must include a statement of the plan’s grandfathered status in plan materials provided to participants describing the plan’s benefits (such as open enrollment materials). The DOL has a model notice for employers to use.

Key Deadlines

Oct. 2, 2024—Apply to CMS for the Retiree Drug Subsidy (Calendar-year Plans Only)

 The retiree drug subsidy (RDS) is available to certain employers who sponsor group health plans covering retirees who are entitled to enroll in Medicare Part D but elect not to do so. To participate in the RDS program, eligible employers must submit an application to CMS before the beginning of the plan year by a date specified by CMS (usually about 90 days before the beginning of the plan year). The approximate dead[1]line is Oct. 2, 2024, for plan years beginning on Jan. 1, 2025. This deadline may be extended by 30 days if CMS grants an extension.

 

Oct. 3, 2024—Provide ICHRA Notice for 2025 Plan Year (Calendar-year Plans Only)

Employers who offer individual coverage health reimbursement arrangements (ICHRAs) must provide a notice to eligible employees regarding the ICHRA’s coverage. This notice must be provided at least 90 days before the beginning of each plan year. For ICHRAs that operate on a calendar year basis, this notice must be provided by Oct. 3, 2024, for the upcoming 2025 plan year. A model notice is available for employers to use.

Oct. 3, 2024—Provide QSEHRA Notice for the 2025 Plan Year (Calendar-year Plans Only)

Employers who offer qualified small employer health reimbursement arrangements (QSEHRAs) must provide a notice to eligible employees regarding the QSEHRA’s coverage. This notice must be provided at least 90 days before the beginning of each plan year. For QSEHRAs that operate on a calendar year basis, this notice must be provided by Oct. 3, 2024, for the upcoming 2025 plan year.

 

Oct. 14, 2024—Provide Medicare Part D Notices to Plan Participants

Notify Medicare Part D eligible individuals by Oct. 14, 2024, whether the health plan’s prescription drug coverage is creditable or non-creditable. CMS has model notices that employers may use.

 

Oct. 15, 2024—File Form 5500 for the 2023 Plan Year (Calendar-year Plans Only)—Form 5500 Deadline Was Extended

File Form 5500 with the DOL by Oct. 15, 2024, if you have a calendar-year plan and applied for the automatic 2.5-month filing extension.

 

Oct. 31, 2024—File Form 941, Employer’s Quarterly Federal Tax Return

File Form 941 with the IRS by Oct. 31, 2024, to report the federal income tax, Social Security tax and Medicare tax you withheld from your employees’ pay during the third quarter of 2023 (July, August and September). Employers who timely deposited all taxes when due have 10 additional calendar days to file Form 941 or until Nov. 10, 2024. However, since Nov. 10, 2024, is a Sunday, the extended deadline is the next business day, which is Nov. 11, 2024.

Compliance Reminders

As the end of the year approaches, consider taking the following steps to encourage employees to utilize any unused benefits for 2024:

  • Remind employees about what happens to unused funds in their health flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) and depen[1]dent care FSAs at the end of the year. Encourage employees to use their unspent balances in these accounts, especially if unused funds are forfeited at the end of 2024 (calendar-year plans only).
  • Review employee paid time off (PTO) balances and remind employees of the company’s policy for unused PTO at the end of the year (for example, perhaps your company caps carryovers of unused PTO).

Key Deadlines

Dec. 15, 2024—Provide SAR to Plan Participants (Calendar-year Plans Only)—If Form 5500 Deadline Was Extended

Provide an SAR to covered employees by Dec. 15, 2024, if you have a calendar-year plan and the plan’s form 5500 deadline was extended. In general, the SAR must be provided within nine months of the close of the plan year. However, if the plan’s Form 5500 deadline was extended, the SAR must be provided within two months after the close of the extension period. For calendar-year plans, this extended deadline is Dec. 15, 2024. Plans that are exempt from the annual 5500 filing requirement are not required to provide a SAR. Unfunded welfare plans are also generally exempt from the SAR requirement.

 

Dec. 31, 2024—Submit a Gag Clause Attestation for Your Health Plan

A federal transparency law requires health plans and health insurance issuers to submit attestations of compliance with the prohibition on gag clauses by Dec. 31 each year. Plans and issuers submit their attestations through a CMS website. If the issuer for a fully insured health plan provides the attestation, the health plan does not also need to provide an attestation. Employers with self-insured health plans can enter into written agreements with their TPAs to provide the attestation, but the legal responsibility remains with the health plan.

Compliance Reminders

As 2024 comes to a close, review your company’s compliance to ensure that all required activities will be completed by the end of the year. This review may include the following tasks:

  • Complete any outstanding annual performance reviews.
  • Confirm that any required workplace employee training will be completed by the appropriate deadline.
  • Encourage employees to fill out a new Form W-4 for 2025 if they have experienced personal or financial changes that impact their tax withholding.
  • Confirm that annual nondiscrimination testing has been performed for employee benefit plans that are subject to these testing requirements, including Section 125 cafeteria plans, self-insured health plans, health FSAs, dependent care FSAs, HRAs, group term life insurance and retirement plans