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Is a Telehealth Benefit Subject to ERISA?
QUESTION: We are considering offering a telehealth benefit to our employees that would be separate from our major medical plan. Will this arrangement be an ERISA plan? ANSWER: Telehealth benefits (also referred to as telemedicine benefits) are often...
IRS announces 2024 contribution limits
The IRS has just released the 2024 limits for Health Savings Accounts (HSAs) and High Deductible Health Plans (HDHPs). HSA contribution and plan limits will increase to $4,150 for individual coverage and $8,300 for family coverage. Changes to these limits will take...
Can a Telehealth-Only Plan Continue After the End of the COVID-19 Emergency?
Question: During the COVID-19 pandemic, we established a telehealth-only plan to provide benefits to individuals who were not eligible for coverage under our regular group health plan. Can we continue to offer this benefit? ANSWER: During the COVID-19 pandemic,...
Is Our Health FSA Subject to COBRA?
QUESTION: Next year, we plan to amend our company’s cafeteria plan to add a health FSA under which participants elect a coverage amount for the year and pay for it with pre-tax salary reductions. There will be no employer contributions, so participants’ health FSA...
How Will the End of the COVID-19 National Emergency Affect Extended Claims and Appeals Deadlines?
QUESTION: Due to the COVID-19 emergency, we have been required to extend deadlines for participants and beneficiaries to submit claims and appeals under our employee benefit plans. How does the end of the COVID-19 national emergency affect these extensions? ...
Can an Election Be Changed After the Plan Year Has Begun When an Employee Made a Mistake in Completing the Election Form?
QUESTION: One of our employees just noticed that her 2023 pay reflects a salary reduction for DCAP benefits. Initially, she said she never elected DCAP benefits. But when we showed her the DCAP election on her election form, she responded that she had made a...
IRS FAQs Explain When Health FSAs, HSAs, or HRAs Can Reimburse Nutrition, Wellness, and General Health Expenses
The IRS has issued FAQs that explain when certain costs related to nutrition, wellness, and general health are medical expenses under Code § 213 that may be paid or reimbursed under a health FSA, HSA, or HRA. As background, Code § 213 defines medical care as amounts...
Can an Adult Child’s Medical Expenses Be Reimbursed Tax-Free From a Parent’s HSA?
QUESTION: Our company sponsors a high-deductible health plan (HDHP) in conjunction with employee HSAs. Can the medical expenses of our employees’ adult children who otherwise qualify for tax-free coverage under the HDHP be reimbursed tax-free from the employees’...
HHS Proposes HIPAA Standards for Electronic Health Care Claims Attachments
HHS has proposed regulations that would adopt a set of standards for the electronic exchange of clinical and administrative data to support prior authorizations and health care claims adjudication. As background, HIPAA requires that covered entities (and their...
CMS Fact Sheet Addresses End of COV-19 Public Health Emergency
HHS’s Center for Medicare & Medicaid Services (CMS) has issued a fact sheet addressing the end of the COVID-19 public health emergency (PHE), which (along with the COVID-19 national emergency) is anticipated to end on May 11, 2023. The fact sheet, which is...
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