Podcast Episode 125: FMLA and Mental Health
July Get Wise Wednesdays – Register Now
Reminder: Public Disclosure of Provider Reimbursement Rates Begins July 1, 2022
Reminder: Form 5500 Filing for Calendar Year Plans Due July 31
Reminder: PCOR Fee, Form 720 Filing Due July 31
HHS Issues Guidance on Audio-Only Telehealth and HIPAA Compliance
Seventh Circuit Reminds Employers: Don’t Discourage FMLA Leave
Departments Release Federal Independent Dispute Resolution Process Checklist
IRS Revises Optional Standard Mileage Rates
In this episode, Suzanne Spradley and Patrick Myers discuss recent guidance concerning the interaction between FMLA and mental health conditions. Suzanne provides some context for this guidance and a brief refresher on FMLA itself. Suzanne and Patrick then discuss how mental health conditions can apply in a FMLA context, including when a mental health condition is a “serious health condition” or a disability. Suzanne continues with a discussion about how mental health conditions and FMLA apply to an employee’s family members, FMLA military caregiver leave, and retaliation. Suzanne and Patrick close with a reminder that other state and federal laws may also apply in this context, and employers should review their FMLA and leave policies to make sure that mental health conditions are provided for.
Periodically, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page for the most up-to-date episode.
Topic: How Things Work When Life Happens: Qualifying Events Compliance Considerations
Offering benefits to employees on a pre-tax basis is only allowed under a Section 125 plan, and those rules limit when employees may change their annual elections. Join us for a brief refresher of the qualifying event rules — both mandatory and permissible. We’ll also discuss common employer pitfalls and practical implications of administering qualifying events.
Time: July 20, 2022
2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET)
This program is pending approval for 1.0 (general) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at hrci.org.
On July 1, 2022, enforcement of the machine-readable file requirement of the Transparency in Coverage (TiC) final rule begins. Under the rule, non-grandfathered group health plans and insurers must publicly post machine-readable files that disclose in-network provider negotiated rates and historical out-of-network allowed amounts and billed charges for plan years beginning on or after January 1, 2022. (Enforcement of the prescription drug rate file requirement is postponed pending regulatory review.)
The files must be in a specified format, updated monthly and posted on a public website accessible to any person free of charge. No conditions can be imposed to access the files, such as establishing a user account or password or submitting personally identifiable information.
Group health plan sponsors should be in consultation with their insurers or third-party administrators to ensure timely compliance with the July 1 deadline. For fully insured plans, the legal obligation can be contractually transferred to the insurer. For self-insured plans, the sponsor remains liable for TiC compliance even if a TPA contractually agrees to assist with the creation and implementation of the files.
For further information, please see:
Applicable plan sponsors must file Form 5500-series returns on the last day of the seventh month after their plan year ends. As a result, calendar-year plans generally must file by July 31. However, the actual due date for reporting on the 2021 plan year will be August 1, 2022, since July 31 falls on a Sunday. Plans may request a two-and-a-half-month extension to file by submitting Form 5558, Application for Extension of Time to File Certain Employee Plan Returns, by that plan's original due date.
As a reminder, group health plans sponsored by a governmental or church entity aren’t required to file a Form 5500, as those plans aren’t subject to ERISA. Additionally, unfunded, insured, or a combination of unfunded and insured health plans with fewer than 100 participants on the first day of the plan year are also exempt from the filing.
NFP has vendors available to assist with filings. Please ask your advisor if you need assistance.
The ACA imposed the PCOR fee on health plans to support clinical effectiveness research. The PCOR fee applies to plan years ending on or after October 1, 2012, and before October 1, 2029. The PCOR fee is generally due by July 31 of the calendar year following the close of the plan year. (Keep in mind that the actual due date will be August 1, 2022, since July 31 falls on a Sunday.)
PCOR fees are required to be reported annually on Form 720, Quarterly Federal Excise Tax Return, for the second quarter of the calendar year. Plan sponsors that are subject to PCOR fees but no other types of excise taxes should file Form 720 only for the second quarter. No filings are needed for the other quarters for such employers.
The PCOR fee is generally assessed based on the number of employees, spouses and dependents that are covered by the plan. The fee for policy and plan years ending on or after October 1, 2020, but before October 1, 2021, remains at the applicable rate of $2.66, multiplied by the average number of lives covered under the plan. For plan years ending on or after October 1, 2021, but before October 1, 2022, the fee is increased to the applicable rate of $2.79, multiplied by the average number of lives covered under the plan.
The PCOR fee can be paid electronically or mailed to the IRS with the Form 720 using a Form 720-V payment voucher. According to the IRS, the fee is tax-deductible as a business expense.
As a reminder, the insurer is responsible for filing and paying the fee for a fully insured plan. The employer plan sponsor is responsible for filing on a self-insured plan, including an HRA. A stand-alone dental or vision HRA would be excepted and wouldn’t be subject to the PCOR fee.