Read up on our first quarterly blog of 2025.
Top Health Plan Compliance Issues for 2025
Employers should be aware of the top compliance issues that may impact their health plan coverage for 2025. Some of these compliance issues are established requirements for employers, such as the new simplified reporting under the Affordable Care Act (ACA). Other compliance issues are anticipated developments employers should monitor, such as additional healthcare transparency requirements.
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Newly Passed Legislation Modifies ACA Reporting Requirements
On December 23, 2024, President Joe Biden signed two bills into law that will streamline the Affordable Care Act’s (ACA) reporting requirements under Internal Revenue Code Sections 6055 or 6056. The Paperwork Burden Reduction Act essentially codifies this alternative manner of furnishing Forms 1095-B and extends this flexibility to furnishing Forms 1095-C.
Accordingly, reporting entities are no longer required to send Forms 1095-B and 1095-C to covered individuals unless a form is requested. Reporting entities must give individuals timely notice of this option in accordance with any requirements set by the IRS. Requests must be fulfilled by January 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later.
Note that states with individual mandates, like California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C., still require employers to distribute paper copies of these residents.
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IVF & Fertility Services
Work and family are traditionally two of the most significant aspects of an employee’s life. Unfortunately, family planning doesn’t always go as planned. This can make the journey to parenthood costly, stressful, and challenging.
Fertility issues contribute to presenteeism, a term that describes employees who are less productive due to personal distractions. In addition to negatively impacting employee morale, engagement, and performance, presenteeism is costly for employers. Harvard Business Review reports that presenteeism costs the US economy more than $150 billion yearly in lost productivity, far exceeding absenteeism costs. Employers that provide fertility benefits may notice that employees are more engaged, productive, and likely to stay at the organization long term.
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Employee Benefit Plan Deadline Relief Issued Due to Recent Natural Disasters
On November 8, 2024, federal agencies issued deadline relief to ensure that employee benefit plans, participants, beneficiaries, qualified beneficiaries, and claimants in disaster areas are not further adversely affected by Hurricane Helene, Tropical Storm Helene, and Hurricane Milton.
The deadlines were extended by disregarding a “relief period” that starts on varying dates in September or October 2024 (depending on location) and ends May 1, 2025. The relief applies to designated disaster areas in Florida, Georgia, North Carolina, South Carolina, Tennessee, and Virginia.
