Tag: Group Health Plan

Editor’s note: Medicare Part D notices are due in a little more than one week so we are re-posting this article that provides details about the requirements for this important deadline. Are you an employer that offers or provides group health coverage to your workers? Does your health plan cover outpatient prescription drugs—either as a…

Question: What are the tax implications of adding a domestic partner and her children to a Massachusetts employee’s benefit plan once the employee’s divorce from his current spouse is finalized? Answer: In your case, the domestic partner may not be eligible to enroll on the group health plan if the employee’s former spouse remains enrolled on the…

Question: If a newly-benefits-eligible employee with a spouse on Medicare due to disability enrolls her spouse on the company group health plan, must her spouse terminate Medicare? If not, which plan would be primary? Answer: The employee’s spouse is not required to terminate Medicare coverage based upon becoming eligible (or enrolling) for coverage under a group health…

Question: What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)? Answer: The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or…

Question: What is the Health Insurance Portability and Accountability Act (HIPAA)? How does it relate to employer responsibilities when offering a group health plan? Answer: The Health Insurance Portability and Accountability Act (HIPAA) places limitations on a group health plan’s ability to impose pre-existing condition exclusions, provides special enrollment rights for certain individuals, and prohibits…

Question:  Are there any drawbacks to moving the effective renewal date of a group health plan in order to capitalize on additional savings before the “Community Rating” standards go into effect on 1/1/14? Answer:  Certain health insurers are offering “early renewals” (prior to 2014) suggesting that they can offer more attractive rates. The Affordable Care…

Question: Can you provide us with  general guidance on spousal carve-outs from the group health plan?  Are they discriminatory? Answer: In general, we are seeing more and more spousal surcharges and carve-outs as part of health plan design. The surcharge for a spouse’s coverage when other coverage is available could be whatever the employer chooses,…

Question: During an open enrollment election period, if an employee drops spousal coverage, would this be a COBRA-qualifying event for the dropped spouse? Our Response:  A group health plan is required to offer COBRA continuation coverage only to a qualified beneficiary after a “qualifying event” occurs.   A qualifying event is a certain event that would…