As we approach the first quarter of the new year, it's crucial to stay on top of compliance deadlines and plan sponsor obligations. This period is packed with important dates and requirements that employers must meet to ensure compliance with federal and state regulations. From filing forms and distributing notices to updating plan documents and conducting audits, staying organized and proactive can help avoid penalties and ensure a smooth benefits administration process. Let's dive into the key deadlines and reminders you need to keep in mind for the first quarter.
We have separated our reminders into two categories: standard federal deadlines and select state and local deadlines. Within each category, we follow our typical chronological approach. Deadlines may or may not be applicable to your group, depending on employer and plan characteristics.
As always, if you have any questions on the reporting and disclosure responsibilities below, please reach out to your Lockton account service team.
Here are potential action items for the first calendar quarter (through March 31, 2025).
STANDARD FEDERAL DEADLINES
Jan. 1 - Ensure medical plan ID cards reflect cost-sharing information (For calendar year plans; non-calendar year plans must distribute by the first day of the plan year)
Applies to all group medical plans (the obligation applies to non-calendar year plans as of the first day of the plan year beginning in 2022), but not excepted benefits such as most dental plans, most vision plans and most health flexible spending accounts (FSA).
The Consolidated Appropriations Act (CAA) requires group health plans to disclose, on any physical or electronic insurance identification card issued, the enrollee’s deductible and out-of-pocket maximums, and the telephone number and Internet website address where the enrollee may receive assistance.
For plan years beginning in 2022, employers may apply a good faith interpretation of the statutory requirement, absent additional federal guidance.
Jan. 1 - Distribute notice of grandfathered status (For calendar year plans; non-calendar year plans must distribute by the first day of the plan year)
Applies to ERISA and non-ERISA grandfathered plans subject to health reform.
Presumably, notice must be given to all participants no later than the first day of each plan year with respect to which the plan maintains grandfathered status. This is most often included in open enrollment or other plan materials supplied to participants.
Lockton has model notice language available upon request.
Jan. 1 - Price Comparison Tool
As part of the CAA and the Transparency in Coverage (TiC) final rules, the Departments of Labor, Health and Human Services, and Treasury issued a list of codes (opens a new window) for 500 items and services required to be included under the price comparison tool. The TiC rules include a requirement for plans and carriers to make available an Internet-based self-service tool to participants, beneficiaries and enrollees for price comparison purposes. The information also must be provided in paper form and by telephone if requested.
All coverage items and services must be available to search for plan years beginning on or after January 1, 2024.
Jan. 31 - Reflect imputed taxable income on Forms W-2
Imputed income might be an issue where health coverage is provided to non-dependent domestic partners and/or their children, or to an employee’s non-dependent adult, biological, step, adopted or foster child beyond the year the child attains age 26, or to other individuals with respect to whom coverage supplied to them is taxable to the employee, for federal tax purposes.
Health coverage supplied to a same-sex spouse is nontaxable (for federal tax purposes) to the employee.
Imputed income may also arise under group-term life insurance and some long-term disability programs.
Depending on state law, state income taxation may vary from federal taxation.
Jan. 31 - Report HSA contributions on Forms W-2
Employers report health savings account (HSA) contributions on employees’ Forms W-2 in Box 12, using code W. IRS instructions say to report “employer contributions” to HSAs but because the IRS views employee pretax payroll deductions as employer dollars, employers should also report employee pretax contributions to their HSAs if the contributions are made through payroll.
Jan. 31 - Report health plan coverage values on Forms W-2
W-2 reporting of health plan coverage values is merely informational and applies to employer sponsors of both grandfathered and non-grandfathered plans. This obligation applies with respect to reportable coverage, whether taxable or nontaxable.
Stand-alone dental and vision coverage, health reimbursement arrangement (HRA) contributions, and health FSAs funded solely by employee pretax contributions are exempt from this reporting requirement. Other exclusions also apply depending on the specific facts and circumstances.
Employers are excused from reporting if they file fewer than 250 Forms W-2 for the prior calendar year.
Feb. 28 - Submit Forms 1094-C and/or 1095-B to IRS with Forms 1094-C or 1094-B (If filing paper forms; see entry below for March 31 if e-filing)
Employers must transmit copies of these forms to the IRS, with one or more Forms 1094-C or 1094-B transmittal documents.
The IRS requires e-filing of these forms if, when aggregating the number of these forms the employer must file with the number of W-2s, 1099s, and similar forms, the total is at least 10 starting with filing due dates falling in 2024 and beyond. The previous standard was at least 250 of the same form. Employers that obtained a waiver of the e-filing requirements must file paper forms by the deadline at left.
For more information on e-filing, see the March 31 deadline for e-filing below.
An automatic 30-day extension of time is available by filing Form 8809 on or before this due date.
March 1 - Submit annual notice of creditable and/or non-creditable coverage to Centers for Medicare and Medicaid Services (CMS) (For calendar year plans; non-calendar year plans must submit within 60 days following the first day of the plan year)
ERISA and non-ERISA plans must certify to CMS that prescription drug coverage offered under the plan is either Medicare Part D creditable or non-creditable.
The filing is made on the CMS.gov (opens a new window) website.
March 1 - File Form M-1 on behalf of multiple-employer welfare arrangements (MEWAs) and certain other arrangements
Applies to some MEWAs, as defined in ERISA, and some collectively bargained, multiple-employer programs.
An annual report (M-1) is not required if between Oct. 1 and Dec. 1 of the prior year the MEWA experienced an origination or special filing event and timely filed the M-1.
Some exceptions to Form M-1 filing apply. See Form M-1 and its instructions for more details.
March 2 - Report coverage offers to ACA full-time employees on Forms 1095-C, and/or self-insured coverage to primary insureds on Forms 1095-C or 1095-B
Applies to employers subject to the ACA employer mandate, and to smaller employers providing self-insured medical coverage to employees, in the previous year.
The employer must provide a Form 1095-C with Parts I and II completed to each employee considered full-time (for ACA employer mandate purposes) for at least a month in the prior calendar year.
Self-insured employers must provide this Form, with Parts I and III completed, to each individual who had self-insured coverage for at least a day in the prior calendar year. Some employers will use Form 1095-B. Minor exceptions apply to this furnishing requirement with respect to individuals who at no time in the prior calendar year were ACA full-time employees. No extension to this deadline is available.
March 31 - E-file Forms 1095-C and/or 1095-B with IRS, with Form 1094-C and 1094-B (If e-filing; see entry above for Feb. 28 if filing paper forms)
Applies to employers providing to employees (or providing or making available to primary insureds) Forms 1095-C or 1095-B.
Employers providing to employees (or providing or making available to primary insureds) Forms 1095-C or 1095-B must transmit copies of these forms to the IRS, with one or more Forms 1094-C or 1094-B transmittal documents. The IRS requires e-filing of these forms if, when aggregating the number of these forms the employer must file with the number of W-2s, 1099s, and similar forms, the total is at least 10 starting with filing due dates falling in 2024 and beyond. The previous standard was at least 250 of the same form.
The employer may apply for a waiver of the e-filing requirement (if it prefers to file paper forms) on IRS Form 8508. However, if the waiver is granted, the employer must submit its paper forms by Feb. 28, subject to a potential 30-day extension of time via Form 8809.
E-filing is accomplished through the IRS’s AIR platform (opens a new window).
An automatic 30-day extension of time is available by filing Form 8809 before the due date.
March 31 - Distribute notice of Excepted Benefit Health Reimbursement Arrangement (EBHRA) (For non-federal government employees eligible for an EBHRA for the upcoming calendar year)
Applies to non-federal government group health plans.
Non-federal government employers that sponsor an EBHRA that reimburses eligible out-of-pocket 213(d) medical expenses must provide eligible employees notice about the EBHRA, the conditions of eligibility, the annual or lifetime caps or other limits on the benefits, and a summary of the benefits provided.
The annual notice deadline is no later than 90 days after the first day of the EBHRA plan year for employees who are eligible for an EBHRA.
SELECT STATE AND LOCAL DEADLINES
Jan. 30 - California - Make San Francisco Healthcare Security Ordinance (HCSO) contributions for prior calendar quarter
For employers subject to the San Francisco HCSO. Quarterly contributions, if any, are due 30 days after the close of each calendar quarter. See the end of February entry below for self-funded employers utilizing the annual true-up method.
Jan. 31 - Massachusetts - Distribute Massachusetts Forms 1099-HC Massachusetts individual mandate disclosures
Applies to employers that, in the prior calendar year, had employees in Massachusetts who had creditable coverage (as defined under Massachusetts state law) under the employer’s plan, and to the Massachusetts Department of Revenue. The disclosure is made to the employees.
The employer has the obligation under state law to furnish the Form, but if the plan is insured and the contract was issued or delivered in Massachusetts, the carrier has the obligation.
The obligation on ERISA employers may be unenforceable due to ERISA preemption, but failure to provide an employee with a Form 1099-HC could trigger additional state taxes on the employee.
Jan 31 - California - Distribute Forms 1095-C to individuals who in the prior year were California residents and covered under the employer’s self-funded medical plan (unless deferred by state authorities)
Applies to employers who provided self-insured medical coverage to California residents in the prior calendar year.
Due to California’s individual mandate requiring residents to have minimum essential coverage, employers that provided self-insured coverage to California residents during the prior calendar year must furnish a federal Form 1095-C to the primary insured showing the period of coverage in the prior calendar year for the primary insured and dependents.
Employers that furnish the Form 1095-C to satisfy IRS requirements are not required to again furnish the form to satisfy California requirements. However, state and IRS due dates may be different.
Jan. 31 - Washington - File prior quarter report and remit payment of payroll tax withholdings Washington workers (WA Cares)
Applies to fully-insured and self-insured ERISA plans. Employers collect premiums from employees via after-tax payroll withholdings to support WA Cares long-term care insurance program for all employees who work primarily in Washington. Employers must remit payroll tax withholdings to the Employment Security Department the same way they do for Paid Family and Medical Leave. Employers will report for both programs at the same time on the same report through the quarterly payroll reporting process. Payments must be submitted to the state by the last day of the month following the calendar quarter in which premiums were withheld.
Reports and payments for Q4 (Oct., Nov. and Dec.) are due Jan. 31 of the following quarter. For more information, see the Washington Cares (opens a new window)Employer Information webpage (opens a new window).
Feb. 28 - California - Make San Francisco Healthcare Security Ordinance expenditures due for prior year for covered employees in self-insured health plans
For employers subject to the San Francisco HCSO. Employers providing health insurance to San Francisco HCSO-covered employees under a self-insured plan and utilizing the annual method for determining the adequacy of healthcare expenditures under that plan have until the last day of February to make any required true-up contributions for the prior year.
Feb. 28 - California - Distribute employee healthcare payment confirmation on employee’s behalf to Healthy San Francisco
Applies to employers subject to the San Francisco Healthcare Security Ordinance, who satisfy the obligations of the ordinance by making contributions to the city, on behalf of covered employees. Provide to a new employee or an employee newly enrolled in Healthy San Francisco or for whom payment was made to fund access to Healthy San Francisco. The notice to a given employee is required only once.
March 2 - New Jersey - Distribute coverage statements to individuals who in the prior year wereNew Jersey residents and covered under the employer’s self-insured medical plan
Applies to employers who provided self-insured medical coverage to New Jersey residents in the prior calendar year.
Due to New Jersey’s individual mandate requiring residents to have minimum essential coverage, employers that provided self-insured coverage to a New Jersey resident during the prior calendar year must furnish to the primary insured a statement showing the period of coverage for the primary insured and dependents. A copy of IRS Form 1095-C satisfies the disclosure requirement, or the employer may instead utilize Form NJ-1095-C.
Employers that furnish the Form 1095-C to satisfy IRS requirements are not required to again furnish the form to satisfy New Jersey requirements.
March 2 - Washington, D.C. - Distribute coverage statements to individuals who in the prior year were District of Columbia residents and covered under the employer’s medical plan District of Columbia individual mandate disclosures
Applies to employers who provided medical coverage to District residents in the prior calendar year.
Residents of the District must comply with the District’s individual healthcare coverage mandate requiring residents to have minimum essential health coverage, unless an exemption applies. Employers that provided self-insured coverage to a District resident during the prior calendar year must furnish to the primary insured early in the current year a statement showing the period of coverage for the primary insured and dependents. Furnishing the IRS Form 1095-C at the time required by the IRS satisfies the District’s furnishing obligation.
Note: While IRS rules do not require automatically furnishing a Form 1095-C to a primary insured who in the prior year had self-insured coverage under the employer plan but was not an ACA full-time employee of the employer at any time during the year, this exception may not apply under District law.
For the latest information on filing due dates and other requirements, check the website (opens a new window) for the District’s Office of Tax and Revenue.
March 2 - Rhode Island - Distribute coverage statements to individuals who in the prior year were Rhode Island residents and covered under the employer’s medical plan
Applies to employers who provided self-insured medical coverage to Rhode Island residents in the prior year.
Due to Rhode Island’s individual mandate requiring residents to have minimum essential coverage, employers that provided self-insured coverage to a Rhode Island resident during the prior year must furnish to the primary insured a statement showing the period of coverage for the primary insured and dependents. A copy of IRS Form 1095-C satisfies the disclosure requirement.
Employers that furnish the Form 1095-C to satisfy IRS requirements are not required to again furnish the form to satisfy Rhode Island requirements.
Employers that provide insured coverage to a Rhode Island resident during the prior year are not required to provide the required coverage information to the resident as long as the insurer provides it.
March 31 - California - Submit Forms 1095-C and/or 1095-B, with Form 1094-C or 1094-B, to the California Franchise Tax Board
Applies to employers who provided medical coverage to California residents in the prior calendar year.
Employers that provided self-insured coverage to California residents in the prior calendar year must file with the Franchise Tax Board copies of the IRS Forms 1095-C with respect to such residents that the employer filed with the IRS for the prior calendar year, along with the employer’s Form 1094-C.
Employers that provided insured coverage to California residents during the prior year are not required to file the required coverage information with the Franchise Tax Board as long as the insurer files it.
As of the date of this publication, California still indicates that it will only require the filing to be made electronically if the employer is submitting at least 250 of the same forms.
March 31 - Massachusetts - Submit coverage statements (Forms 1099-HC) to the Massachusetts Department of Revenue (Massachusetts individual mandate reporting)
Applies to employers who provided self-insured creditable coverage (under Massachusetts law) to employees in the prior calendar year.
Employers that provided self-insured coverage to Massachusetts employees during the prior calendar year must file with the Department of Revenue copies of the MA Forms 1099-HC provided to such employees by Jan. 31.
For employers that provided insured coverage to Massachusetts employees during the prior year, the
insurer is required to provide Form 1099-HC to such employees and make the filing with the Department of Revenue.
Filing is accomplished electronically.
For the latest information on filing due dates and other requirements, check the website (opens a new window) for the Commonwealth’s Department of Revenue.
March 31 - New Jersey - Submit coverage statements to the New Jersey Division of Revenue and Enterprise Services
Applies to employers who provided medical coverage to New Jersey residents in the prior calendar year.
Employers that provided self-insured coverage to New Jersey residents during the prior calendar year must file with the Division of Revenue and Enterprise Services copies of the IRS Forms 1095-C with respect to such residents that the employer filed with the IRS for the prior calendar year, along with the employer’s Form 1094-C. Although New Jersey will accept the same sort of coverage information on Forms NJ-1095, employers will typically want to simply submit copies of the forms they filed with the IRS.
Employers that provided insured coverage to New Jersey residents during the prior year are not required to file the required coverage information with the Division of Revenue and Enterprise Services as long as the insurer files it.
March 31 - Rhode Island - Submit coverage statements to the Rhode Island Department of Revenue, Division of Taxation (Deferred by state authorities from Jan. 31)
Applies to employers who provided medical coverage to Rhode Island residents in the prior calendar year.
Employers that provided self-insured coverage to Rhode Island residents during the prior calendar year must file with the Department of Revenue, Division of Taxation, copies of the IRS Forms 1095-C with respect to such residents that the employer filed with the IRS for the prior calendar year, along with the employer’s Forms 1094-C. Although Rhode Island will accept the same sort of coverage information on an equivalent statement, employers will typically want to simply submit copies of the forms they filed with the IRS.
Employers that provided insured coverage to Rhode Island residents during the prior year are not required to file the required coverage information with the Department of Revenue, Division of Taxation as long as the insurer files it.
Note: Generally, when a filing deadline or notice obligation falls on a Saturday, Sunday or federal holiday, the filing or notice may be filed or distributed on the next day that is not a Saturday, Sunday or federal holiday. This general rule may or may not hold true for state-imposed deadlines.
Not legal advice: Nothing in this alert should be construed as legal advice. Lockton may not be considered your legal counsel, and communications with Lockton's Compliance Consulting group are not privileged under the attorney-client privilege.
For more alerts, insights and additional information, click here (opens a new window) to visit Lockton's ERISA Compliance Consulting page.
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