As we approach the fourth quarter of 2024, it’s crucial for employers to stay vigilant about upcoming employee benefits compliance deadlines. This period is marked by several key due dates that require timely attention to ensure adherence to regulatory requirements. From filing annual reports to updating plan documents, staying on top of these deadlines helps avoid penalties and ensures smooth operations. This alert aims to provide a comprehensive overview of the critical compliance dates and deadlines for the fourth quarter, helping you navigate the complexities of employee benefits administration with confidence.
Our fourth quarter guide is categorized by federal and state deadlines in chronological order with additional notice requirements due at open enrolment.
Deadlines may or may not be applicable to your group, depending on employer and plan characteristics.
Here are potential action items for the fourth calendar quarter (through December 31, 2024).
STANDARD FEDERAL DEADLINES
Oct. 2 - Distribute notice of Qualifying Small Employer Health Reimbursement Arrangement (QSEHRA) for employers offering calendar year QSEHRAs
Applies to small employers (not subject to the ACA employer mandate) who sponsor a QSEHRA, in lieu of any other group medical coverage, that reimburses employees for individual market medical insurance premiums on a tax-free basis.
The notice must be provided to each “eligible employee” regardless of enrollment status and must include the employee’s maximum HRA benefit for the year, among other information. The notice is due at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the QSEHRA.
A model notice is available from your Lockton account service team.
Oct. 2 - Distribute notice of Individual Coverage Health Reimbursement Arrangement (ICHRA) for employers offering calendar year ICHRAs
Applies to employers of any size who offer an ICHRA, in lieu of any other traditional group medical coverage, that reimburses employees for individual market medical insurance premiums or Medicare premiums.
The notice must be provided to each “eligible employee” regardless of enrollment status. It must include information about the benefits provided by the IHCRA and the effect of the ICHRA coverage on the ability to qualify for federal subsidies in an individual market.
The notice is due, generally speaking, at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the ICHRA.
A model notice Is available from your Lockton account service team.
Oct. 2 - Submit Medicare Part D subsidy application to CMS to obtain Part D subsidy for 2024 plan year (for calendar year retiree drug plans)
Applies to ERISA and non-ERISA plans seeking federal subsidies for providing retiree drug coverage. Generally, the application deadline is 90 days prior to the beginning of the plan year. An extension of approximately 30 days can be requested from the Center for Medicare & Medicaid Services (CMS) prior to the application deadline.
Oct. 14 - Distribute notices of creditable and/or non-creditable coverage (if not provided in the previous 12 months)
Provide this notice to employees, retirees and dependents enrolled in Medicare and also enrolled (or seeking enrollment in) the employee’s group medical plan.
Most employers supply these notices at open enrollment, and such notices are deemed given for the next 12 months unless there’s a material change in the creditable or non-creditable nature of the coverage. Thus, if distributed in enrollment packets during the previous 12 months (and there’s no material change in the Rx coverage), the mid-October deadline may be ignored.
These notices may be combined with other notices but must be "conspicuous.” There must be a text box atop the packet noting in 14-point font that the packet includes a Medicare Part D notice. The notice may be mailed or hand-delivered; electronic distribution is possible, but special consent rules apply.
Oct. 15 (if a non-calendar year plan) - File Form 5500 for the prior calendar year plan year, if filing under an extension from a July 31 deadline
Applies to ERISA plans.
Form 5500 extensions are available by filing a Form 5558 with the DOL on or before the filing’s initial due date. Calendar year plans with a July 31, 2024 deadline for 2023 Forms 5500 and that obtained a 2-1/2-month extension via Form 5558 should file by Oct. 15, 2024.
Dec. 15 - Distribute summary annual reports (SARs), if Form 5500 for a calendar year plan was filed under an extension
Applies to calendar-year ERISA plans that filed Form 5500 under an extension.
For non-calendar year plans, the SAR deadline is two months after the plan’s extended 5500 deadline.
Dec. 29 - Last day for employers to distribute portion of MLR rebate
The employer must distribute the portion of an MLR Rebate that is considered plan assets within 90 days of receiving the rebate (by Dec. 29 if received on Sept. 30). Otherwise, the employer may be subject to the general ERISA trust requirements. Plan sponsors that receive a rebate prior to Sept. 30 may need to adjust their deadline to use the rebate.
For more information see Lockton’s Guide to Medical Loss Ratio (opens a new window).
Dec. 31 - Submit to CMS the gag clause prohibition attestation (GCPCA)
Under the Transparency provision of the Consolidated Appropriations Act of 2021 (CAA), plans and issuers must annually submit to CMS an attestation that the plan or issuer is in compliance with the gag clause prohibition.
The first gag clause prohibition attestation was due by Dec. 31, 2023, covering the period beginning Dec. 27, 2020, or the effective date of the group health plan coverage (if later), through the date of attestation. Subsequent attestations, covering the period since the last preceding attestation, are due by Dec. 31 of each year thereafter.
Attestations are collected by CMS via the online portal (opens a new window).
Dec. 31 - Distribute annual Women's Health and Cancer Rights Act notice (for calendar year plans)
Applies to ERISA and non-ERISA plans. Self-insured state and local governmental plans may opt out.
Notice must be provided to participants (employees and retirees), COBRA and other beneficiaries receiving benefits and alternate recipients under QMCSOs. This notice is typically distributed at initial enrollment and then annually, prior to each plan year.
Including this notice in the annual enrollment packet is appropriate and typical, as long as the notice is "prominent." Electronic disclosure is permitted, in accordance with DOL requirements.
Dec. 31 - Distribute notice of premium assistance under Medicaid or the Children's Health Insurance Program (CHIP) for calendar year plans
Applies to ERISA and non-ERISA plans.
The notice must be provided to each employee, regardless of eligibility or enrollment status, and is best provided as a separate document, even if offered with enrollment materials. It should be provided by the last day of the plan year preceding the year to which the notice relates.
A model notice is available through your Lockton account service team and is updated periodically by federal authorities.
Dec. 31 and upon request - Provide nondiscrimination notice; also must post on website and in physical location
Applies to entities covered by Section 1557 of the Affordable Care Act, such as:
Healthcare providers receiving funding from the Department of Health and Human Services (this includes providers receiving Medicare or Medicaid payments).
Employers receiving Medicare Part D reimbursements for their post-65 retiree drug coverage.
The obligation is to include in these documents a nondiscrimination notice apprising employees of the employer’s obligation to comply with section 1557.
First day of open enrollment - Distribute the Summary of Benefits and Coverage (SBC)
Applies to ERISA and non-ERISA plans.
The SBC must be provided to benefit eligible employees at open enrollment if employees must make affirmative benefit elections. If employees do not need to make affirmative benefit elections (automatic re-enrollment), the SBC must be provided 30 days prior to the beginning of the plan year.
First day of open enrollment - Michelle’s Law notice
Applies to ERISA and non-ERISA plans.
The notice must be provided at open enrollment if the plan covers full-time students beyond age 26.
First day of open enrollment - Distribute the fixed indemnity policy notice
Plans offering group fixed indemnity policies are required to provide a notice explaining that coverage is not comprehensive, major-medical coverage.
Applies only to fixed indemnity policies. This does not include specific disease insurance, critical illness, or accident coverage. The notice must be provided to prospective enrollees at enrollment and at re-enrollment beginning in 2025. Must be prominently displayed in marketing, application, and enrollment (and re-enrollment) materials.
The notice must be in 14-point font. The insurer may satisfy this requirement on behalf of the plan.
First day of open enrollment - Distribute HIPAA special enrollment notice
Applies to ERISA and non-ERISA plans.
Provide to participants. Best to insert into enrollment packets. Model notices are available on the DOL’s EBSA website and from your Lockton account service team. Notice may be provided electronically in accordance with DOL requirements.
The notice must also be provided when coverage is initially offered.
First day of open enrollment - Distribute HIPAA privacy notice
Applies to ERISA and non-ERISA plans.
Required of sponsors of self-insured health plans, including partially self-insured health plans (e.g., the employer reimburses, as through an HRA, a portion of an otherwise insured plan’s deductible). Provide to all enrolled individuals. However, delivery to the enrolled participant is deemed to be delivery to all their dependents. If dependent requests a copy of the notice, however, the plan must supply it.
Best to include in enrollment packets. Model notices are available from your Lockton account service team. Notice may be provided electronically, but only if the individual recipient consents to receive it electronically. A plan that has a website is required to post its notice of privacy practices prominently on the website and make the notice available electronically through the website.
Insured plans, where the sponsor is “hands on” PHI, are required to have a notice of privacy practices, but the sponsor (on behalf of the plan) is not required to distribute it – only to provide it upon request.
First day of open enrollment - Distribute notice of availability of alternative standards to maintain a wellness program
Applies to ERISA and non-ERISA plans.
When an employer operates an activities-based or outcomes-based wellness program subject to the ACA, wellness program materials must include a notice that where an individual is unable to satisfy the employer’s desired standard (or it would be unwise to try), the employer will fashion an individualized, alternative standard for the individual.
A specific timing or method for distribution is not addressed in the regulations; however, such disclosure must be included in all plan materials describing the terms of the program (written or online).
Regulations include model language that can be used to satisfy the disclosure requirement.
Plan materials are not required to describe a specific reasonable alternative standard, only the availability of one. The plan may accept the recommendations of the individual’s physician as the appropriate alternative standard and, in some cases, may be required to do so.
Other notices that may be included at open enrollment
COBRA general notice - must be provided when plan coverage first begins, but also can be provided at OE.
Notice of grandfathered status (if applicable) - provide to participants during OE with respect to plans that maintained grandfathered status.
Notice of right to designate primary care physician, and no preauthorization requirement for OB/GYN care - provide to all participants in a plan that requires designation of a primary care provider or that provides coverage for OB/GYN care and requires designation of a primary care provider.
SELECT STATE AND LOCAL DEADLINES
Oct. 30 - Make San Francisco HCSO contributions for prior calendar quarter
For employers subject to the San Francisco Healthcare Security Ordinance.
Quarterly contributions, if due for the quarter ending Sept. 30, are due by Oct. 30. Self-funded employers have the option of utilizing an annual true-up method in lieu of quarterly contributions. The true-up contributions are due in February of each year, for the prior year.
Nov. 15-Dec. 15 - File Massachusetts Health Insurance Reporting Disclosure (HIRD) form
Applies to any employer that reported six or more employees in any Massachusetts unemployment wage report during the past 12 months. The employer must file the HIRD form through the Massachusetts Department of Revenue web portal, MassTaxConnect.
The disclosure is made during the filing period of Nov. 15 – Dec. 15, annually.
Upon hire and annually thereafter - Notify eligible employees of benefits provided by the employer’s group medical plan, compared to Illinois’s EHB package
Employers with employees in Illinois are required to provide such employees who are eligible for the employer’s group medical plan (without regard to enrollment or coverage status) a written list of the covered benefits provided by the employer’s group medical plan, comparing that list against the state’s essential health benefits (EHB) package (its EHB benchmark plan).
Illinois has provided additional information on this requirement, including a model disclosure template. The statute provides the notice may be provided via email or website posting.
This requirement is likely preempted by ERISA, for employers whose plans are subject to ERISA.
First day of open enrollment - Provide FSA participants in California with notice regarding any deadline to withdraw FSA funds prior to the end of the plan year
California FSA disclosure regarding claim filing deadline.
Applies to non-ERISA plans (including dependent care and adoption assistance flexible spending accounts (FSAs) maintained by ERISA employers). ERISA arguably preempts this notice requirement with respect to health FSAs maintained by ERISA employers.
Notice requirement applies to employers with respect to employees in California, enrolled in an FSA (health, dependent care or adoption assistance) that imposes a deadline to withdraw funds from the FSA that is prior to the end of the plan year. For instance, if an FSA requires participants who terminate employment before the end of the plan year to submit claims within 90 days of employment termination, as opposed to the end of the plan year, notice of that deadline must be provided. The law does not prescribe a notice due date, but logically notice should be provided at or shortly after enrollment, or upon employment termination.
Notice must be provided in two different forms, such as written form, postal mail, electronic mail, text message or in person.
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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