As most employers start preparation for open enrollment, we can’t forget key deadlines for health plan compliance in the third quarter of 2024. Meeting these deadlines is crucial not only for staying organized but also for complying with legal mandates that can significantly impact plan sponsors.
Several reporting and disclosure requirements are mandated throughout the year, and the overview below summarizes compliance deadlines that are tied to a group health plan’s plan year. Please note: the summary illustrates the deadlines that are applicable to calendar-year plans. For non-calendar year plans, the deadlines must be adjusted to align with each plan’s specific plan year.
The below summary is divided between federal and state/local deadlines in chronological order. Deadlines may or may not apply to your group, depending on the employer and plan characteristics. Here are potential action items for the third calendar quarter of 2024:
STANDARD FEDERAL DEADLINES
July 31 - Submit PCORI tax
The PCORI tax is applicable to insured and self-funded plans, but the plan sponsor is responsible for the tax only with respect to self-funded plans. For plan years ending after Sept. 30, 2023, and before Oct. 1, 2024, the applicable dollar amount is $3.22. For plan years ending after Sept. 20, 2022, and before Oct. 1, 2023, the applicable dollar amount is $3.00.
The payment for all plan years ending in 2023 is due by July 31, 2024.
The fee does not apply to most “excepted benefits” or to health reimbursement arrangements (HRAs) where the HRA and associated medical plan are self-insured and have the same plan year.
The PCORI tax may NOT be paid with ERISA plan assets in most cases (there is an exception for certain multiemployer plans); it is the responsibility of the employer or plan sponsor. The tax is submitted with and reported on IRS Form 720 (opens a new window) for the second calendar quarter, under Part II of that Form.
For more details, see our recent alert (opens a new window) on the PCORI filing responsibility for 2024.
July 31 - File Form 5500 for the plan year ending Dec. 31, 2023 (Unless extension is obtained)
ERISA plans with a calendar year plan generally must file Form 5500 by July 31 annually unless the plan sponsor obtains an extension.
This applies to all calendar year ERISA plans unless otherwise exempted. Filing is completed electronically through the Department of Labor’s (DOL) EFAST2 portal. More information on how to file electronically can be found here. (opens a new window)
Welfare plans (other than MEWAs) that are fully insured, unfunded, or a combination of both are excused from filing if they have fewer than 100 participants covered on the first day of the ERISA plan year.
Form 5500 extensions are available by filing Form 5558 with the DOL on or before the filing’s initial due date. Filing Form 5558 can allow the plan up to an additional 2 1/2 months to complete the filing.
Sept. 30 (or Dec. 15 if Form 5500 is filed under an extension) - Distribute Summary Annual Report (SAR) for calendar year plans
A summary of the plan’s financial performance for the previous calendar year must be distributed to participating employees, former employees, COBRA beneficiaries and Qualified Medical Child Support Order (QMCSO) recipients within nine months of the close of that plan year.
The SAR requirement does not apply to self-funded plans that pay benefits exclusively from the employer’s general assets, even if those do include employee contributions, as long as those contributions are made through a Section 125 cafeteria plan.
SAR language is rather standard, and the disclosures may be made according to the DOL’s requirements for electronic disclosure if desired.
Sept. 30 - Pay annual fee due from health insurers
Self-funded MEWAs must make fee payments by Sept. 30 via electronic transfer. MEWAs with $25 million or less in net written premium for a “data year” will not owe any annual fee for the “fee year” that follows (Self-funded MEWAs are rare).
Sept. 30 - Medical Loss Ratio (MLR) rebates
Issuers must spend a minimum percentage of their premium dollars, or medical loss ratio (MLR), on medical care and healthcare quality improvement. Issuers that do not meet the applicable MLR must pay rebates to consumers.
Sponsors of insured health plans may receive rebates if their issuers do not meet their MLR. Rebates must be provided to plan sponsors by Sept. 30, following the end of the MLR reporting year. Employers that receive rebates should consider their legal options for using the rebate. Any rebate amount that qualifies as a plan asset under ERISA must be used to benefit the plan’s participants and beneficiaries.
Also, as a general rule, plan sponsors should use the rebate within three months of receiving it to avoid ERISA’s trust requirements. Plan sponsors that receive a rebate before Sept. 30 may need to adjust their deadline to use the rebate.
Aug. 31 and Sept. 30 - File Form 5500 for plan years ending Jan. 31, 2024, and Feb. 28, 2024, respectively
ERISA plans must file a Form 5500 at least annually unless the plan is exempted from the filing requirement. Filing is accomplished electronically through the DOL’s EFAST (opens a new window)2 portal.
Form 5500 extensions are available by filing Form 5558 with the DOL on or before the filing’s initial due date. Filing Form 5558 allows the plan up to an additional 2 1/2 months to complete the filing.
SELECT STATE AND LOCAL DEADLINES
July 30 - Make San Francisco HCSO contributions for the prior calendar quarter
Required if the employer is subject to the San Francisco Health Care Security Ordinance (HCSO) and, with respect to enrollees in a self-insured plan, is not taking advantage of the annual true-up calculation method of self-insured expenditures allowed by the HCSO. Fully insured plan sponsors cannot use the annual true-up method.
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 deadline.
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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