- The U.S. Department of Labor recently proposed revisions to Form 5500, the related schedules, and the rules that govern the forms. In general, these changes would first apply for the 2019 plan year, although certain changes may be implemented earlier. These proposed revisions were published on July 21, 2016, and comments are being accepted for 75 days, through October 4.The proposed revisions are intended to “modernize the financial statements and investment information filed about employee benefit plans; update the reporting requirements for service provider fee and expense information; enhance accessibility and usability of data filed on the forms; require reporting by all group health plans covered by Title I of ERISA; and improve compliance under ERISA and the Internal Revenue Code through new questions regarding plan operations, service provider relationships, and financial management of the plan.”
For welfare plans, one of the most significant changes is the elimination of the exemption from the Form 5500 filing requirement for certain small group health plans (those with less than 100 employees participating on the first day of the plan year). There is also expanded use of Schedule C (service provider information) for certain small plans funded through a trust, although most unfunded or fully insured health and welfare plans of any size will continue to qualify for an exception to the Schedule C requirement. However, other changes would also affect large plans. For example, a new Schedule J for group health plans requires reporting information such as plan design, the categories of benefits provided, whether the plan is a high-deductible health plan (HDHP) or includes a health reimbursement arrangement (HRA) or flexible spending account (FSA), whether the plan is grandfathered, the number of individuals offered coverage as well as how many elected COBRA continuation coverage, claims payment policies and practices, enrollment data, financial disclosures, denied claims information, cost sharing, and identification of service providers, such as third-party administrators (TPAs), pharmacy benefit managers (PBMs), or wellness program managers.
Further, the schedule will include compliance questions, such as whether the SPD and SBCs are in compliance, whether coverage is provided in compliance with applicable federal laws and DOL regulations, including, among others, HIPAA, GINA, MHPAEA and the ACA.
While this will certainly add to the burden of small businesses that provide employee benefits, there is plenty of time to prepare. The silver lining for employers is that the disclosures and resulting transparency will likely lead to stronger competition in the insurance market.
- Peter Marathas, Compliance Director
About The Authors. This alert was prepared for JACounter by Stacy Barrow and Mitchell Geiger. Mr. Barrow and Mr. Geiger are employee benefits attorneys with Marathas Barrow & Weatherhead LLP, a premier employee benefits, executive compensation and employment law firm. They can be reached at firstname.lastname@example.org or email@example.com.
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