The Department of Labor (DOL), the Internal Revenue Service (IRS), and the Pension Benefit GuarantyCorporation (PBGC) recently proposed significant changes to the form 5500 which has implications for both large employers and small employers. Targeting an effective date of 2019 plan year filings, the recent DOL Factsheet explains that many changes are on the horizon in an attempt to modernize and improve the Form 5500 annual return/report filed by employee benefit plans. They identify the driving forces behind the changes include a desire to 1) modernize financial reporting, 2) provide greater information regarding group health plans, 3) enhance data mine-ability, 4 ) improve service provider fee information, and 5) enhance compliance with ERISA and the code.
The most notable proposed changes include:
- Removing the small group exemption where previously many employers with less than 100 enrolled participants were exempt from filing;
- Adding a new comprehensive schedule J (Group Health Plan Information) requirement;
- New Schedule C requirement for each service provider;
- And an expanded schedule H for funded plans.
Regardless of a group’s size, benefit plans should pay special attention to the new Schedule J requirements. Plans will now be asked to complete information on the types of benefits offered and the funding methods, including if benefits are HDHP, health FSA or HRA. There will also be questions on participant contributions and employer contributions as well as enrollment information, including participants and dependents. There appears to be requirements for claims data (including claims submitted, denied, appealed, paid, and where claims are paid from – insurer, trust or employer general assets. And last but not least, there will be a focus on plan compliance with questions around COBRA, grandfathered status, MLR rebates, HIPAA, GINA, MHP SBC requirements, and SPD requirements.
As traditionally occurs, the DOL has asked for comments to the proposed regulations and these comments are due by October 4, 2016. It is clear that the agencies are working together to significantly increase Form 5500 reporting obligations for many employers with group health plans. As explained in the fact sheet, the agencies are looking to update the filing requirement to gather data sufficient to support their enforcement efforts. Therefore, employers should take note and make sure to tighten up their benefit plan compliance over the next year. The silver lining is that the agencies have provided plenty of lead time for employer’s to get into compliance.
If you have questions about these new regulations, or about your health benefit plan’s compliance with some of the regulations mentioned in the proposed regulations, contact your HCW consultant.