Federal Updates
Retirement Update
FAQ
FAQ: How do employers comply with the Massachusetts Minimum Creditable Coverage (MCC) and Health Insurance Responsibility Disclosure (HIRD) requirements?
State Updates
California
CFRA Revised to Include Bereavement Leave
November 08, 2022
On September 29, 2022, Gov. Newsom signed AB 1949 into law. The new law adds an entitlement to bereavement leave to the state’s existing California Family Rights Act (CFRA). Employers with five or more employees will be required to provide at least five days bereavement leave for employees experiencing the death of the following family members: spouse, child, parent, sibling, grandparent, grandchild, domestic partner or parent-in-law. Employees will be eligible after 30 days of employment. The leave must be taken within three months of the family member’s death.
The entitlement is separate from and in addition to CFRA’s existing 12-week entitlement. The question of whether the leave is paid or unpaid is dependent upon the employer’s existing bereavement leave policy. The leave may be paid or unpaid, but it should be consistent with the employer’s policy. For example, if the employer has an existing bereavement leave policy in which employees are paid for three days, the employee must receive paid bereavement up to the employer’s existing allowance (three days) and any remaining days out of the five (two days) may be unpaid.
The new law is effective January 1, 2024. Employers should work to revise their leave policies as necessary. The CFRA poster is expected to be revised.
Disability and Paid Family Leave Benefits to Increase in 2025
November 08, 2022
On September 30, 2022, Gov. Newsom signed SB 951 into law. The new law will increase benefit amounts payable under the state’s Disability and Paid Family Leave programs. Effective for leaves beginning on or after January 1, 2025, benefits will be paid at 90% of the employee’s wages (up to the annual maximum limit) when the employee’s wages (during the base period) were higher than $722.50, but equal to or lower than 70% of the state average quarterly wage. If the employee’s wages were more than 70% of the state average quarterly wage, benefits would be paid at 70% of the employee’s wages (up to the annual maximum limit).
Employers who supplement the state’s benefits or allow employees to integrate paid time off should be aware of the upcoming change and revise payroll systems and leave policies as necessary.
Delaware
Cost-Sharing Limitation for Diabetes Equipment and Supplies
November 08, 2022
On October 22, 2022, Gov. Carney signed SB 316 into law. The new law prohibits group health plans from imposing a cost-sharing requirement greater than $35 per month per participant for diabetes equipment and supplies. This includes blood glucose meters and strips, urine testing strips, syringes, continuous glucose monitors and supplies, and insulin pump supplies. The $35 monthly maximum applies regardless of the amount or types of supplies and equipment prescribed. The limit applies once the participant’s deductible has been met.
The requirement is effective for policies issued or renewed on or after January 1, 2024. Employers should work with their insurer to make sure that the change is implemented and plan documents are updated.
Fairness in Cost-Sharing for Prescription Drugs Act
November 08, 2022
On October 26, 2022, Gov. Carney signed SB 267 into law. The new law requires insurers to include any prescription cost-sharing amount paid by the participant or by another party on behalf of the participant toward the participant’s cost sharing limits under the policy. Cost-sharing requirements include deductible, copayment, coinsurance or out-of-pocket maximum. For example, an amount paid by a drug manufacturer toward a participant’s cost for a prescription would be counted toward the deductible and out-of-pocket maximums. Importantly, if the policy is a qualified high deductible health plan (HDHP), this requirement does not apply until the participant has met the annual statutory HDHP deductible.
The new law is effective for policies issued or renewed on or after January 1, 2024. Employers should work with their carrier to make sure the changes are implemented to the policy and plan documents are revised.
District of Columbia
Coverage for Medically Necessary Food
November 08, 2022
After passage by the DC Council in June 2022, approval by Mayor Bowser in July 2022, and the required review by the US Congress, Bill 24-0171 has become law. Under the new law, health insurance policies are required to provide coverage for medically necessary food as prescribed for certain diseases and conditions, including Crohn’s disease, ulcerative colitis, inflammatory bowel disease, gastroesophageal reflux disease that is nonresponsive to standard medical therapies, malabsorption due to liver or pancreatic disease, and food protein-induced enterocolitis syndrome. The coverage must be treated at least the same as other conditions regarding cost-sharing requirements.
Maryland
MarylandSaves Program Effective September 1, 2022
November 08, 2022
The MarylandSaves Program was created in 2016 with HB 1378 and went into effect on September 1, 2022. The program is a state-run retirement savings program for employers who do not otherwise offer employees a savings arrangement. Such arrangements include an IRA, defined benefit plan, 401(k), Simplified Employee Pension (SEP) plan, a Savings Incentive Match Plan for Employees (SIMPLE) plan or another arrangement, if in compliance with federal law, that the state board specifies by regulation. Employers who do not sponsor such an arrangement for employees must now meet certain requirements.
Those employers must register with the MarylandSaves Program, automatically enroll employees in the program and withhold and forward five percent of each employee’s compensation each pay period. Each employee’s contribution will automatically increase by one on January 1 of each year up to the maximum 10%. Employees may opt out or change their contribution percentage at any time. All contributions will be placed in a Roth IRA. Lastly, covered employers must distribute the program description to employees, which details the program and opt-out instructions.
Importantly, employers who already sponsor a qualified savings arrangement for employees must file an exemption. Employers qualify if they have sponsored an arrangement in the current or preceding calendar year. Governmental employers are also exempt.
HB 1378, 2016 »
Program Description, Employer Notice »
Employer Registration »
Employer Exemption »
Massachusetts
Reminder: MA HIRD Form Is Available on November 15 and Due December 15, 2022
November 08, 2022
The Health Insurance Responsibility Disclosure (HIRD) form is a state reporting requirement in Massachusetts that applies to in-state and out-of-state employers with six or more employees working in Massachusetts. The HIRD form collects employer-level information about employer-sponsored health plans to assist MassHealth in identifying members who can participate in, and who may be eligible for premium assistance from, MassHealth. The HIRD reporting is filed through the MassTaxConnect (MTC) web portal by December 15 but is available to complete starting November 15.
To file a HIRD form, employers must log in to their MTC account and select the “Withholding tax” account, then select the “File health insurance responsibility disclosure” hyperlink.
MA PFML 2023 Premium Rate and Maximum Benefit Amount Announced
November 08, 2022
2023 Individual Mandate Coverage OOP and Deductible Minimum Creditable Coverage (MCC) Limits
November 08, 2022
The Massachusetts Individual Mandate requires each Massachusetts resident to have health coverage that meets the Minimum Creditable Coverage (MCC) standards set by the Commonwealth Health Insurance Connector (Connector) or pay a penalty through their state tax returns. The Connector has announced the 2023 deductibles and out-of-pocket maximum limits for minimum creditable coverage (MCC). The 2021, 2022 and 2023 limits are summarized below.
Although employers are not required to provide MCC for their Massachusetts employees, insurers, or in some cases employers, are required to complete Form 1099-HC that indicates whether a plan is MCC or not and distribute the form to their Massachusetts employees. The same form must then be submitted to the state Department of Revenue (DOR) by January 31, following the plan year.
Additionally, employers with six or more employees who work in Massachusetts are required to submit an annual report, entitled the Health Insurance Responsibility Disclosure (HIRD) form, where MCC status is also reported, by December 15. You can find additional information in the FAQ section of this Compliance Corner.
Therefore, employers who have employees in Massachusetts should be aware of the 2023 MCC limits.
Deductible Limits | 2023 | 2022 | 2021 |
Employee-only tier deductible | $2,850 | $2,750 | $2,700 |
Employee-only tier separate Rx deductible | $350 | $340 | $300 |
Family tier deductible | $5,700 | $5,500 | $5,400 |
Family tier Rx deductible | $700 | $680 | $660 |
Maximum Out-of-Pocket (OOP) Limits | 2023 | 2022 | 2021 |
Employee-only tier OOP max | $9,100 | $8,700 | $8,550 |
Family tier OOP max | $18,200 | $17,400 | $17,100 |
Bulletin 02-22. The MCC Regulations for Calendar Year 2023 »
Bulletin 06-21. The MCC Regulations for Calendar Year 2022 »
Bulletin 05-20. The MCC Regulations for Calendar Year 2021 »
Mass Healthcare: Frequently Asked Questions for Employers, Form MA 1099-HC »
New Hampshire
NH PFML Website Launched
November 08, 2022
New Hampshire’s Paid Family and Medical Leave (NH PFML) program will be available beginning January 1, 2023. Open enrollment for employer plans begins on December 1, 2022, and open enrollment for individuals runs from January 1, 2023, through March 2, 2023. NH PFML provides 60% wage replacement (up to the Social Security wage cap) for either six or twelve weeks per year for absences related to the following life events:
- A worker’s own serious health condition when disability coverage does not apply, including childbirth
- For a worker to bond with a child during the first year of birth, including placement for adoption or fostering
- For a worker to care for a family member with a serious health condition
- Any qualifying urgent demand or need arising out of the fact that the worker’s spouse, child or parent is a covered military member on covered active duty
- For a worker to care for a covered service member with a serious injury or illness if the eligible worker is the service member’s spouse, child, parent or next of kin
An unpaid period of up to seven days must be exhausted once per benefit period, after which a claim may be paid. Leave can be taken all at once or in partial days in a minimum of four-hour increments.
The program is voluntary for private employers, but New Hampshire employees may still purchase a NH PFML individual plan if their employer does not offer an equivalent plan. Employers who choose to participate qualify for a Business Enterprise Tax (BET) credit equal to 50% of their NH PFML insurance premium payments on the six-week plan.
Nonparticipating large employers (50 or more employees) must still collect premium payments through payroll deductions for any employees who have elected individual NH PFML coverage. All employers must assist with the claims process for any employees who have elected individual coverage. The state has launched a website to provide employers guidance with the NH PFML program, available at Employer Responsibilities | NH Paid Family Medical Leave and Employers | NH Paid Family Medical Leave.
Employers with employees in New Hampshire should review the new guidance. The state is also developing an Employer Toolkit said to be available soon.
New Jersey
2023 Maximum Weekly Benefit Amount Announced
November 08, 2022
The New Jersey Department of Labor and Workforce Development has announced the 2023 maximum weekly benefit amount that eligible employees will receive under temporary disability insurance is 85% of their average earnings up to a maximum of $1,025 per week (2022: $993 per week).
For the 2023 premium rates for temporary disability insurance (TDI) and family leave insurance (FLI), please refer to the October 27, 2022, edition of Compliance Corner.
This material was created by PPI Benefit Solutions to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The service of an appropriate professional should be sought regarding your individual situation. PPI does not offer tax or legal advice. "PPI®" is a service mark of Professional Pensions, Inc., a subsidiary of NFP Corp. (NFP). All rights reserved.