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Benefits

Open Enrollment Season – A Checklist for Employers

Here at SIMA we offer a comprehensive set of tools and support materials to ensure your employees remain engaged, educated, and, most of all, enrolled in a plan that helps them make better decisions for a healthy physical and financial future. Here are just a few things to do before, during, and after the enrollment period. Pre-Enrollment:  4-10 weeks before Open Enrollment Plan kickoff event around enrollment Send a letter, email, or text message about upcoming enrollment period Print flyers or order materials to hand out at enrollment event Open Enrollment:  1-2 weeks before and during Open Enrollment Send reminders about...

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HSA and Retirement: How to Use Your Health Savings Account

When you get ready to retire, there’s a good chance one of your biggest expenses will be health care. Luckily, there are tools you can use to help make the most of your money. If you qualify, you might be able to use a health savings account (HSA) as a sort of “retirement account” to help you continue to grow your wealth. “An HSA isn’t actually a retirement account; it’s completely different,” said Tom Vipond, emerging products consultant at TD Ameritrade. “However, it is a tax-advantaged savings account that can be used as part of your retirement strategy.” Here’s what you need...

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Medicare Part D – Creditable Coverage Disclosure Notice to Individuals

Employers must send Medicare Part D Creditable Coverage Disclosure Notices to individuals each year by October 14th and at additional specified times during the year. All employers that provide prescription drug coverage to individuals who are eligible for Medicare Part D are required to notify those individuals whether or not the coverage that is provided is creditable, as part of the Medicare Part D creditable coverage requirements. Notices must be provided to Medicare-eligible active working individuals and their dependents, Medicare-eligible COBRA individuals and their dependents, Medicare-eligible disabled individuals covered under the prescription drug plan, and any retirees and their dependents who...

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ACA Affordability Contribution Rate Set at 9.78% for 2020

New Figure Marks Decrease from 2019 Under the employer shared responsibility ("pay or play") provisions of the Affordable Care Act, applicable large employers—generally those who have 50 or more full-time employees (including full-time equivalent employees)—may be subject to a penalty if they do not offer affordable coverage that provides minimum value to their full-time employees and their dependents. For plan years beginning in 2020, the Internal Revenue Service has announced that coverage will generally be considered affordable if the employee's required contribution for the lowest-cost self-only health plan offered is 9.78% or less of his or her household income for the taxable...

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Reminder: PCORI Fees Due July 31

The Affordable Care Act imposes a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to help fund the Patient-Centered Outcomes Research Institute. The fee, required to be reported only once a year on the second quarter Form 720 and paid by its due date, July 31, is based on the average number of lives covered under the policy or plan. The fee applies to policy or plan years ending on or after Oct. 1, 2012, and before Oct. 1, 2019. The Patient-Centered Outcomes Research Institute fee is filed using Form 720, Quarterly Federal...

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EEOC Delays Amending Wellness Program Regulations to End of 2019

On May 22, 2019, the Equal Employment Opportunity Commission (EEOC) announced its plans to issue amended regulations related to wellness program incentives by December 2019. This signals the second pushback of the EEOC’s deadline to publish new wellness program incentive regulations. Back in 2016, the EEOC had finalized two rules that regulated employer-sponsored wellness programs. These rules allowed employers to offer incentives for wellness programs that asked employees health-related questions or included medical exams. The rules also allowed employers to offer incentives in exchange for health-related information about employees’ spouses. In August 2017, a federal district court had vacated portions of the...

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IRS Releases Inflation-adjusted Limits for HSAs and HDHPs for 2020

On May 28, 2019, the IRS released Revenue Procedure 2019-25 to announce the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2020. These limits include: The maximum HSA contribution limit The minimum deductible amount for HDHPs The maximum out-of-pocket expense limit for HDHPs These limits vary based on whether an individual has self-only or family coverage under an HDHP. HSA Contribution Limits for 2020 The IRS limits for HSA contributions increase for 2020. Eligible individuals with self-only HDHP coverage will be able to contribute up to $3,550 for 2020, while eligible individuals with family HDHP coverage will...

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Reminder: PCORI Fees Due July 31

Fees Apply to Employers Sponsoring Certain Self-Insured Plans As a reminder, employers that sponsor certain self-insured health plans are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Fees for plan years that ended in 2018 are due July 31, 2019. Employers must report and pay the required PCORI fees annually via IRS Form 720. For plan years that ended between January 1, 2018 and September 30, 2018, the fee is $2.39 multiplied by the average number of lives covered under the plan. For plan years that ended between October 1, 2018 and December 31, 2018, the fee is $2.45 multiplied by...

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Medicare Part D Creditable Coverage Notice Reminder

All group health plans that provide prescription drug coverage to Medicare Part D eligible individuals (whether actively working, retired, or disabled) are required to notify CMS whether or not the coverage provided is creditable. This disclosure is required whether the coverage is primary or secondary to Medicare. Employers must file their Disclosure Notice through the CMS website Instructions and guidance on completing the notice are also available. NOTE: If you are offering an actual Part D Plan, you are exempt from this filing requirement. Employers who have applied for a retiree drug subsidy are NOT required to complete this form. You will...

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