Form 5500 Changes and the New Schedule J Information


Under a brand-new proposition, the IRS/DOL might get rid of the exemption of small companies from the Type 5500 filing requirement as it associates with their health and well-being advantage Strategies. This would lead to around 2.7 MILLION extra companies being needed to submit Internal Revenue Service Form 5500. This requirement would most likely be effective for Plan years beginning on or after January 1, 2019.

Under this exact same proposition, a brand-new schedule (Schedule J) might be needed for ALL health and well-being Strategies. Totally guaranteed group health strategies with less than 100 individuals might be needed to finish a minimal part of (Schedule J) covering details on involvement, protection, insurance coverage business, and standard advantages.

– The number of people are getting COBRA protection under the Strategy.
– Who might be covered under the Strategy (staff members, retired people, partners, and/or dependents).
– Whether the Strategy has a high deductible.
– Whether the Strategy is an FSA or HRA (or has either as an element).
– Whether the Strategy is asserting grandfathered status under the ACA.
– Info about any refunds or compensations from a company, such as a medical loss ratio refund under the ACA.
– Overall premium payment and other information relating to stop loss protection.
– Details about company and individual contributions (for Strategies not finishing Set up H), and whether any contribution forwarding was unforeseen.
– Insurance claims payment info, consisting of:
————-Counts of insurance claims authorized and rejected, with a dollar quantity of insurance claims paid.
————-Counts of advantage insurance claim appeals (and outcomes of appeals).
————-Counts of advantage insurance claims adjudicated late.
————-Counts of pre-service insurance claims appealed (and outcomes of appeals).
————-Whether the Strategy was not able to pay insurance claims at any time throughout the year.
– For Strategies with insurance plan, whether premiums were paid prompt and whether any overdue payments led to protection lapse.
– Self-reporting of compliance with numerous federal laws (consisting of HIPAA, GINA, MHPAEA, and ACA).
– Whether the Strategy undergoes, and if so, has actually adhered to the Type M-1 filing requirements, a concern that would be moved from the existing Type 5500.

ERISA compliance is the law and reporting and disclosure guidelines are ever altering. Contact Benefits Compliance Consultants, Inc. today at 1-515-244-2424 or email us at [email protected] for a complimentary compliance evaluation and to find out how our business can conserve you time and cash.