Five Stories that Matter in Michigan This Week – February 24, 2023

  1. $35 Million in Grants Available for Small Nonprofits

The State of Michigan, Department of Labor and Economic Opportunity (LEO) and Michigan Nonprofit Association (MNA) have teamed up to help Michigan charities whose operations were impacted by the COVID-19 pandemic.

Why it Matters: Under this initiative, called the MI Nonprofit Relief Fund, grants in amounts between $5,000 and $25,000 will be awarded to selected entities with annual revenues total under $1 million. In addition, eligible entities must be based in Michigan and recognized by the IRS under Section 501(c)(3). Learn more.

———

  1. Michigan Cannabis Regulatory Agency Suspends Licenses, Issues Advisory

The Michigan Cannabis Regulatory Agency (CRA) recently suspended the licenses of a marijuana processor and issued a safety advisory for items manufactured with “illicit product.”

Why it Matters: This action is an important reminder to marijuana businesses in Michigan that the CRA is active in regulating businesses and taking enforcement action when appropriate. TAS Asset Holdings is the second processor to have its license suspended by the CRA this month. The CRA also announced disciplinary action against 10 marijuana businesses on February 10.

———

  1. CRA Publishes January 2023 Data, Average Price Drops

Per recent monthly data published by the Cannabis Regulatory Agency, the average retail flower price of an ounce of cannabis is $80.16, an all-time low, and almost a 50% decrease compared to last year’s average price of $152.74.

Why it Matters: While the prices of cannabis and cannabis-related products continue to decrease and make consumers happy, growers on the other hand are seeing profits decrease resulting in them seeking ways to halt new licenses to be granted in an effort to steady prices. Contact our cannabis law attorneys if you have any questions.

———

  1. DOL Issues Telework Guidance to Employers

On February 9, 2023, the U.S. Department of Labor (DOL) issued a Field Assistance Bulletin (Bulletin) addressing several questions related to compliance with the Fair Labor Standards Act (FLSA) and Family and Medical Leave Act (FMLA) when a business employs teleworkers.

Why it Matters: The Bulletin provides that the protections under the FLSA apply equally to employees who telework as to employees working at an office, factory, construction site, retail outlet, or any other worksite location.

———

  1. ERISA Health and Welfare Plan Voluntary Audit Service

Fraser Trebilcock is excited to introduce our Health and Welfare Plan Voluntary Audit Service to help businesses ensure their health and welfare plans are compliant with the Employee Retirement Income Security Act (ERISA).

Why it Matters: ERISA is a complex set of regulations that governs employee benefit plans, including health and welfare plans. Failure to comply with ERISA can result in costly fines and penalties, not to mention damage to your company’s reputation. Learn more from your Fraser Trebilcock attorney.

Related Practice Groups and Professionals

Business & Tax | Robert Burgee
Cannabis Law | Sean Gallagher
Labor, Employment & Civil Rights | Aaron Davis
Employee Benefits | Robert Burgee

Five Stories that Matter in Michigan This Week – November 25, 2022

  1. U.S. Supreme Court Declines Challenge to 2018 Seattle Hotel Health Insurance Law

The U.S. Supreme Court on Monday, November 14, 2022, turned away a challenge to a 2018 Seattle law requiring hotels to pay for health insurance for low-wage workers.

Why it Matters: The justices declined to hear an appeal by a group called the ERISA Industry Committee (ERIC) of a lower court’s ruling that upheld the law. The U.S. Supreme Court’s decision not to take up the challenge could encourage other cities and states to adopt similar requirements intended to address the widespread lack of health insurance among low-wage employees. (as reported by Reuters on November 21, 2022.)

———

  1. EEOC Issues New Workplace “Know Your Rights” Poster

The Equal Employment Opportunity Commission has issued an updated “Know Your Rights” workplace poster. Employers with more than 15 workers are required to display the poster, which can be found here, in their workplace. The updated poster identifies and summarizes laws that protect workers from discrimination and retaliation, and explains how employees or applicants can file a complaint if they believe that they have experienced discrimination.

Why it Matters: Employment law is a constantly evolving area, so it’s important for employers to stay abreast of new developments, such as this updated poster requirement from the EEOC. Contact a member of our Labor, Employment & Civil Rights team with any questions.

———

  1. Business Planning for the Future

A lot of small-to-medium size businesses devote time and focus on their near-term future but may not think of what 5-10 years will bring. The value of a business can often be in the ability to transition it to a new owner, but some business owners are unsure how to set themselves up to be successful in this arena.

Why it Matters: Capitalizing on the ability to plan for the long-term will aid your business in any transitions that may occur. Learn more here.

———

  1. FTC Safeguards Rule Deadline Extended, But Don’t Wait to Implement Data Security Compliance Protocols

The Federal Trade Commission recently extended the deadline, from December 9, 2022, to June 9, 2023, for compliance with the most stringent requirements of its latest rulemaking, revisions to the Safeguards Rule under the Gramm Leach Bliley Act (“the GLBA”).

Why it Matters: The GLBA, which was implemented over 20 years ago, defines how businesses gather, use, and share certain financial information about their customers. The Safeguards Rule establishes certain data security requirements for how a business stores that information. Learn more from our Fraser Trebilcock attorneys on the matter.

———

  1. Sixth Circuit Rules that Notice is Required to Terminate Contract for Successive Performances

Under Section 440.2309(2) of Michigan’s Uniform Commercial Code, a contract that “provides for successive performances but is indefinite in duration” may be terminated at any time (without cause). However, as a U.S. Court of Appeals for the Sixth Circuit decision points out, reasonable notice of such termination must be provided, unless the requirement of notice is waived via the contract.

Why it Matters: The court’s ruling in the case of Stackpole International Engineered Products v. Angstrom Automotive Group is a reminder for buyers and sellers, especially in the manufacturing industry, who enter into contracts that provide for successive performances to work with experienced legal counsel in the drafting, review and enforcement of commercial contracts to avoid contractual disputes and litigation.

Related Practice Groups and Professionals

Employee Benefits | Sharon Goldzweig
Labor, Employment & Civil Rights | Aaron Davis
Business & Tax | Mark Kellogg
Business & Tax | Robert Burgee

Five Stories that Matter in Michigan This Week – November 18, 2022

  1. Proposed Modifications to Michigan Court Rules Seek to Make Pandemic-Inspired Changes Permanent, Making it Harder to Evict Tenants

During the COVID-19 pandemic, Michigan’s court rules related to landlord-tenant eviction procedures were modified in some ways to utilize video conferencing and to make certain proceedings more efficient, and modified in other ways that made it more difficult for landlords to evict residential and commercial tenants.

Why it Matters: Pursuant to recently proposed amendments to Michigan Court Rule 4.201, Michigan’s State Court Administrative Office has taken steps to make many pandemic-era changes to minimize evictions permanent. Some of the proposed rules are allowing a judge to adjourn trial for at least seven days if a default judgment is not entered, and staying an eviction case if a tenant has applied for rent assistance. Learn more from our Fraser Trebilcock real estate attorneys on the matter.

———

  1. Michigan Small Business Growth Remains Strong

According to a recent report from the small Business Association of Michigan, Michigan’s entrepreneurial economy continues to grow. Among other things, SBAM’s Entrepreneurship Score Card shows that Michigan small businesses have outperformed U.S. averages in terms of the percentages of businesses being opened and revenue.

Why it Matters: Small businesses have always been the backbone of economic growth in Michigan and across the country. This report highlights the resilience of Michigan entrepreneurial economy.

———

  1. Business Planning for the Future

A lot of small-to-medium size businesses devote time and focus on their near-term future but may not think of what 5-10 years will bring. The value of a business can often be in the ability to transition it to a new owner, but some business owners are unsure how to set themselves up to be successful in this arena.

Why it Matters: Capitalizing on the ability to plan for the long-term will aid your business in any transitions that may occur. Learn more here.

———

  1. CRA Issues Michigan Consumer Advisory

Earlier this week, CRA issued a bulletin giving notice to consumers that a marijuana business that operates as both a state-licensed medical and adult-use recreational, Green Culture, sold unregulated products that may have contained several contaminants, such as mold and/or bacteria.

Why it Matters: Following the investigation, the CRA suspended both of Green Culture’s licenses. Marijuana businesses should heed this as a warning, the CRA are cracking down on businesses that do not follow the strict guidelines and rules laid out by the state agency.

———

  1. IRS Announces 2023 Cost-of-Living Adjustment for Retirement and Health and Welfare Benefit Plans

The Internal Revenue Service recently announced 2023 cost-of-living adjustments for retirement and health and welfare benefit plans. The significant adjustments reflect the increase in inflation over the last year. The adjustments are detailed in IRS Notice 2022-55. For example, the contribution limit for a Simple 401(k) will increase to $15,500 in 2023 from $14,000 in 2022, and for a Health FSA, limits will increase to $3,050 in 2023 from $2,850 in 2022.

Why it Matters: Business owners and employers should be aware of these adjustments and share this information with employees as we approach the new year. If you have any questions regarding these adjustments, please contact our Employee Benefits team.

Related Practice Groups and Professionals

Real Estate | Jared Roberts
Business & Tax | Mark Kellogg
Cannabis Law | Sean Gallagher
Employee Benefits | Robert Burgee

Five Stories that Matter in Michigan This Week – November 4, 2022

  1. IRS Announces 2023 Cost-of-Living Adjustment for Retirement and Health and Welfare Benefit Plans

The Internal Revenue Service recently announced 2023 cost-of-living adjustments for retirement and health and welfare benefit plans. The significant adjustments reflect the increase in inflation over the last year. The adjustments are detailed in IRS Notice 2022-55. For example, the contribution limit for a Simple 401(k) will increase to $15,500 in 2023 from $14,000 in 2022, and for a Health FSA, limits will increase to $3,050 in 2023 from $2,850 in 2022.

Why it Matters: Business owners and employers should be aware of these adjustments and share this information with employees as we approach the new year. If you have any questions regarding these adjustments, please contact our Employee Benefits team.

———

  1. Viridis North, LLC Can Proceed with Lawsuit Against CRA

In November 2021, the CRA (formerly known as the MRA), issued its largest ever marijuana recall because of concerns over safety tests conducted by two companies, Viridis Laboratories, LLC, and Viridis North, LLC. These two companies filed a lawsuit against four individuals who were employed by the CRA in their individual capacities. Last week, U.S. District Court Judge Paul L. Maloney granted an order in part motion to dismiss all claims alleged by Viridis Laboratories, LLC, and Viridis North, LLC, except for, “Plaintiff Viridis North’s claim for violation of its substantive due process rights.” Viridis Labs. v. Kluytman, 1:22-cv-283, 12(W.D. Mich. Oct. 27, 2022).

Why it Matters: The decision by the Court allows Viridis North LLC to proceed with its lawsuit in determining whether or not there was a violation of their substantive due process rights stemming from the November 2021 marijuana recall. Fraser Trebilcock attorneys will monitor the situation as developments continue.

———

  1. Year End Gift Tax Planning Perspective

If you’re thinking about beginning an annual gifting program, or want to continue a program you’ve already started, there are some things you should know. From an estate and gift tax planning perspective, the most commonly used method for tax-free giving is the annual gift tax exclusion. This method allows you to give up to $16,000 for 2022 (increasing to $17,000 in 2023) to each donee.

Why it Matters: The method allows you to give up $16,000 without reducing your estate and lifetime gift tax exclusion amount. It’s also important to note that there is no limit to the number of people to whom you may make such gifts, and that the annual gift tax exclusion is applied on a per-donee basis.

———

  1. Department of Labor Issues New Proposed Rule on Independent Contractors

The U.S. Department of Labor recently issued a Notice of Proposed Rulemaking that, if adopted, would change the standard for analyzing a worker’s classification as either an employee or independent contractor.

Why it Matters: Employers who misclassify employees can face severe financial consequences. That’s why it is important that organizations remain diligent in analyzing their workers’ classifications. Learn more on the subject.

———

  1. EV Company Relocating to MI Recipient of Funds from MSF

A Utah-based electric vehicle company that is set to relocate their headquarters to southeastern Michigan, received a $2.5 million Michigan Business Development Program performance-based grant from the Michigan Strategic Fund to aid in the move.

Why it Matters: Officials in Michigan have been working hard to grow Michigan’s economy, and these programs are an incentive for businesses that are looking to relocate or expand their footprint in the state.

Related Practice Groups and Professionals

Employee Benefits | Robert Burgee
Cannabis Law | Sean Gallagher
Trusts & Estates | Elizabeth Siefker
Labor, Employment & Civil Rights | David Houston
Energy, Utilities & Telecommunications | Michael Ashton

Five Stories that Matter in Michigan This Week – October 14, 2022

  1. Lawsuit Challenges New Election Challenger/Poll Watcher Guidance

The Michigan GOP and the Republican National Committee filed a lawsuit seeking to rescind new instructions for election challengers and poll watchers issued by the Michigan Bureau of Elections. Among issues raised in the lawsuit is a new requirement having challengers obtain a credential using a form from the Michigan Secretary of State’s Office.

Why it Matters: There were many lawsuits filed in the wake of the 2020 election, and it’s likely that there will be many more arising from this November’s hotly contested races. Fraser Trebilcock’s election law team provides proactive guidance for political campaigns and causes, and representation in connection with election-law disputes.

———

  1. Student Loan Forgiveness Will Not Be Taxed

Earlier this month with legislative bipartisan support, it was announced that Michigan will not collect taxes as revenue on the federal student loan forgiveness or the state’s Public Service Loan Forgiveness program. Individuals who are eligible can receive up to $20,000 of their student loans forgiven.

Why it Matters: In August, Fraser Trebilcock reported on President Biden’s announcement on student loan forgiveness of up to $20,000. This latest news comes as a relief for those who are participating in the loan forgiveness program.

———

  1. Changes Could Be Coming for Sales Tax on Automobiles

Pending a final vote, Michigan drivers will save some money when they purchase a vehicle. Previously, car buyers would be taxed the state’s 6% sales tax on the list price, but now under the proposed bills, it would now tax the amount the buyer purchased it for.

Why it Matters: The legislation could be another change for automobile owners in Michigan. If the bills pass, the sales tax would now have to consider the manufacturer incentives that may be present for certain cars.

———

  1. State Fines and Suspends Detroit-based Medical Marijuana Business

The Cannabis Regulatory Agency has suspended for 30 days and fined $75,000 a Detroit-based medical marijuana business for improperly handling marijuana products by not having the required identification tracking numbers on the products.

Why it Matters: In the highly regulated medical and recreational marijuana industry, businesses can face high fines and lengthy suspensions for failing to abide by the rules set forth by the Cannabis Regulatory Agency. Marijuana businesses are required to follow video surveillance rules in Michigan.

———

  1. October 14 Deadline: Medicare Part D Notice of Creditable (or Non-Creditable) Coverage

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires entities who offer prescription drug coverage to notify Medicare Part D eligible individuals whether their prescription coverage is creditable coverage. These notices of either creditable or non-creditable coverage are due for distribution prior to October 15 of each year.

Why it Matters: Failure to provide notice can result in a late enrollment penalty to those persons who go 63 days or longer without creditable coverage. Learn more here.

Related Practice Groups and Professionals

Election Law | Garett Koger
Business & Tax | Paul McCord
Cannabis Law | Sean Gallagher
Employee Benefits | Robert Burgee

Five Stories that Matter in Michigan This Week – September 30, 2022

  1. House Bill Proposes to Establish a Version of the Telephone Consumer Protection Act in Michigan

The federal Telephone Consumer Protection Act seeks to stop unwanted telephone solicitation. Michigan House Bill 6307, the Michigan Telephone Solicitation Act (the “MTSA”), would enact similar restrictions on a state level.

Why it Matters: If enacted, Michigan would follow in the footsteps of other states, such as Florida, Oklahoma, and Washington, who have implemented similar protections for residents. The MTSA would exempt certain solicitation calls, such as those made with express authorization and those to existing customers. Violations, especially knowing violations and those impacting vulnerable individuals, would be subject to stiff civil penalties. The bill also proposes to establish a private cause of action for impacted individuals.

———

  1. October 14 Deadline: Medicare Part D Notice of Creditable (or Non-Creditable) Coverage 

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires entities who offer prescription drug coverage to notify Medicare Part D eligible individuals whether their prescription coverage is creditable coverage. These notices of either creditable or non-creditable coverage are due for distribution prior to October 15 of each year.

Why it Matters: Failure to provide notice can result in a late enrollment penalty to those persons who go 63 days or longer without creditable coverage. Learn more here.

———

  1. FDA Appoints Birenbaum as Senior Public Health Advisor on Cannabis Research and Regulatory Actions 

The U.S. Food and Drug Administration (the “FDA”) recently hired Norman Birenbaum, former cannabis program director for the state of New York, to serve as its senior public health advisor on cannabis research and regulatory actions.

Why it Matters: The appointment of Norman Birenbaum signals a turn for cannabis and cannabis-based products on the federal level. He brings experience in policy analysis as a founding president of a national cannabis regulatory association, and is anticipated to expand the FDA’s relationship with the healthcare community and patient advocate groups, as they look to gather more data on cannabis.

———

  1. General Motors Co. Reverses Return to Office Plan Following Backlash 

Top executives from GM reportedly reversed course from last week’s reported plan to require salaried employees to return to company offices for at least three days a week, which would go into effect later this year.

Why it Matters: Following the outcry from employees who felt the plan was ushered in too quickly, executives have backed off the three-day in-office requirement this calendar year and instead continued to practice the “Work Appropriately” philosophy first adopted in 2020.

———

  1. Michigan Car Insurance Rates Drop Nationally

With the introduction of new out-of-state car insurance companies into Michigan, the state has dropped from the nation’s top spot in cost of car insurance, to fourth. The 2019 auto insurance reform bill that passed is believed to be the major factor in reducing costs.

Why it Matters: Reduced costs for automobile owners is a positive sign for Michiganders. Elected officials are working towards providing consumers with a choice for their automobile insurance, which will help reduce costs for citizens.

Related Practice Groups and Professionals

Energy, Utilities & Telecommunication | Michael Ashton
Employee Benefits | Robert Burgee
Cannabis Law | Sean Gallagher
Labor, Employment & Civil Rights | Aaron Davis
Insurance Law | Emily Vanderlaan

Client Alert: October 14 Deadline: Medicare Part D Notice of Creditable (or Non-Creditable) Coverage

Medicare Part D notices (of either creditable or non-creditable coverage) are due for distribution prior to October 15th. 

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires entities who offer prescription drug coverage to notify Medicare Part D eligible individuals whether their prescription coverage is creditable coverage. With respect to group health plans including prescription coverage offered by an employer to any Medicare Part D eligible employees (whether or not retired) or to Medicare Part D Medicare-eligible spouses or dependents, the employer must provide those individuals with a Notice of Creditable or Non-Creditable Coverage to advise them whether the drug plan’s total gross value is at least as valuable as the standard Part D coverage (i.e., creditable). Medicare Part D notices must be provided to Medicare-eligible individuals prior to October 15th of each year (i.e., by October 14th).

The initial notices were due by November 15, 2005 and have been modified numerous times. The newest model notices and guidance were issued for use after April 1, 2011. Therefore, any notices you send from this point forward must conform to the new guidelines. Use of the former model notices will not suffice.

Downloads to the updated guidance and various notices can be found on the CMS website HERE and HERE.

As a reminder, there are five instances in which such notice must be provided:

  1. Prior to an individual’s initial enrollment period for Part D;
  2. Prior to the effective date of enrollment in your company’s prescription drug coverage;
  3. Upon any change in your plan’s creditable status;
  4. Prior to the annual election period for Part D (which begins each October 15); and
  5. Upon the individual’s request.

Providing the notice above is important as a late enrollment penalty will be assessed to those persons who go 63 days or longer without creditable coverage (for example, if they enroll in an employer’s prescription plan which is not as valuable as the Part D coverage instead of enrolling directly in the Medicare Part D coverage).

If your plan does not offer creditable prescription drug coverage and if the Part D eligible person enrolls in your plan instead of the Part D plan for at least 63 days, a permanent late enrollment penalty of 1% of the premium is added to the Medicare premium for each month the person does not enroll in Part D.

Please contact us if you need assistance with your Notice of Creditable (or Non-Creditable) Coverage.

Reminder: Submit Medicare Part D Notice to CMS

As discussed above, employers offering group health plans with prescription drug coverage are required to disclose to all Part D-eligible individuals who are enrolled in or were seeking to enroll in the group health plan coverage whether such coverage was “actuarially equivalent,” i.e., creditable. (Coverage is creditable if its actuarial value equals or exceeds the actuarial value of standard prescription drug coverage under Part D.) This notice is required to be provided to all Part D eligible persons, including active employees over age 65.

The regulations also require group health plan sponsors with Part D eligible individuals to submit a similar notice to the Centers for Medicare and Medicaid Services (“CMS”). Specifically, employers must electronically file these notices each year through the form supplied on the CMS website.

The filing deadline is 60 days following the first day of the plan year.

At a minimum, the Disclosure to CMS Form must be provided to CMS annually and upon the occurrence of certain other events including:

  1. Within 60 days after the beginning date of the plan year for which disclosure is provided;
  2. Within 30 days after termination of the prescription drug plan; and
  3. Within 30 days after any change in creditable status of the prescription drug plan.

The Disclosure to CMS Form must be completed online at the CMS Creditable Coverage Disclosure to CMS Form web page HERE.

The online process is composed of the following three step process:

  1. Enter the Disclosure Information;
  2. Verify and Submit Disclosure Information; and
  3. Receive Submission Confirmation.

The Disclosure to CMS Form requires employers to provide detailed information to CMS including but not limited to, the name of the entity offering coverage, whether the entity has any subsidiaries, the number of benefit options offered, the creditable coverage status of the options offered, the period covered by the Disclosure to CMS Form, the number of Part D eligible individuals, the date of the notice of creditable coverage, and any change in creditable coverage status.

For more information about this disclosure requirement (instructions for submitting the notice), please see the CMS website for updated guidance HERE.

As with the Part D Notices to Part D Medicare-eligible individuals, while nothing in the regulations prevents a third-party from submitting the notices (such as a TPA or insurer), the ultimate responsibility falls on the plan sponsor.

This alert serves as a general summary, and does not constitute legal guidance. Please contact us with any specific questions.


Robert D. Burgee is an attorney at Fraser Trebilcock with over a decade of experience counseling clients with a focus on corporate structures and compliance, licensing, contracts, regulatory compliance, mergers and acquisitions, and a host of other matters related to the operation of small and medium-sized businesses and non-profits. You can reach him at 517.377.0848 or at bburgee@fraserlawfirm.com.


Aaron L. Davis works in employee health and welfare benefits. He is also Chair of the firm’s labor law practice and serves as Firm Secretary. He has litigation experience in a diverse range of employment matters, including Title VII, the Age Discrimination and Employment Act, the Americans with Disabilities Act, the Family Medical Leave Act, and the Fair Labor Standards Act. You can reach him at 517.377.0822, or email him at adavis@fraserlawfirm.com.

Client Alert: Updated PCORI Fees Payable in 2022

In Notice 2022-4, the Internal Revenue Service set forth the PCORI amount imposed on insured and self-funded health plans for policy and plan years that end on or after October 1, 2021 and before October 1, 2022.

Background

The Patient-Centered Outcomes Research Institute (PCORI) fee is used to partially fund the Patient-Centered Outcomes Research Institute which was implemented as part of the Patient Protection and Affordable Care Act.

The PCORI fees were originally set to expire for plan years ending before October 1, 2019. However, on December 20, 2019, the Further Consolidated Appropriations Act was enacted and extended the fee to plan years ending before October 1, 2029.

The fee is calculated by using the average number of lives covered under a plan and the applicable dollar amount for that plan year. Code section 4375 imposes the fee on issuers of specified health insurance policies. Code section 4376 imposed the fee on plan sponsors of applicable self-insured health plans. This Client Alert focuses on the latter.

Due to the fact that the US Department of Health and Human Services did not publish updated National Health Expenditures tables for 2021, this year’s fees are based on the projections set out in the 2020 tables. As such, plans should pay close attention to next year’s fee changes as the accuracy of 2020’s projections may be affected by current inflationary trends.

Adjusted Applicable Dollar Amount

Notice 2022-4 sets the adjusted applicable dollar amount used to calculate the fee at $2.79. Specifically, this fee is imposed per average number of covered lives for plan years that end on or after October 1, 2021 and before October 1, 2022. For self-funded plans, the average number of covered lives is calculated by one of three methods: (1) the actual count method; (2) the snapshot method; or (3) the Form 5500 method.

Deadline and How to Report

The PCORI fee is due by August 1, 2022 (as the typical due date, July 31, 2022, falls on a Sunday), and must be reported on Form 720.

Instructions are found here (see Part II, pages 8-9).

The Form 720 itself is found here (see Part II, page 2).

Form 720, as well as the attached Form 720-V to submit payment, must be used to report and pay the requisite PCORI fee to the IRS. While Form 720 is used for other purposes to report excise taxes on a quarterly basis, for purposes of this PCORI fee, it is only used annually and is due by July 31st of each relevant year.

As previously advised, plan sponsors of applicable self-funded health plans are liable for this fee imposed by Code section 4376. Insurers of specified health insurance policies are also responsible for this fee.

  • For plan years ending on or after October 1, 2017 and before October 1, 2018, the fee is $2.39 per covered life.
  • For plan years ending on or after October 1, 2018 and before October 1, 2019, the fee is $2.45 per covered life.
  • For plan years ending on or after October 1, 2019 and before October 1, 2020, the fee is $2.54 per covered life.
  • For plan years ending on or after October 1, 2020 and before October 1, 2021, the fee is $2.66 per covered life.
  • For plan years ending on or after October 1, 2021 and before October 1, 2022, the fee is $2.79 per covered life.

Again, the fee is generally due no later than July 31 (see above for 2022 date) of the year following the last day of the plan year.

As mentioned above, there are specific calculation methods used to configure the number of covered lives and special rules may apply depending on the type of plan being reported. While generally all covered lives are counted, that is not the case for all plans. For example, HRAs and health FSAs that are not excepted from reporting only must count the covered participants and not the spouses and dependents. The Form 720 instructions do not outline all of these rules.

More information about calculating and reporting the fees can be found here.

Questions and answers about the PCORI fee and the extension may be found here.

As you are well aware, the law and guidance are continually evolving. Please check with your Fraser Trebilcock attorney for the most recent updates.

This alert serves as a general summary, and does not constitute legal guidance. Please contact us with any specific questions.


Robert D. Burgee is an attorney at Fraser Trebilcock with over a decade of experience counseling clients in business transactions, civil matters, regulatory compliance, and employee matters. Robert also has a background in employee benefits, having been a licensed agent since 2014. You can reach him at 517.377.0848 or at bburgee@fraserlawfirm.com.


Aaron L. Davis works in employee health and welfare benefits. He is also Chair of the firm’s labor law practice and serves as Firm Secretary. He has litigation experience in a diverse range of employment matters, including Title VII, the Age Discrimination and Employment Act, the Americans with Disabilities Act, the Family Medical Leave Act, and the Fair Labor Standards Act. You can reach him at 517.377.0822, or email him at adavis@fraserlawfirm.com.

Client Alert: Broker & Consultant Fee Transparency to Group Health Plans

As the health care arena continues to evolve following the ACA and its progeny, one common theme in the regulations has been to increase transparency in the marketplace. Following on that theme, the Department of Labor recently issued its Field Assistance Bulletin No. 2021-03 aimed at the fees charged by group health insurance brokerages and consultants. The language of the Bulletin sets forth the Department’s short to medium term enforcement policy in regard to the amendments made to ERISA section 408(b)(2)(B), which was included as part of the Consolidated Appropriations Act of 2021 (CAA). Taken together, these documents set forth one method the Department will take to achieve the government’s goal of requiring group health plan sponsors, who are charged to act in a fiduciary capacity, to consider the costs of the services provided by certain vendors.

Who is affected?

ERISA section 408(b)(2)(B) applies to all group health plans, regardless of group size, and includes both insured and self-funded plans; all of which are “covered plans.” The sole exception applies to certain small employer health reimbursement arrangements.

The new language applies to “covered service providers” who provide plan related services to “covered plans.” Covered service providers include individuals and entities that enter into a contract or arrangement to provide one or more of the following services to a covered plan:

  • Brokerage services with respect to selection of:
    • Insurance products (including vision and dental);
    • Plan management services, vendors, and administrative supports; and
    • Stop-loss, pharmacy benefit, wellness, and other plan services.
  • Consulting services related to the development or implementation of:
    • Plan design, insurance or insurance product selection (including vision and dental);
    • Plan management services, vendors, group purchasing organization agreements, and services; and
    • Stop-loss, pharmacy benefit, wellness, and other plan services.

In addition to providing covered services, the broker, consultant, or other covered service provider must reasonably expect $1,000 or more in direct or indirect compensation in connection with its contract or arrangement with the covered plan.

Additionally, the Bulletin clarifies that only covered service providers who are a party to the contract or arrangement with the covered plan are required to make the disclosure. In this way, the amended statute does not require affiliates or subcontractors, solely by virtue of offering services to the covered plan as an affiliate or subcontractor of the covered service provider, to individually make the disclosures, as they will not have entered into the contract or arrangement with the covered plan.[1]

What information must be disclosed?

Covered service providers must disclose to covered plans specified information regarding the services to be provided and the compensation the covered service provide reasonably expects to receive in connection with its services. At a minimum, this information must include:

  • A description of the services to be provided by the covered service provider;
    • Including, where applicable, information about those services for which the covered service provider will provide or reasonably expects to provide services directly to the covered plan as a fiduciary.
  • A description of the direct compensation that the covered service provider expects to receive in connection with the contract or arrangement with the covered plan. In most instances, such direct compensation will include some form of commission.
  • A description of all indirect compensation that the covered service provider, its affiliates, or subcontractors expect to receive.
    • Where a covered service provider employs the use of affiliates, subcontractors, or both, the disclosure should also include a description of the arrangement between the covered service provider and the affiliate or subcontractor.
    • Indirect compensation disclosures should also include (1) an identification of the services for which such indirect compensation will be received, (2) any formulae relied up in the calculation of such indirect compensation,  (3) identification of the payer of such indirect compensation, and (4) a description of the arrangement and any formula amongst and between the payer of the indirect compensation and the covered service provider, affiliates, or subcontractors.
  • A description of any compensation the covered service provider expects to receive in connection with the termination of the contract, along with a calculation of how any prepayments will be calculated and refunded.

In addition to describing the types of compensation, the covered service provider notice should also include the manner in which such compensation will be received.

Finally, a covered service provider must set forth the services that the covered service provider is rendering to the covered plan as a fiduciary.

When are the disclosures required?

The CAA amendments became applicable on December 27, 2021. Covered service providers, therefore, are required to make their fee disclosures for any new contracts or arrangements as of that date. The Bulletin clarifies that the “effective” date of the contract or arrangement is the date the contract or arrangement was executed, which may not necessarily be the beginning of a new plan year. Therefore, covered plans should consult with and collect the requisite information from their covered service providers for any contracts or arrangements that are written, renewed, or extended in 2022.

Furthermore, in order to meet the objectives of the policy (i.e. allowing covered plans to perform cost-benefit analysis related to the fees charged and services provided by their brokers and consultants), covered service providers are required to make the disclosures set forth above “reasonably in advance” of the date on which the contract or arrangement is entered into, extended, or renewed. Furthermore, any change in such disclosures are required to be made as soon as practicable.

How does a covered plan ensure disclosure?

While the disclosures contemplated by the statutory provision are intended to come from the covered service provider, the fiduciary responsibility rest with the covered plan sponsor. The primary enforcement mechanism, therefore, is to deem nonconforming deals to be prohibited transactions under the statute. However, no such determination shall be made provided covered plans meet the following requirements:

  • “The responsible plan fiduciary did not know that the covered service provider failed or would fail to make required disclosures and reasonably believed that the covered service provider disclosed the information required to be disclosed.
  • The responsible plan fiduciary, upon discovering that the covered service provider failed to disclose the required information, requests in writing that the covered service provider furnish such information.
  • If the covered service provider fails to comply with a written request…within 90 days of the request, the responsible plan fiduciary notifies the Secretary of the covered service provider’s failure…”

Conclusion

As plan fiduciaries consider their options this year, whether its with a new carrier or a renewal, they should begin working with their brokers and consultants to gain a better understanding of the fees that are charged and prepare to answer inquiries about the reasonableness thereof.

[1] Affiliates and subcontractors should review the nature of their relationship to covered plans to ensure that their services do not extend beyond the scope of the services provided on behalf of a covered service provider, thus possibly triggering the need for the affiliate or subcontractor itself to disclose.

This alert serves as a general summary, and does not constitute legal guidance. Please contact us with any specific questions.


Robert D. Burgee is an attorney at Fraser Trebilcock with over a decade of experience counseling clients in business transactions, civil matters, regulatory compliance, and employee matters. Bob also has a background in employee benefits, having been a licensed agent since 2014. You can reach him at 517.377.0848 or at bburgee@fraserlawfirm.com.


Aaron L. Davis works in employee health and welfare benefits. He is also Chair of the firm’s labor law practice and serves as Firm Secretary. He has litigation experience in a diverse range of employment matters, including Title VII, the Age Discrimination and Employment Act, the Americans with Disabilities Act, the Family Medical Leave Act, and the Fair Labor Standards Act. You can reach him at 517.377.0822 or email him at adavis@fraserlawfirm.com.