Employee Benefits Relief in the Year-End COVID-19 Stimulus Legislation

The Consolidated Appropriations Act, 2021 (H.R. 133) (the “Act”) was passed by both houses of Congress on December 21, 2020, and signed into law by the President on December 27, 2020. The Act is an incredible 5,593 pages long and contains both an omnibus spending bill to fund the government through September 30, 2021 and a COVID-19 stimulus package that provides approximately $900 billion in emergency relief to individuals and businesses.

The Act contains numerous provisions that impact employee benefit plans. The principal takeaways from the Act that plan sponsors must consider are summarized below. In contrast to the length of the Act itself, this alert is intended to provide a high level summary. Please reach out to us if you have specific questions about the Act.

Health and Welfare Plan Related Provisions

This is the largest health care legislative package since the Affordable Care Act and the Act includes almost a dozen new patient protections with quickly approaching effective dates, which will result in significant new regulation being issued in 2021.

FSA Flexibility

The Act provides for significant additional flexibility for both health care flexible spending arrangements (“FSA”) and dependent care FSAs. These provisions are optional, not required, and employers will need to amend their plans to provide the new rights, if they choose to offer them.

Carryover. Any unused funds in FSAs from a plan year ending in 2020 or 2021 may be carried over and used at any time in the next plan year. These carryovers will be allowed under rules similar to the existing carryover rules for health FSAs (but without the dollar limit on carryovers).

Grace Periods. FSAs with grace periods may extend those grace periods to up 12 months for plan years ending in 2020 or 2021. Normally, grace periods have a maximum 2 ½-month period.

Post-Termination Reimbursement. If an employee terminates participation during calendar year 2020 or 2021, FSAs may also reimburse for otherwise eligible expenses incurred through the end of that year (plus any grace period).

Dependent Care Post-Age 13 Coverage. For dependent care FSAs, if a dependent became too old to have their care expenses reimbursed (age 13) due to the pandemic, any unused funds may be used for the remainder of the plan year in which they aged out. Further, if any funds remain unused at that time, those funds can be used until the child turns 14.

Prospective Changes Permitted. For plan years ending in 2021, employees may prospectively change their FSA contributions without incurring a permitted election change event.

“No Surprise” Medical Billing Provisions

Under a section titled the “No Surprises Act,” the Act includes several provisions to regulate surprise medical billing from certain non network providers, air ambulances and for emergency services. These provisions concern bills from out-of-network providers requiring more money from the patient after the health plan has paid its part. This can happen in an emergency setting or where a patient goes into an in-network hospital, but is treated there by an out-of-network provider.

Generally, the Act provides that individuals covered by a group health plan or individual/group health insurance receiving non-emergency services at a network facility cannot be balance billed by a non-network provider, unless the non-network provider provides notice to the individual and the individual consents. An exception exists for “ancillary services”, such as anesthesiology, pathology, and radiology, and the Act also fleshes out associated details, such as payment timelines and dispute resolution processes.

The agencies are required to begin finalizing implementing regulations regarding the methodology for making payments by July 1, 2021, with the rest to come by December 31, 2021. These provisions become effective January 1, 2022.

These rules replace the current Affordable Care Act rules governing the payment of emergency services and apply to both grandfathered and non-grandfathered plans.

Additional Health Plan Provisions

ID Card Information. ID cards for group health plans (physical or electronic) must include, in clear writing, the deductible, out-of-pocket limits, and consumer assistance information.

Continuity of Care. Patients undergoing treatment for a serious and complex condition, who are pregnant, receiving inpatient care, scheduled for non-elective surgery or terminally ill must be notified if their provider leaves the network and given the opportunity to continue care (at an in-network rate) for 90 days.

Cost Comparison Tools. Plans and carriers will be required to offer cost comparison tools (via phone or the internet) starting with plan years beginning on or after January 1, 2022.

Gag Clauses Prohibited. “Gag” clauses will be prohibited. These clauses prevent health plans from sharing provider-specific reimbursements and information. Prohibiting these clauses facilitates the creation of the cost-comparison tools.

Provider Directories. Group health plans must update provider directories at least every 90 days and establish a system to respond to inquiries about the network status of a provider within one business day.

Mental Health Parity. Plans will be required to analyze the nonquantitative treatment limitations that they apply to mental health and substance use disorder benefits to show that the limitations are comparable to those that are used for medical/surgical benefits.

Retirement Plan Related Provisions

Partial Plan Terminations. The Act provides for temporary relief from the 100% vesting requirement for partial plan terminations caused by employee turnover under Code section 411(d)(3) if the turnover is due to COVID-19. A qualified plan will not incur a partial termination during any plan year which includes the period beginning on March 13, 2020, and ending on March 31, 2021, if the number of active participants covered by the plan on March 31, 2021, is at least 80% of the number of active participants covered by the plan on March 13, 2020.

Coronavirus-Related Distributions. The Act extends the COVID-19 in-service distribution relief under the CARES Act to money purchase pension plans.

Disaster Relief (Not Including COVID). The Act provides special disaster related distribution and loan rules (similar to prior natural disaster relief, including a distribution right, increase in loan limits, loan suspensions, etc.) for FEMA declared disasters (other than COVID-19) from January 1, 2020 through 60 days after enactment of the Act. 

Consolidated Appropriations Act, 2021

Webinar: The Must-Do’s and Common Mistakes of Employee Benefit Planning

Lisa Dursey joins Stephanie Rising of The Rising Effect in a 15-minute webinar discussing the must-do’s and common mistakes of administering employee benefit plans. This webinar provides a concise primer on how to structure and correctly administer your plans.

Stephanie starts the webinar by explaining the importance of your new-hire process, and then dives more deeply into traditional and lifestyle benefits that attract and retain talented employees. Lisa then outlines the common mistakes that are made in administering those benefits, and how to correct them.

Contact ERISA Benefits Law to discuss your benefit plan administration or for help resolving any plan errors. Please note that in addition to general benefits advice, ERISA Benefits Law attorneys are well versed in designing sick leave policies for COVID-19.

IRS Announces COLA Adjusted Retirement Plan Limitations for 2021

The Internal Revenue Service today released Notice 2020-79 announcing cost of living adjustments affecting dollar limitations for pension plans and other retirement-related items for tax year 2021.

Highlights Affecting Plan Sponsors of Qualified Plans for 2021

  • The contribution limit for employees who participate in 401(k), 403(b), most 457 plans, and the federal government’s Thrift Savings Plan remains unchanged at $19,500.
  • The catch-up contribution limit for employees aged 50 and over who participate in 401(k), 403(b), most 457 plans and the federal government’s Thrift Savings Plan remains unchanged at $6,500.
  • The limitation under Section 408(p)(2)(E) regarding SIMPLE retirement accounts remains unchanged at $13,500.
  • The limit on annual contributions to an IRA remains unchanged at $6,000. The additional catch-up contribution limit for individuals aged 50 and over is not subject to an annual cost-of-living adjustment and remains $1,000.
  • The limitation on the annual benefit under a defined benefit plan under Section 415(b)(1)(A) remains unchanged at $230,000.
  • The limitation for defined contribution plans under Section 415(c)(1)(A) is increased for 2021 from $57,000 to $58,000.
  • The annual compensation limit under Sections 401(a)(17), 404(l), 408(k)(3)(C), and 408(k)(6)(D)(ii) is increased from $285,000 to $290,000.
  • The dollar limitation under Section 416(i)(1)(A)(i) concerning the definition of “key employee” in a top-heavy plan remains unchanged at $185,000.
  • The dollar amount under Section 409(o)(1)(C)(ii) for determining the maximum account balance in an employee stock ownership plan subject to a five year distribution period is increased from $1,150,000 to $1,165,000, while the dollar amount used to determine the lengthening of the five year distribution period remains unchanged at $230,000.
  • The limitation used in the definition of highly compensated employee under Section 414(q)(1)(B) remains unchanged at $130,000.

The IRS previously updated Health Savings Account limits for 2021. See our post here.

The following chart summarizes various significant benefit Plan limits for 2019 through 2021:

Type of Limitation202120202019
415 Defined Benefit Plans$230,000$230,000$225,000
415 Defined Contribution Plans$58,000$57,000$56,000
Defined Contribution Elective Deferrals$19,500$19,500$19,000
Defined Contribution Catch-Up Deferrals$6,500$6,500$6,000
SIMPLE Employee Deferrals$13,500$13,500$13,000
SIMPLE Catch-Up Deferrals$3,000$3,000$3,000
Annual Compensation Limit$290,000$285,000$280,000
SEP Minimum Compensation$650$600$600
SEP Annual Compensation Limit$290,000$285,000$280,000
Highly Compensated$130,000$130,000$125,000
Key Employee (Officer)$185,000$185,000$180,000
Income Subject To Social Security Tax  (FICA)$142,800$137,700$132,900
Social Security (FICA) Tax For ER & EE (each pays)6.20%6.20%6.20%
Social Security (Med. HI) Tax For ERs & EEs (each pays)1.45%1.45%1.45%
SECA (FICA Portion) for Self-Employed12.40%12.40%12.40%
SECA (Med. HI Portion) For Self-Employed2.90%2.90%2.90%
IRA Contribution$6,000$6,000$6,000
IRA Catch-Up Contribution$1,000$1,000$1,000
HSA Max. Contributions Single/Family Coverage$3,600/
$7,200
$3,550/ $7,100$3,500/ $7,00
HSA Catchup Contributions$1,000$1,000$1,000
HSA Min. Annual Deductible Single/Family$1,400/ $2,800$1,400/ $2,800$1,350/ $2,700
HSA Max. Out Of Pocket Single/Family$7,000/
$14,000
$6,900/ $13,800$6,750/ $13,500

How to Register as a Pooled Plan Provider

The Department of Labor issued a Proposed Rule on August 27, 2020 setting forth the registration requirements for Pooled Plan Providers (PPPs). Under the Proposed Rule, PPPs who plan to begin operating on January 1, 2021 must submit an initial registration on or after October 3, 2020 and on or before December 2, 2020.

Background

The Setting Every Community Up for Retirement Enhancement (SECURE) Act permits “pooled employer plans” (PEPs) to begin operating starting on January 1, 2021. PEPs are multiple employer plans with participating employers that don’t share a common industry or location. PEPs are intended to allow smaller employers to leverage their collective purchasing power to reduce retirement plan costs and administrative burdens. A PPP acts as the plan administrator and is a named plan fiduciary for a PEP.

The SECURE Act requires PPPs to register with the Secretary of Labor before beginning operations, and includes a separate authorization for the DOL to require reporting of other information. The SECURE Act did not include specific content requirements for the PPP registration.

Proposed Rule

The Proposed Rule includes requirements for an initial registration filing, supplemental filings, and a final filing, as described below. The DOL explains that the purpose of these filings is to provide time-sensitive knowledge to the DOL, the Treasury Department, and the IRS to permit those agencies to oversee PPPs, and to allow employers hiring a PPP to be able to exercise their fiduciary duties of selection and monitoring.

  • Initial Filing: The prospective PPP must make an initial filing 30 to 90 days before beginning operations, which must include the following information:
    1. Basic identifying information about the pooled plan provider, including: legal business name; Federal EIN; telephone; mailing address; website, if any; identifying information for the primary compliance officer of the PPP; and agent for service of legal process.
    2. Approximate date when plan operations are expected to commence.
    3. A description of the administrative or investment services (including investment management, investment advice, investment products, plan administration, and custodial or trustee services) that will be offered, including identification of, and a description of the role of, affiliates who will help provide those services.
    4. A statement disclosing any criminal convictions related to the PPP.
    5. A statement disclosing any pending legal or regulatory proceedings.
  • Supplemental Filing: Supplemental filings are required for information about reportable events, which would include any change in the information filed as part of the initial registration and also significant financial and operational events related to the PPP and the PEPs it sponsors.
  • Final Filing: A final filing must be made once the last PEP has been terminated and ceased operations.

The Proposed Rule requires electronic filing of all PPP registrations, and also provides that a new EBSA form be established– EBSA Form PR (Pooled Plan Provider Registration) (Form PR) – as the required filing format for PPP registrations. The proposed Form PR, and draft instructions, which are attached as Appendix A to the proposal, provide blanks for a PPP to report the information required for the initial, supplemental and final filings described above.

Next Steps

This Proposed Rule was published in the Federal Register on September 1, 2020. The DOL will accept comments on the Proposed Rule for 30 days after the proposal is published in the Federal Register.

In addition to the Proposed Rule, the IRS and DOL are authorized by the SECURE Act to issue the following additional guidance related to PEPs:

  • Model plan language that may be used for a plan to be treated as a PEP;
  • Guidance about the administrative duties and other actions required to be performed by a PPP;
  • Guidance about procedures to be taken to terminate a PEP;
  • Guidance about what actions an employer must take to facilitate the administration of the PEP;
  • Guidance identifying instances in which employers should be kicked out of PEPs; and
  • Information about what audits, examinations or investigations of a PPP the DOL may perform.

Until guidance is issued, employers and PPPs will not be treated as failing to meet the applicable requirements so long as they comply in good faith with a reasonable interpretation of the SECURE Act.

New Lifetime Income Disclosure Requirement for Pension Benefit Statements

The DOL issued an interim final rule on August 18, 2020 that gives plan administrators the opportunity to limit their liability with respect to the lifetime income illustrations that will be required soon for pension benefit statements for defined contribution plans. The rule provides a set of assumptions to use in preparing the lifetime income illustrations, as well as model language that may be used for benefit statements.

Background

The SECURE Act amended the pension benefit statement requirements under section 105 of the Employee Retirement Income Security Act of 1974 (ERISA) to require that a participant’s accrued benefits be included on his or her pension benefit statement as both (1) a current account balance and (2) an estimated lifetime stream of payments. The SECURE Act required that the estimated lifetime stream of payments be shown as both a single life annuity (SLA) and a qualified joint and survivor annuity (QJSA), at least annually.

Actuarial Assumptions & Model Language

The interim final rule prescribes the following assumptions for calculating the lifetime stream of payments:

+ Assumed Commencement Date: Plan administrators must calculate monthly payment illustrations as if the payments begin on the last day of the benefit statement period.

+ Assumed Age: Plan administrators must assume that, on the assumed commencement, a participant is the older of age 67 or the participant’s actual age.

+ QJSA Assumptions: Plan administrators must assume that all participants have a spouse of equal age. Plan administrators must also use a  Qualified Joint and 100% Survivor Annuity.

+ Assumed Interest Rate: Plan administrators must use the 10-year constant maturity Treasury rate (10-year CMT) as of the first business day of the last month of the statement period to calculate the monthly payments.

The interim final rule requires that plan administrators provide various explanations about the estimated lifetime income payments to participants. The rule provides model language that may be used for each of the required explanations, and the model language may be integrated into a plan’s pension benefit statements or attached to the statements as an addendum. See pages 93 through 98 of the IFR for the model language.

Limitation on Liability

In accordance with the SECURE Act, the interim final rule provides that no plan fiduciary, plan sponsor, or other person will be liable under ERISA for providing a lifetime income illustration that (1) uses the published assumptions to calculate the lifetime income equivalents, and (2) uses the DOL’s model language, or language substantially similar to the model language, in participants’ benefit statements. This relief from liability addresses the concern of many plan fiduciaries that participants might sue them if actual monthly payments in retirement fall short of illustrations provided prior to retirement.

Effective Date & Comment Period

The interim final rule will be effective 12 months after the date of its publication in the Federal Register. The interim final rule includes a 60-day comment period.

For more information, please see the Interim Final Rule, the DOL Fact Sheet, and the DOL News Release.