Potomac Basin Inc., LLC

Please click here for all the updated information on Healthcare Reform.

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From the Family Leave and Medical Act (FLMA) to HSAs, HIPAA Privacy and Security, and more — be sure to review the 10 things you need to know about your insurance coverage for employees.

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The U.S. Department of Labor’s Employment Standards Administration, Wage and Hour Division, administers and enforces the Family and Medical Leave Act (FMLA) for all private, state and local government employees, and some federal employees. The FMLA became effective on August 5, 1993 for most employers and entitles eligible employees to take up to 12 workweeks of unpaid, job-protected leave in a 12-month period for specified family and medical reasons.

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A Section 125 Cafeteria Plan must provide that participant elections are irrevocable and cannot be changed during the period of coverage, generally the plan year. However, an employer may design the plan to permit certain exceptions to the rule, known as qualifying events, which are governed by the Treasury Regulations in Section 1.125. In general, if an employee requests an election change under these events, the request must be consistent with the event, and the request must be made within the time period governed by the Plan Document and SPD, typically 30 days.

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Click inside for a list of Compliance Checklists available through Potomac Basin Group for organizations with fewer than 100 employees, for groups under 50 employees, and for groups with fewer than 20 employees, and a fiduciary checklist.

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There was a time when employer-provided group health coverage was at risk if an employee was fired, changed jobs, or got divorced. That substantially changed in 1986 with the passage of the health benefit provisions in the Consolidated Omnibus Budget Reconciliation Act (COBRA). Now, many employees and their families who would lose group health coverage because of serious life events are able to continue their coverage under the employer’s group health plan, at least for limited periods of time. Inside you’ll links to download the Employer’s Guide, the Employee’s Guide, the and the COBRA timeline.

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The Women’s Health and Cancer Rights Act (WHCRA) provides protections for individuals who elect breast reconstruction after a mastectomy. Under WHCRA, group health plans offering mastectomy coverage must also provide coverage for certain services relating to the mastectomy, in a manner determined in consultation with the attending physician and the patient. Required coverage includes all stages of reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, prostheses, and treatment of physical complications of the mastectomy, including lymphedema.

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For your information, click inside to find useful websites that assist with compliance. You’ll also find additional compliance information, courtesy of our parent company NFP.

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