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February 2024 Newsletter

Thursday, February 08, 2024

Employee Wellness 

Provide your employees with the latest wellness newsletter with the February edition of Live Well, Work Well

Educate employees about their benefits with the February Benefits & Me Newsletter.

New Electronic Filing Requirements for Employers

Beginning in 2024, employers that file at least 10 returns during the calendar year must file electronically. Reporting entities must aggregate most information on returns, such as Forms W-2 and 1099, to determine if they meet the 10-return threshold for mandatory electronic filing. The forms must be provided to covered individuals by March 1, 2024. The due date for filing the forms electronically is April 1, 2024. 

Employer Reporting Requirements:

Level-Funded/Self-Funded Employers that are Not Applicable Large Employers (ALEs)

  • Complete the 1095-B and provide it to covered individuals by 3/1/2024.
  • Complete the 1094-B and E-file the 1094/1095-Bs to the IRS by 4/1/2024.

Level-Funded/Self-Funded Applicable Large Employers (ALEs)

  • Complete Part III of the 1095-C for all covered individuals in addition to Parts I and II on the 1095-C and provide it to employees by 3/1/2024.
  • Complete the 1094-C and E-file the 1094/1095-Cs to the IRS by 4/1/2024.

Fully Insured Applicable Large Employers (ALEs)

  • Complete the 1095-C and provide it to employees by 3/1/2024.
  • Complete the 1094-C and E-file the 1094/1095-Cs to the IRS by 4/1/2024.

Medicare Part D Disclosures due by February 29, 2024 

Group health plan sponsors are required to complete an online disclosure form with the Centers for Medicare & Medicaid Services (CMS) on an annual basis indicating whether the plan's prescription drug coverage is creditable or non-creditable. This disclosure requirement applies when an employer-sponsored group health plan provides prescription drug coverage to individuals who are eligible for coverage under Medicare Part D.

The plan sponsor must complete the online disclosure within 60 days after the beginning of the plan year. For calendar year health plans, the deadline for the annual online disclosure is February 29, 2024 (since 2024 is a leap year).

Click here to learn more.

Medicare News

Glaucoma Screenings with Medicare

Federal Bill Seeks AI Tools to Stop Medicare Fraud

CMS Releases Proposed Payment Updates for 2025 Medicare Advantage and Part D Programs

Sentara Health Plans RxDC Reporting

Sentara Health Plans (formerly Optima Health) is gathering the required data to meet the RxDC reporting timelines under the Consolidated Appropriations Act (CAA). They intend to file 2023 reference year data to CMS by the June 1, 2024, deadline on behalf of the following commercial group plans:

  • Fully Insured Small, Mid-Market, and Large groups
  • Self-Funded and BusinessEDGE® groups: if you intend to file on your own behalf, please contact your Sentara Health Plans representative by February 23, 2024.

No action is required on the part of the group for Fully Insured Small Group, Fully Insured Mid-Market, and BusinessEDGE plans.

To complete the filing for Fully Insured and Self-Funded Large groups, Sentara will require each group to supply additional information. These groups will receive an email with a link to complete an electronic form. The form will be tailored to the group type and will only gather the required information needed to file the report on the group’s behalf. The deadline to submit the form is February 23, 2024.

HR Insights

February HR Brief Newsletter

ACA Reporting Penalties

Pay or Play Affordability Percentage Will Decrease for 2024

Aetna Small Group Update: Humira to be Replaced by Biosimilar Products

Starting on April 1, 2024, Aetna's formulary will no longer include Humira (adalimumab). Instead, members will have coverage for a selection of biosimilar adalimumab products. These products are lower cost than Humira.

This change impacts all Small Group Aetna Funding AdvantageSM and 

Aetna® Fully Insured 51-100 plans, which all use the Advanced Control Plan – Aetna formulary.

Members’ prior authorizations will automatically transfer to an available biosimilar product for any claims after April 1, 2024. A new prescription for the biosimilar will be needed, but many pharmacies, including CVS Specialty® Pharmacy, will contact the provider to handle the change on the member’s behalf.

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