Compliance Resource Center

2024 PCORI Fee Deadline

Plan administrators sponsoring self-funded health plans, Health Reimbursement Arrangements (HRAs), and non-excepted Flexible Spending Arrangements (FSAs) must submit and pay their 2024 PCORI Fees using IRS Form 720 on or before July 31, 2025.  For these purposes, self-funded plans include Level Funded plans, Individual Coverage HRAs (ICHRAs), as well as so-called “deductible buy-down” and “partially self-funded” health plans. 

Although PCORI Fees also apply to fully insured plans, the insurer is responsible for submitting and paying PCORI fees on behalf of the fully insured plan.  If you are uncertain as to what types of plans you offer or are not sure if this applies to you, please contact a member of your AssuredPartners Account Management Team.

Please see our most recent PCORI blog entry here.

DOL Form 5500 Deadline
(for plan years ending December 31, 2024; actual deadline varies based on plan year end date)

Unless excepted, all ERISA health and welfare plans must file a DOL Form 5500 by the last day of the seventh month following the end of the plan year, or the next business day if the deadline falls on a weekend.  This deadline can be extended two months by a timely Form 5558 filing.

Although ERISA health and welfare plans with fewer than 100 participants on the first day of the plan year are generally exempted from filing a 5500, all MEWAs as well as so-called "funded" plans (e.g., with plan assets held in a trust, such as a VEBA trust) that are not fully insured must file regardless of plan size.

Plans that meet the criteria for a governmental plan or church plan ERISA exception do not have to file a Form 5500.

Summary Annual Report (SAR) Deadline
(Applicable to plan years that ended on December 31, 2024; actual deadline will vary based on plan year end date for non-calendar year plans)

Most plans that file a Form 5500 must furnish participants with a corresponding Summary Annual Report (SAR) by the last day of the ninth month following the end of the plan year, or within two months after any granted Form 5500 extension.  Excepted from the SAR requirement are large, self-funded plans that are "unfunded" (generally speaking, when there is no trust involved and benefits are paid out of the general assets of the employer).

Plans that meet the criteria for a governmental plan or church plan ERISA exception do not have to file a Form 5500 and therefore do not have to provide a SAR.

Creditable Coverage Notice Deadline

Among other responsibilities, employers and other plan sponsors who provide prescription drug coverage must provide an annual notice confirming whether the coverage is "creditable" or "non-creditable" before October 15 of each year.  While some choose to conduct the annual distribution at Open Enrollment (and then also throughout the year to each newly eligible individual when coverage is first offered, thus meeting this obligation well ahead of the deadline), some provide it on the last day permitted, each October 14.

For more information about the technical timing requirements of Notices of Creditable and/or Non-Creditable Coverage, please contact a member of your AssuredPartners Account Management Team or visit the CMS landing page found at https://www.cms.gov/medicare/prescription-drug-coverage/creditablecoverage?redirect=/creditablecoverage.

Note that this participant notice is related but separate from the "CMS Online Disclosure".  This reporting of the creditability of your prescription drug plan to CMS is also required within 60 days of a new plan year as well as within 30 days after any change in creditable coverage status.

CAA Gag Clause Attestation Deadline 
(for health plans and/or standalone or carve out benefits which include access to a provider network)

Health plans and insurers are required to submit their annual Gag Clause Prohibition Compliance Attestation (GCPCA) by December 31, 2025.  While most fully insured health plans will be able to rely on their insurers to submit the GCPCA on the plan’s behalf, self-funded and level funded group health plans will need to enter into a written agreement with their TPA to handle it for them (if that is a service their TPA is willing to provide).  In cases where health plans enter into contracts with providers directly, the employer/plan sponsor may need to submit the GCPCA themselves.  This includes standalone and carve-out health-related benefits, including Behavioral Health Plans, Telehealth Plans, Direct Primary Care programs, transplant programs, Specialty Rx Plans, and EAPs and Employer Wellness Programs that provide significant medical care.

Plans that are not subject to attestation requirements include ICHRAs, HRAs, FSAs, HSA bank accounts, HIPAA Excepted Benefits (such as standalone dental/vision/LTC plans, most Cancer/Critical Illness worksite benefits, on-site medical clinics, and EAPs and Employer Wellness Programs that do not provide significant medical care).  It also does not apply to stop-loss insurance nor Workers Compensation benefits.

Deadline for Missing or Corrected Names/SSNs
(for employers who file IRS Form 1095-series forms)

Employers who submit 1095-series and other IRS forms with an incorrect name or SSNs (e.g., discovered after receiving an IRS ‘mismatch error’ notice) are subject to a $50 per-instance IRS penalty unless they can document their reasonable efforts to obtain it.  Upon notification of a mismatch, a formal follow-up request must be made to the primary insured no later than December 31 of the year in which the mismatch is discovered (automatically extended to January 31 if the relationship begin in the month of December).  If no response is received and the record is still incorrect, the corrected name/SSN must be requested yet again, this time no later than Dec. 31 of the following year.

Other deadlines may be approaching for your plan.