ThinkTank | 2019 Health Plan Deadlines

Employers must comply with numerous reporting and disclosure requirements throughout the year in connection with their group health plans. This Compliance Overview explains key 2019 compliance deadlines for employer-sponsored group health plans. It also outlines group health plan notices that employers must provide annually. Often, employers furnish these notices with the plan’s enrollment materials during its annual open enrollment period.

Some of the compliance deadlines summarized below are tied to a group health plan’s plan year. For these requirements, the chart below shows the deadline that applies to calendar year plans. For non-calendar year plans, these deadlines will need to be adjusted to reflect each plan’s specific plan year.

Determining the Plan Year
The “plan year” is the calendar, policy or fiscal year on which the records of the plan are kept. Many employers operate their group health plans on a calendar year basis, from Jan. 1 through Dec. 31 of each year. Other employers operate their plans on a non-calendar year basis, which may be consistent with the company’s taxable year or with an insured plan’s policy year.

2019 Compliance Deadlines

Deadline	Requirement	Applicability	Description
Jan. 31	Form W-2 (including health plan costs)	Employers that filed 250 or more IRS Forms W-2 for the prior calendar year	Employers that filed 250 or more IRS Forms W-2 for the prior calendar year must include, the aggregate cost of employer-sponsored health plan coverage on employees’,Forms W-2. This reporting is optional for employers that had to file fewer, than 250 Forms W-2 for the prior calendar year. Employers must file Forms W-2,with the Social Security Administration and furnish Forms W-2 to employees by,Jan. 31 of each year, unless an extension applies.
Feb. 28	Section 6056 reporting (paper filing deadline)	Employers that are ALEs and sponsor fully insured, health plans	Internal Revenue Code (Code) Section 6056 requires applicable large employers (ALEs) with fully insured health plans to report information about the health plan,coverage to the IRS each year, using IRS Forms 1094-C and 1095-C.,The deadline for filing paper versions of the forms with the IRS is Feb. 28,,2019; the deadline for electronic filing is April 1, 2019.
Feb. 28	Section 6055 reporting (paper, filing deadline)	Employers that are not ALEs and sponsor, self-insured health plans	Code Section 6055 requires employers with self-insured health plans to report information about the coverage to the IRS each year. Employers that are not ALEs use IRS Forms 1094-B and 1095-B to meet these reporting obligations. The deadline for filing paper versions of the forms with is Feb. 28, 2019; the deadline for electronic filing is April 1, 2019.
Feb. 28	Sections 6055/6056 reporting, (paper filing deadline)	Employers that are ALEs and sponsor self-insured, health plans	Code Sections 6055 and 6056 require ALEs that sponsor self-insured health plans to,report information about the coverage to the IRS each year, using IRS Forms 1094-C,and 1095-C. The deadline for filing paper versions of the,forms is Feb. 28, 2019; the deadline for electronic filing is April 1, 2019.
March 1 *calendar year plans	Medicare Part D disclosure to CMS	Group health plans that provide prescription drug coverage to individuals who are eligible for Medicare Part D	Group health plan sponsors that provide prescription drug coverage to Medicare Part D-eligible individuals must disclose to the Centers for Medicare & Medicaid Services (CMS) whether prescription drug coverage is creditable or non-creditable. In general, a plan’s prescription drug coverage is creditable if its actuarial value equals or exceeds the actuarial value of the Medicare Part D prescription drug coverage. Plan sponsors must make the disclosure annually and at other select times, using CMS’ online disclosure form. Plan sponsors must submit the annual disclosure to CMS within 60 days after the beginning of the plan year. For calendar year plans, the deadline is March 1, 2019.
March 4	Section 6056 individual statements	Employers that are ALEs and sponsor fully insured health plans	Code Section 6056 requires ALEs with fully insured health plans to provide information about health plan coverage to their full-time employees each year, using IRS Form 1095-C. The forms must be provided to employees on or before Jan. 31; however, the IRS extended the deadline for 2018 employee statements, from Jan. 31, 2019, to March 4, 2019.
March 4	Section 6055 individual statements	Employers that are not ALEs and sponsor self-insured health plans	Code Section 6055 requires employers with self-insured health plans to provide information about the coverage to enrolled employees each year. Employers that are not ALEs use IRS Form 1095-B to provide this health coverage information, generally on or before Jan. 31. However, the IRS extended the deadline for furnishing 2018 employee statements, from Jan. 31, 2019, to March 4, 2019.
March 4	Sections 6055/6056 individual statements	Employers that are ALEs and sponsor self-insured health plans	Code Sections 6055 and 6056 require ALEs that sponsor self-insured health plans to report information about the coverage to covered employees each year, using IRS Form 1095-C. In general, these forms must be provided on or before Jan. 31; however, the IRS extended the deadline for furnishing 2018 employee statements, from Jan. 31, 2019, to March 4, 2019.
April 1	Section 6056 reporting (electronic filing deadline)	Employers that are ALEs and sponsor fully insured health plans	Code Section 6056 requires applicable large employers (ALEs) with fully insured health plans to report information about health plan coverage to the IRS, using IRS Forms 1094-C and 1095-C. In general, the annual deadline for electronic filing is March 31; however, because March 31, 2019, is a Sunday, the deadline is April 1, 2019.
April 1	Section 6055 reporting (electronic filing deadline)	Employers that are not ALEs and sponsor self-insured health plans	Code Section 6055 requires employers with self-insured health plans to report information about the coverage to the IRS each year. Employers that are not ALEs use IRS Forms 1094-B and 1095-B to meet these reporting obligations. In general, the annual deadline for electronic filing is March 31; however, because March 31, 2019, is a Sunday, the deadline is April 1, 2019.
April 1	Sections 6055/6056 reporting (electronic filing deadline)	Employers that are ALEs and sponsor self-insured health plans	Code Sections 6055 and 6056 require ALEs that sponsor self-insured health plans to report information about the coverage to the IRS each year, using IRS Forms 1094-C and 1095-C. In general, the annual deadline for electronic filing is March 31; however, because March 31, 2019, is a Sunday, the deadline is April 1, 2019.
July 31	PCORI fee (for plan years ending in 2018)	Employers with self-insured health plans	Employers with self-insured health plans must pay an annual fee to fund the Patient Centered Outcomes Research Institute (PCORI). Self-insured health plans that are subject to PCORI fees include self-funded medical plans, as well as HRAs offered in conjunction with fully insured group medical plans. HRAs offered with self-insured group medical plans are not subject to separate PCORI fees if the HRA and the medical plan have the same plan sponsor and plan year. Employers use IRS Form 720 to report and pay PCORI fees, which are due by the July 31 of the year that follows the last day of the plan year. The PCORI fees are temporary—the fees do not apply to plan years ending on or after Oct. 1, 2019.
July 31 *calendar year plans	Form 5500 (regular deadline)	Employers with ERISA-covered group health plans that do not qualify for the small plan exemption	,Employers with ERISA-covered welfare benefit plans are required to file an annual Form 5500, unless a reporting exemption applies. The Form 5500 must be filed by the last day of the seventh month following the end of the plan year, unless an extension applies. For calendar year plans, this deadline is July 31, 2019. An employer may request a one-time extension of 2 ½ months by filing IRS Form 5558 by the normal due date of the Form 5500. If the Form 5558 is filed on or before the normal due date of the Form 5500 or 5500-SF, the extension is automatically granted. Small health plans (fewer than 100 participants) that are fully insured, unfunded or a combination of insured/unfunded, are generally exempt from the Form 5500 filing requirement.
Sept. 30	Medical loss ratio (MLR) rebates	Employers with fully insured health plans that receive MLR rebates	Issuers must spend a minimum percentage of their premium dollars, or medical loss ratio (MLR), on medical care and health care quality improvement. Issuers that do not meet the applicable MLR must pay rebates to consumers. Sponsors of insured health plans may receive rebates if their issuers did not meet their MLR. Rebates must be provided to plan sponsors by Sept. 30 following the end of the MLR reporting year. Employers that receive rebates should consider their legal options for using the rebate. Any rebate amount that qualifies as a plan asset under ERISA must be used for the exclusive benefit of the plan’s participants and beneficiaries. Also, as a general rule, plan sponsors should use the rebate within three months of receiving it to avoid ERISA’s trust requirements. Plan sponsors that receive a rebate prior to Sept. 30 may need to adjust their deadline for using the rebate.
Sept. 30 *calendar year plans	Summary annual report (regular deadline)	Group health plans that are subject to the Form 5500 filing requirement (and have not extended the Form 5500 deadline)	Employers that are required to file a Form 5500 must provide participants with a summary of the information in the Form 5500, called a summary annual report (SAR). The plan administrator generally must provide the SAR within nine months of the close of the plan year. For calendar year plans, this deadline is Sept. 30, 2019. If an extension of time to file the Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period. Plans that are exempt from the annual 5500 filing requirement are not required to provide an SAR. Large, completely unfunded health plans are also generally exempt from the SAR requirement.
Oct. 14	Medicare Part D notices	Group health plans that provide prescription drug coverage to individuals eligible for Medicare Part D	Employers with group health plans that provide prescription drug coverage must notify Medicare Part D-eligible individuals by Oct. 14 of each year about whether the drug coverage is at least as good as,Medicare Part D coverage (in other words, whether their prescription drug coverage is “creditable” or “non-creditable”). If a health plan’s open enrollment period begins on or before Oct. 14, the Medicare Part D notice may be included in the plan’s open enrollment materials. Model disclosure notices are available on CMS’ website.
Oct. 15 *calendar year plans	Form 5500 (extended deadline)	Employers with ERISA-covered group health plans that do not qualify for the small plan exemption (and have timely requested an extension to the filing deadline)	,Employers with ERISA-covered welfare benefit plans are required to file an annual Form 5500, unless a reporting exemption applies. The Form 5500 must be filed by the last day of the seventh month following the end of the plan year, unless an extension applies. An employer may request a one-time extension of 2 ½ months by filing IRS Form 5558 by the normal due date of the Form 5500. If the Form 5558 is filed on or before the normal due date of the Form 5500 or 5500-SF, the extension is automatically granted. For calendar year plans, this extended deadline is Oct. 15, 2019.
Dec. 15 *calendar year plans	SAR (extended deadline)	Group health plans that are subject to the Form 5500 filing requirement (if Form 5500 deadline was extended)	,Employers that are required to file a Form 5500 must provide participants with a summary of the information in the Form 5500, called a SAR. The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file the Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period. For calendar year plans, this extended deadline is Dec. 15, 2019. Plans that are exempt from the annual 5500 filing requirement are not required to provide a SAR. Large, completely unfunded health plans are also generally exempt from the SAR requirement.

This Compliance Overview is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.

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2019 Compliance Deadlines