2021 Open Enrollment/ Employee Benefit Changes
Group health plan sponsors need to be aware of the changes affecting the design and administration of health plans beginning on or after January 1, 2021. As always, RBN is a resource for you for information, plan changes, and required compliance.
Plan Design Changes
ACA Affordability Standard:Under the ACA’s employer shared responsibility rules, most organizations with 50+ more full-time equivalent employees are required to offer minimum value health coverage to their full-time employees and dependent children or risk paying a penalty. Under the ACA, health coverage is considered affordable if the employee’s required contribution to the plan does not exceed 9.83% of the employee’s household income for the tax year.
Out-of-Pocket Maximum:Non-grandfathered health plans are subject to limits on cost sharing for essential health benefits (EHB). The annual limit on total enrollee cost sharing for EHB for plan years beginning on or after January 1, 2021, is $8,550 for self-only coverage and $17,100 for family coverage. For 2021 plan years, the out-of-pocket maximum limit for HDHPs is $7,000 for self-only coverage and $14,000 for family coverage.
Preventive Care Benefits: The ACA requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements for the services. Health plans are required to adjust their first-dollar coverage of preventive care services based on the latest preventive care recommendations.
Health FSA Contributions: The ACA imposes a dollar limit on employees’ salary contributions to a health flexible spending account (FSA) offered under a cafeteria plan. The IRS has not yet announced the health FSA limit for 2021 plan years. RBN will keep you posted.
HDHP & HSA Limits for 2021: The HSA contribution limits will increase effective January 1, 2021, while the HDHP out-of-pocket limit will increase effective for plan years beginning on or after January 1, 2021.
Type of Limit | 2020 | 2021 | Change | |
HSA Contribution Limit | Self-Only | $3,550 | $3,600 | Up $50 |
Family | $7,100 | $7,200 | Up $100 | |
HSA Catch-up Contributions (not subject to adjustment for inflation) | 55+ | $1,000 | $1,000 | No Change |
HDHP Minimum Deductible | Self-Only | $1,400 | $1,400 | No Change |
Family | $2,800 | $2,800 | No Change | |
HDHP Maximum Out-of-pocket Expense Limit (deductibles, copayments & other amounts, but not premiums) | Self-Only | $6,900 | $7,000 | Up $100 |
Family | $13,800 | $14,000 | Up $200 |
Wellness Plan Design & ADA Compliance: If you sponsor a wellness program that asks for health information or includes medical exams, you should carefully review any incentive associated with the program. If the EEOC issues proposed wellness rules before the start of the 2021 plan year, RBN will keep you posted.
Notices & Disclosures to Include:
- CHIP Notice
- CHIPRA Notice
- Grandfathered Plan Notice
- HIPAA Opt-out for Self-funded,
- Non-federal Governmental Plans
- HIPPA Privacy Notice
- Initial COBRA Notice
- Medicare Part D Notice(s)
- Michelle’s Law Notice
- Notice of HIPPA Special Enrollment Rights
- Notice of Patient Protections
- Summary Annual Report
- Summary Plan Description
- Wellness Program Notices
- WHCRA Notice
HR EMPLOYEE COMMUNICATIONS TO SEND BEFORE 2021:
Employee Contact Information: Verify and/or update employee contact information. Correct employee addresses and contact information are needed for W-2s and ACA forms.
PTO Balances: If your organization rolls over unused paid time off, verify employees know how much time they have and how much time can be rolled over to 2021. Remind employees of the company’s policies with time off benefits and expectations for next year.
Benefits Elections: If your organization has a 1/1 effective date, make sure all employees have completed their elections by the end of the year.
FSA Information: If your employees have flexible spending accounts, remind them to submit all receipts by the end of the year.
HSA Contributions: There are new contribution limits for Health Savings Accounts in 2021. Remind your employees to update their contributions.
RBN as a Resource
RBN is a resource for you and your company for open enrollment and employee benefit packages. We will work with you to design an offering package that best suits your unique needs. Additionally, we will make sure your plan is in compliance with all updates