Key Compliance Changes in 2024: What Brokers Need to Know

Quick look: Each new year brings new compliance changes. When it comes to benefits, brokers must balance offering what clients want with ensuring they’re in accordance with requirements. Here are highlights of what changes brokers should be aware of in 2024 and how a PEO partner can help ease the transition.

Keeping up with compliance is a necessary part of benefit planning. Whether it involves reform regarding implementation, filing, or reporting duties, it’s up to brokers to be current on the latest. As benefit trends and employee demands continue to shape the industry, so do changes required by law.

Here’s a look at key compliance updates for 2024, and how a professional employer organization (PEO) partner can help brokers and their clients confidently move forward.

New proposed ruling regarding the MHPAEA

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) mandates parity between mental health/substance use disorder benefits and medical/surgical benefits. With the proposed ruling, there’s a focus on ensuring the application of Non-Quantitative Treatment Limitations (NQTLs) on mental health benefits is not more stringent than on medical/surgical benefits.

This requires detailed documentation and comparative analysis by group health plans and health insurance issuers​ to demonstrate such parity. However, based on a congressional report reviewing over 200 NQTLs, it revealed none met with regulator expectations.

Therefore, the newly proposed rule (expected to take effect on January 1, 2025) is written to clarify requirements to strengthen the enactment of the MHPAEA with punitive action for those failing to comply. 

Changing IRS and ACA thresholds

The IRS has reduced the electronic filing threshold from 250 forms to 10 forms in aggregate, affecting the filing of various forms including Forms 1094 and 1095. This means nearly all employers will need to file electronically, which is a significant change from previous years​​, which allowed forms to be mailed in.

Due to the drastically lower threshold, it’s advisable for all employers to calculate how many total IRS forms will be filed in 2024. Also, clients who have largely filed by mail in the past should register to e-file with the IRS to make the process more seamless.

An additional threshold change involves the Patient Protection and Affordable Care Act (ACA). ACA mandates affordable health coverage for full-time employees which meets minimum value requirements. This threshold is updated annually, and has decreased in 2024 to 8.39% from 9.12% in 2023.

While this threshold is applicable to larger employers, it’s still beneficial for all businesses to review their offerings to ensure they are in compliance as they grow.

Update to price comparison tools and cost-sharing estimators

Under the Transparency in Coverage (TiC) rule, health plans or issuers must now provide internet-based, self-service tools for price comparison and cost-share estimators. Initially, these tools were required to cover 500 specific healthcare services, but starting in 2024, they must include all covered items and services​​.

With the changes come a need for employee education for how to use the tools available. The goal of price comparisons is to help both employers and employees in controlling costs for benefits relevant to a given work population. Making decision-making information readily accessible continues to be part of the larger conversation in providing healthcare equity.

Marketplace and qualified health plan (QHP) changes

There are updates to the rules for enrollees with QHPs, new Special Enrollment Periods (SEPs) for loss of Medicaid/CHIP, changes to plan display error SEPs, and modifications in how ages are calculated for stand-alone dental plans. Additionally, all individual market QHPs and small business health option program (SHOP) plans must meet network adequacy and essential community provider standards​​​​.

Furthermore, numerous bipartisan health care proposals may affect transparency of Pharmacy Benefit Managers’ (PBMs) business practices, provider competition, access to telehealth and mental healthcare, and changes to employers’ ACA reporting duties. While many of these provisions are not expected to take effect until after 2024, brokers should stay informed as the legislative process evolves​​.

Preparing for compliance reform with the help of a PEO

Overall, compliance regulations in 2024 focus on enhancing healthcare affordability, expanding provider availability, simplifying consumer choice, and improving the enrollment process. This includes updates to risk adjustment models and requirements for agents and brokers, aiming to enhance overall program integrity​​.

These reforms and new requirements underscore the importance of brokers as advisors, helping clients navigate the evolving landscape of healthcare legislation and compliance. A PEO partner plays a crucial role in helping brokers and their clients stay compliant with healthcare changes while also optimizing their benefit options. This assistance is particularly valuable given the complexity and frequent updates in healthcare laws and regulations.

PEOs can act as an intermediary between businesses and insurance brokers, ensuring the healthcare plans offered align with current legal requirements and are beneficial for both employers and employees. With a collaborative, people-first approach, a PEO partner like ExtensisHR offers an all-encompassing HR solution with compliance-specific services including:

• Employer Protection Program (EPP)
• Risk management and workplace safety
• State unemployment insurance and management
• Workers’ compensation insurance

Through decades of HR expertise, administrative support, educational resources and training, and ongoing support and updates, ExtensisHR provides the oversight and implementation brokers and their clients need to stay protected. By minimizing potential risks and being diligent about compliance, it frees up time and pressure for employers to focus on other areas of development.

This is an addition to a full suite of HR services which include benefit administration, payroll management, recruitment and retention, and more. Plus, proprietary, mobile-first HR technology gives business leaders secure access and innovative reporting tools to manage HR tasks. By bridging the connection between businesses and a PEO partner, brokers can play an impactful part in helping their clients grow.

As a broker-friendly PEO, we are focused on supporting your efforts in providing clients full-service, cost-friendly benefit solutions.

Learn more about how ExtensisHR can help drive your business forward. Contact our team of HR experts today.