Comply on the Fly

Part D Creditable Coverage Changes

M3 Insurance — Tue, 21 Apr 2026 11:00:00 GMT

CMS has issued new guidance that simplifies Medicare Part D creditable coverage disclosures for account based plans.

In this episode of Comply on the Fly, Karen Breitnauer breaks down what the 2027 changes mean for FSAs, HRAs, and ICHRAs and what plan sponsors need to do now to stay compliant as the simplified determination method also changes.

If you oversee benefits or support plan administration, this episode will help you understand what no longer applies, what still does, and where to focus now to avoid missed disclosures and compliance gaps heading into the next plan year.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Gail's Law: 2025 WI Act 103

M3 Insurance — Tue, 07 Apr 2026 11:00:00 GMT

A new Wisconsin mandate is coming, and it will require plan sponsors to take a closer look at breast cancer screening coverage starting in 2027.

In this episode of Comply on the Fly, host Karen Breitnauer walks through 2025 Wisconsin Act 103, also known as Gail’s Law. Karen explains who the law applies to, when the requirements take effect, and what types of screenings must be covered. Understand the important statutory definitions, outlines how plan designs will need to evolve, and offers a clear bottom line for employers and plan administrators preparing for 2027.

If you sponsor a Wisconsin plan, this episode provides a practical overview of what is changing, why it matters, and where to focus now to stay compliant.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

CHIPRA: Children's Health Insurance Program Reauthorization Act

M3 Insurance — Tue, 24 Mar 2026 11:00:00 GMT

In this episode of Comply on the Fly, Karen Breitnauer breaks down CHIPRA, Children's Health Insurance Program Reauthorization Act, and why it is often misunderstood. The conversation sets the foundation for understanding special enrollment rights tied to Medicaid and CHIP and what employers are responsible for communicating. If CHIPRA feels like a routine compliance task, this episode explains why it deserves more attention.

PBM Reform Part 2 - FTC Settlement Agreement

M3 Insurance — Tue, 10 Mar 2026 11:00:00 GMT

In this follow‑up episode of Comply on the Fly, host Karen Breitnauer continues the ongoing discussion around pharmacy benefit manager reform by breaking down the newly proposed settlement between Express Scripts and the Federal Trade Commission. After a month of rapid developments, this episode explains how alleged insulin price inflation led to federal action, what the FTC claims occurred within PBM rebate structures, and the significant changes Express Scripts has agreed to make.

Understand key elements of the agreement, and what is still under discussion. Hear what employers should watch as public comment continues, as the PBM landscape continues to shift, and as more changes could be coming next.

Benefits Buyer's Remorse: Compliance Reality Check

M3 Insurance — Tue, 27 Jan 2026 12:00:00 GMT

Ever have employees come to you in January already regretting their benefit elections? In this episode of Comply on the Fly, Karen breaks down the very real phenomenon of benefits buyer’s remorse—when employees realize that low premiums can mean higher out-of-pocket costs and suddenly want a do-over. From Section 125 qualifying events (and what doesn’t count) to mid-year plan changes, self-funded vs. fully insured flexibility, and why “I don’t like this plan” isn’t a compliance strategy, this episode explains what employers can—and can’t—do once coverage is in effect. A timely reminder that strong open enrollment education can prevent a lot of January regret.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Understanding HIPAA

M3 Insurance — Tue, 10 Feb 2026 12:00:00 GMT

A key HIPAA compliance deadline is coming: self-funded plan sponsors must update their Notice of Privacy Practices by February 16, 2026. In this episode of Comply on the Fly, understand what that deadline means for employers who sponsor self-funded health plans, including self-funded medical or dental plans, HRAs and ICHRAs, and medical FSAs. Karen breaks down when employers are responsible for providing a Notice of Privacy Practices, how often it must be distributed, and what new disclosures are required under updated 42 CFR Part 2 rules related to substance use disorder records.

Understand what’s changing, where compliance gaps often exist, and how to update notices before the deadline—without unnecessary complexity.

One Big Beautiful Bill Act and Employee Benefits

M3 Insurance — Tue, 29 Jul 2025 13:00:00 GMT

On this episode of Comply on the Fly, host Karen B unpacks the employee benefits provisions in the newly signed “One Big Beautiful Bill Act” (OBBBA), a sweeping piece of legislation with implications for health savings accounts (HSAs), dependent care FSAs, and Marketplace plan eligibility.

The OBBBA revives and expands key benefits provisions that had expired or been under debate, including first dollar coverage for telehealth, the integration of Direct Primary Care (DPC) arrangements with HSA eligibility, and changes to Marketplace HDHP rules. It also raises the contribution cap for dependent care FSAs starting in 2026.

If you sponsor high-deductible health plans, offer telehealth or direct primary care options, or administer dependent care FSAs, this episode is a must-listen for understanding how the OBBBA could impact your benefit offerings.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Minnesota Paid Leave

M3 Insurance — Tue, 23 Sep 2025 11:00:00 GMT

Minnesota’s new paid family and medical leave law takes effect January 1, 2026. If you have employees in the state, you’ll need to act. This COTF episode features M3’s Alex O’Connor, to break down what employers need to know: compliance options, premium costs, deadlines, and how to prepare your team.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 5: OSHA COVID-19 Mandate ETS

M3 Insurance — Tue, 09 Nov 2021 14:14:04 GMT

So, what about that vaccine mandate? This episode covers information around this ETS as of 11/7/21. On 11/4/21 the Occupational Safety and Health Administration (OSHA) released its emergency temporary standard (ETS), mandating COVID-19 vaccinations/testing in private employer organizations with 100 or more employees. Get the answer to this question in under four minutes in this episode of Comply on the Fly. Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 7: OSHA ETS Vaccination Mandate - Stays & Legal Challenges

M3 Insurance — Tue, 23 Nov 2021 11:45:00 GMT

What is the current status of the legal challenges to OSHA's ETS, or Emergency Temporary Standard, regarding vaccinations and testing/masking for private employers with 100 or more employees? Get the answer in under four minutes in this episode of Comply on the Fly, which covers the current (as of 11/18/21) legal status of the OSHA ETS and what it means for employers.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep44: Medicare Part D - Notice of Creditable or Non-Creditable Coverage

M3 Insurance — Tue, 19 Sep 2023 10:45:00 GMT

What is the Medicare Part D Creditable or Non-Creditable Coverage Notice, who do I need to provide it to, and how?

This episode of Comply on the Fly covers Medicare Part D Creditable or Non-Creditable Coverage Notices, which must be provided prior to the start of the annual Medicare Part D open enrollment period on October 15th every year.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions. Season 2 of Comply on the Fly focuses on actual client questions, so send your compliance question to AskKarenB@m3ins.com and we'll do our best to cover it in an upcoming episode!

S3-Ep14: 2024 PCORI Fees

M3 Insurance — Tue, 21 May 2024 10:45:00 GMT

2024 PCORI fees. What are they and how do I pay them?

It's the perfect time to discuss how and where to pay the PCORI Fees, which are due annually on July 31st. If you sponsor a self-funded health plan or an HRA integrated with a fully insured plan, tune in to this episode of Comply on the Fly to learn about your IRS payment obligations.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Medicare Part D Disclosure

M3 Insurance — Tue, 24 Sep 2024 12:00:00 GMT

This episode of Comply on the Fly dives into an important, timely issue: Medicare Part D’s creditable coverage notices and the significant updates for employers this year. Karen B breaks down how to determine if your drug plan meets Medicare Part D standards and explains the compliance impacts of the 2022 Inflation Reduction Act. She also covers key deadlines, creditability assessment methods, and practical tips to ensure your Medicare-eligible employees receive the proper notices. Tune in for a clear guide to help you stay compliant this Medicare season.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

NQTL Comp Analysis

M3 Insurance — Tue, 22 Oct 2024 12:00:00 GMT

In this episode of "Comply on the Fly," Karen B breaks down the critical topic of mental health parity and the comparative analysis requirement under the Mental Health Parity and Addiction Equity Act (MHPAEA). Learn how this regulation guarantees equal treatment for mental health benefits and what steps employers must take to remain compliant and avoid penalties. With new rules kicking in for 2025, tune in for the essential guidance you need to stay ahead.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2025 FSA Limit and IRS Notices

M3 Insurance — Tue, 05 Nov 2024 13:00:00 GMT

Recent IRS updates have impacted 2025 contribution limits for flexible spending and transportation benefits. In this episode of Comply on the Fly, host Karen B breaks down these updates, new eligible expenses, and expanded preventive care options—all of which affect plan design and employee communications. Listen in to make informed decisions on plan adjustments, ensuring compliance and optimizing benefits for your employees.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2024 Wrap and 2025 Reminders

M3 Insurance — Tue, 17 Dec 2024 12:00:00 GMT

As 2024 winds down, this episode of Comply on the Fly helps you gear up for 2025. Host Karen recaps the year's key compliance highlights and previews what lies ahead, including potential last-minute regulatory shifts with a new administration taking office. Explore critical topics like mental health parity requirements, important deadlines for self-funded health plans, and legislative updates on ACA 1095 forms. Stay informed and prepared for the compliance challenges of the new year!

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions. 

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

ACA Reporting Changes

M3 Insurance — Tue, 14 Jan 2025 13:00:00 GMT

Two recently signed bills are bringing much-needed relief for employers navigating ACA reporting. In this episode of Comply on the Fly, Karen B breaks down the latest updates that simplify compliance and reduce administrative headaches. Learn how the new laws provide more flexibility in distributing 1095-B and 1095-C forms and extend deadlines for responding to penalty letters. These changes could save you time, help you avoid penalties, and make staying compliant easier than ever. Tune in to discover how these updates can streamline your ACA reporting process!

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

5500 Filings

M3 Insurance — Tue, 28 Jan 2025 17:00:00 GMT

Keeping your business compliant with ERISA requirements isn’t just about checking a box—it’s about safeguarding your employees and your organization from unnecessary risks. In this episode of Comply on the Fly, we dive into a critical topic every employer needs to know: Form 5500 filing for health and welfare benefit plans under ERISA. If your plans have over 100 participants, this requirement is non-negotiable. Tune in as we break down what it means, what’s required, and how to stay ahead of compliance deadlines.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

ACA Penalty Calculations

M3 Insurance — Tue, 11 Feb 2025 12:00:00 GMT

In this episode of Comply on the Fly, Karen dives into the timely topic of ACA affordability and why employers should prioritize analyzing their coverage offers early. With 2024 reporting season upon us, Karen breaks down how to calculate affordability using federal poverty levels or wages, offering real-world examples to guide decisions. Learn how to ensure compliance and avoid unnecessary expenses while making informed decisions that support your employees’ well-being and your bottom line.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Annual Gag Clause Attestation Requirements

M3 Insurance — Tue, 04 Nov 2025 21:10:21 GMT

In this episode of Comply on the Fly, host Karen B. breaks down the annual Gag Clause Attestation requirement due by December 31 and the latest guidance from federal departments.

Understand how new FAQs clarify what counts as a prohibited gag clause—from downstream agreements and discretionary disclosures to limits on data access—and what plan sponsors should do if such clauses exist in their contracts.

Tune in for a concise, practical overview to help your organization stay compliant and avoid enforcement risks.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep35: COVID-19 Coverage & HDHPs

M3 Insurance — Tue, 04 Jul 2023 10:45:00 GMT

Can I continue to offer COVID-19 testing and treatment under my HSA, or Health Savings Account compatible high deductible health plan, or HDHP, now that the national emergency and public health emergency is over?

This Comply on the Fly episode covers guidance issued recently by the IRS in Notice 2023-37, which modifies how COVID-19 testing and treatment coverage works in regard to High Deductible Health Plan (HDHP) deductibles.

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Ep 9: 1095C Deadline Extension - ACA Reporting

M3 Insurance — Tue, 07 Dec 2021 12:30:00 GMT

Did the IRS recently extend the ACA reporting deadline? In a previous episode of Comply on the Fly, we told you that the IRS and Department of Treasury had not issued any extensions and to plan accordingly. However, very recently, the IRS issued proposed regulations permanently extending the date by which employers must provide the 1095C to employees. This episode covers what has changed and what it means for you as an employer.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 28: Health Coverage Opt-Out Arrangements

M3 Insurance — Tue, 26 Apr 2022 10:45:00 GMT

Can I offer cash to my employees who waive health insurance?

Opt-out arrangements allow employers to provide cash to an employee who waives group health plan coverage. This episode of Comply on the Fly covers what employers need to know about 'cash-in-lieu' of coverage arrangements.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 37: COBRA Notice of Unavailability

M3 Insurance — Tue, 28 Jun 2022 10:45:00 GMT

I've never heard of the COBRA Notice of Unavailability - can you tell me what this is?

Though many employers are unware of the COBRA Notice of Unavailability, it is a required notice and included on the document request for DOL audits. This episode of Comply on the Fly covers what employers need to know about it providing this notice to employees.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-E25: COBRA, Medicare, and Dependents - Refresher Episode

M3 Insurance — Tue, 25 Apr 2023 10:45:00 GMT

Is COBRA offered to a spouse and dependents if an employee enrolls in Medicare?

This refresher episode of Comply on the Fly explains why an employee voluntarily terminating their coverage to enroll in Medicare causes any spouse or dependents on their plan to lose coverage with no COBRA rights.

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S2 Ep10: FMLA - Intermittent Leave Tips

M3 Insurance — Tue, 10 Jan 2023 11:35:00 GMT

Are there any guidelines or best practices around how to identify possible intermittent FMLA situations or when supervisors should notify HR of a potential need?

Intermittent leave tends to be one of the most difficult things for employers to deal with in regards to FMLA. This episode of Comply on the Fly offers tips for identifying and managing intermittent FMLA leave.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep32: 2023 PCORI Fees

M3 Insurance — Tue, 13 Jun 2023 10:45:00 GMT

What is the PCORI fee for this year and how do I pay it?

This episode of Comply on the Fly covers the 2023 PCORI fees. These fees are paid annually and are due by July 31st, so it is a perfect time to discuss how the fees apply and where to pay them.

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S3-Ep1: 2024 FSA Limits

M3 Insurance — Tue, 14 Nov 2023 11:45:00 GMT

Has the IRS released the new FSA limits for 2024?

As we kick off the third season of Comply on the Fly, Karen B. covers the recently released IRS Revenue Procedure 2023-34 which officially increased the maximum health flexible spending or FSA contribution limit for calendar year 2024. Tune in to find out the new FSA limits for 2024.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions. Email your compliance question to AskKarenB@m3ins.com and we'll do our best to cover it in an upcoming episode!

S2-Ep34: Special Enrollment Options

M3 Insurance — Tue, 27 Jun 2023 10:45:00 GMT

I'm an employer that offers health benefit plan options. An employee would like to add his dependent child to the plan mid-year due to a loss of coverage under the spouse's plan. The employee is currently enrolled in our high deductible health plan option, but would like to switch to the HMO copay option when he enrolls his dependent. Is the employee allowed to switch plan options midyear due to the qualifying event?

This Comply on the Fly answers an employer's question about coverage changes during a special enrollment event, as required under HIPAA.

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S2-Ep36: FMLA & Serious Health Condition Definition

M3 Insurance — Tue, 11 Jul 2023 10:45:00 GMT

How do I know if an employee's situation qualifies as a serious health condition for FMLA purposes?

This Comply on the Fly dives into how FMLA defines a serious health condition to help employers understand when their employees qualify for leave.

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S2-Ep37: ERISA Document Delivery

M3 Insurance — Tue, 18 Jul 2023 10:45:00 GMT

How can I provide the Summary Annual Report, or SAR, to my plan participants??

This Comply on the Fly covers the three approved delivery methods for ERISA required documents so employers can choose the most effective method for their employee population.

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S2-Ep38: 2023 PCORI Fees Reminder

M3 Insurance — Tue, 25 Jul 2023 10:45:00 GMT

What is the PCORI fee for this year and how do I pay it?

With the 2023 PCORI fees due July 31st, this episode of Comply on the Fly reminds employers how the fees apply and where to pay them. This is a refresher of the episode that aired on 6.13.23.

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S2-Ep39: Section 105h Non-Discrimination Testing

M3 Insurance — Tue, 01 Aug 2023 10:45:00 GMT

What is Section 105h Non-discrimination Testing, and does it apply to me?

Non-discrimination requirements and testing can be very confusing. This Comply on the Fly episode clarifies Section 105h of the Internal Revenue Code.

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S2-Ep41: COBRA & Health FSAs

M3 Insurance — Tue, 22 Aug 2023 10:45:00 GMT

What are the requirements for offering COBRA for a Health Flexible Spending Account, also known as an FSA?

Health FSAs are considered group health plans and therefore you are required to offer COBRA upon the occurrence of a COBRA qualifying event, however the offer of COBRA can be limited for FSAs. This episode of Comply on the Fly covers the conditions around extending offers of COBRA for Health FSAs.

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S2-Ep42: ACA Affordability 2024 Percentage

M3 Insurance — Tue, 29 Aug 2023 10:45:00 GMT

Has the Affordable Care Act affordability calculation percentage for 2024 been released yet?

The IRS recently released Revenue Procedure 2023-29 decreasing the affordability calculation to 8.39% for 2024. This Comply on the Fly helps employers understand if this decreased rate will require them reduce employee contribution amounts in order to meet ACA affordability in 2024.

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S2-Sp46: Open Enrollment Notices

M3 Insurance — Tue, 17 Oct 2023 10:45:00 GMT

Can you remind me of the notices I need to provide during open enrollment?

In this Comply on the Fly Karen B. covers which notices employers are required to include in the open enrollment materials they provide to their employees. Even if it is not your organization's open enrollment season, this episode is a good refresher regarding notices you need to provide.

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S2-Ep 47: Section 125 + Other Employer Qualifying Events

M3 Insurance — Tue, 24 Oct 2023 10:45:00 GMT

I have an employee who wants to switch to her spouse's plans as it is open enrollment time at her spouse's employer. Can she drop our coverage and make the switch?

In this Comply on the Fly Karen B. discusses a situation where an employee wants to move onto their spouse's benefit plan during the spouse's open enrollment period. There is particular focus on how to handle the employee's Section 125 pre tax premium elections in a situation like this.

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Minnesota Paid Leave FAQs

M3 Insurance — Thu, 20 Nov 2025 16:41:17 GMT

Since Minnesota first announced its Paid Leave program, Comply on the Fly has been sharing resources to help employers prepare. In this episode, Karen B and Compliance Attorney Alex O’Connor tackle the most common questions coming in as we approach the 2026 go-live date.

They cover how PTO, vacation, sick leave, and short-term disability interact with the new benefits, what employers need to know about “topping off,” private plan exception timelines, required notices, and how Minnesota Paid Leave coordinates with FMLA.

If you’re looking for quick, practical answers and clarity on what’s surfaced most often so far, this episode is a must-listen.

S3-Ep2: Does a New Spousal Surcharge Enact Special Enrollment?

M3 Insurance — Tue, 28 Nov 2023 11:45:00 GMT

Does a newly implemented spousal surcharge on one spouse's plan provide an special enrollment opportunity move to the other spouse's plan if the open enrollment periods do not coincide?

In this episode of Comply on the Fly, Karen B. discusses the nuances of special enrollment eligibility. Tune in to find out if the implementation of a new spousal surcharge would classify as a Section 125 qualifying event for special enrollment.

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S3-Ep3: ACA Reporting Update - 1094 + 1095 Form Filing for the 2023 Calendar Year

M3 Insurance — Tue, 12 Dec 2023 11:45:00 GMT

In preparing for 2023 end of year reporting, are there any changes to the Affordable Care Act (ACA) 1094 and 1095 form reporting requirements to consider?

This year the IRS is requiring that most employers file their 1094 and 1095 forms electronically. Tune in to this episode of Comply on the Fly as Karen B. covers the details of new filing requirements to learn if they impact you.

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S3-Ep6: Handling Missed PCORI Fee Payments

M3 Insurance — Tue, 23 Jan 2024 11:45:00 GMT

We've missed payment of our PCORI fees, how do we reconcile this error?

If your organization missed the annual July 31st deadline for filing payment of PCORI fees, tune in to this Comply on the Fly to hear what steps need to be taken to bring you back into compliance.

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S3-Ep4: Does the FMLA 12-month Period Reset on January 1st?

M3 Insurance — Tue, 26 Dec 2023 11:45:00 GMT

Federal FMLA allows for 12 weeks of leave in a 12-month period. Is employee eligibility renewed to a full 12 weeks on January 1st of the new year?

The answer to this question depends on whether your organization measures the 12-month FMLA period based on the calendar-year, fixed-year, forward-looking, or rolling method. Tune in to this Comply on the Fly to learn more.

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S3-Ep5: Affordability Coding for 1095-C Forms

M3 Insurance — Tue, 09 Jan 2024 11:45:00 GMT

What is the right affordability coding to use on 1095-C forms to accurately show that an employer has offered affordable coverage to their full time employees?

Failure to properly complete the 1095-C forms you file with the IRS can result in unnecessary penalties. Tune in to this Comply on the Fly to learn the right codes to use, and the right places to use them, to accurately reflect the offers of affordable coverage you have made to your employees.

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S3-Ep7: Medicare Part D Annual CMS Reporting

M3 Insurance — Tue, 06 Feb 2024 11:45:00 GMT

When is the Medicare Part D reporting that must be done on an annual basis to the Centers for Medicare and Medicaid Services (CMS) due?

Completion the Annual Medicare Part D reporting is required within 60 days of the start of the plan year. So, if your health plan aligns with the calendar year, be prepared to handle the reporting in January or February by tuning in to this episode of Comply on the Fly.

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S3-Ep9: HSAs & Medicare - Refresher Episode

M3 Insurance — Tue, 05 Mar 2024 11:45:00 GMT

Can our Medicare eligible employees contribute to an HSA? Or can we, as the employer continue to contribute to the HSA of a Medicare eligible employee?

The relationship between Medicare and HSAs is confusing, but this refresher episode of Comply on the Fly reminds employers of what they need to know.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep43: ACA Affordability - Calculation + Penalty Exposure

M3 Insurance — Tue, 12 Sep 2023 10:45:00 GMT

After doing the ACA affordability calculation for 2024, are all ALE's (Applicable Large Employers) required to make coverage affordable for all full-time employees?

This Comply on the Fly helps employers understand how to calculate ACA affordability in 2024 and determine their potential penalty exposure if they are not able to offer affordable coverage to all of their full time employees.

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Ep 1: Medicare Part D Notices

M3 Insurance — Tue, 12 Oct 2021 14:25:00 GMT

What is the Medicare Part D creditable or non-creditable coverage notice, who do I need to provide it to, and how?

Get the answer to this question in just three and a half minutes in this episode of Comply on the Fly. Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2025 HSA and HDHP Information

M3 Insurance — Tue, 18 Jun 2024 11:00:00 GMT

The IRS issued the limits for 2025 on HSAs and the associated HDHPs. Understand the new contribution limits and compliance requirements that will impact your healthcare planning. This latest episode of COTF breaks down the key changes, providing essential insights for employers and employees to maximize their benefits and ensure compliance with the latest regulations.

2025 Open Enrollment Reminders

M3 Insurance — Tue, 07 Oct 2025 16:36:15 GMT

In this episode of Comply on the Fly, host Karen Breithnauer shares key reminders for employers during open enrollment, including required notices like HIPAA, CHIPRA, and Medicare Part D. It’s a quick, must-listen for HR professionals, benefits administrators, and compliance leads looking to avoid costly oversights. In under five minutes, Karen breaks down the most important federal compliance tasks into a clear checklist, complete with practical timing reminders and updates to affordability thresholds.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2026 ACA Affordability Percentage

M3 Insurance — Tue, 12 Aug 2025 10:00:00 GMT

Big changes are coming for employers in 2026. In this episode, Karen breaks down the latest update to Affordable Care Act (ACA) rules, including the new IRS affordability percentage that could impact your health plan strategy.

If you're an applicable large employer with 50 or more full-time employees, this matters. Falling short of affordability requirements could lead to significant penalties per employee.

Learn what the new percentage means, how to apply safe harbors, and what steps to take now to stay compliant and avoid costly consequences.

Tune in and get ahead of the changes.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 46: Benefit Eligibility Pointers

M3 Insurance — Tue, 30 Aug 2022 10:45:00 GMT

How many hours can an employee work and still be eligible for benefits? We have a full time employee, but this employee has only been working 25 hours per week for the past few months.

While there are no simple answers to determining benefit eligibility for certain employees, this episode of Comply on the Fly offers pointers on how to look at your policy documents to determine benefit eligibility in atypical situations.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 18: HSAs - Individual Accounts for Dependents

M3 Insurance — Tue, 15 Feb 2022 11:45:00 GMT

Can a dependent of an employee open their own HSA or health savings account?

Individuals who meet certain criteria and coverage conditions are eligible to establish and contribute to their own HSA (Health Savings Account). This episode of Comply on the Fly helps employer plan sponsors understand if and when a dependent of an employee may be eligible for their own HSA.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

COTF: ERISA 5500 Refresher

M3 Insurance — Tue, 30 Jul 2024 12:00:00 GMT

If you are a private sector employer, ERISA SPDs and the required 5500s are an important part of remaining compliant with your federal obligations and avoiding unnecessary fees. This refresher episode of Comply on the Fly covers the basics of ERISA 5500 compliance.

S2-Ep31: 2024 HSA Limits for High Deductible Health Plans

M3 Insurance — Tue, 06 Jun 2023 10:49:00 GMT

Have the 2024 HSA or health savings account limits been released yet?

This episode of Comply on the Fly details the new released 2024 single and non-single HSA and high deductible health plan limits.

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PBM Reform Part 1 - CAA 2026/DOL proposed rules

M3 Insurance — Tue, 24 Feb 2026 20:35:51 GMT

What if the entire PBM landscape shifted before your next renewal, and you didn’t see it coming?

In this episode of Comply on the Fly, Karen B. breaks down a whirlwind month of PBM activity and what employers should be watching now. From new transparency proposals to fresh statutory requirements, this episode gives listeners the essential signals without the noise—perfect for busy HR and benefits professionals who need to stay sharp in a fast-changing space.

Tune in and stay ahead of the next wave of PBM changes.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 25: All About FMLA & COBRA

M3 Insurance — Tue, 05 Apr 2022 10:15:00 GMT

All about FMLA and COBRA offers. Recently, we received a question similar to this one: We have an employee out on STD and transitioning to LTD. FMLA was exhausted well out on STD. When should I offer COBRA to this employee?

This episode of Comply on the Fly helps unblur the lines between FMLA leave, COBRA eligibility and short-term and long term disability (STD/LTD) coverage.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2025 Part D Creditable Coverage

M3 Insurance — Tue, 09 Sep 2025 11:00:00 GMT

In this episode of Comply on the Fly, host Karen B. dives into an annual compliance requirement: Medicare Part D creditable coverage notices. Employers that sponsor health plans must tell Medicare eligible participants whether their prescription drug coverage is creditable, meaning it is as good as or better than Medicare Part D.

This notice helps participants avoid late enrollment penalties and must be provided each year by October 15.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 17: Special Enrollment vs. Section 125

M3 Insurance — Tue, 08 Feb 2022 11:45:00 GMT

What is the difference between special enrollment and Section 125 qualifying events?

Special enrollment quite often gets confused with Section 125 qualifying events. This episode of Comply on the Fly helps employers understand the difference.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 15: COBRA Initial Notice

M3 Insurance — Tue, 25 Jan 2022 11:55:00 GMT

What is the COBRA Initial or General Notice, and when do I need to provide it?

The COBRA Initial or General Notice is a required notice under the Consolidated Omnibus Budget Reconciliation Act and is applicable to employers with 20 or more employees. This episode covers what those employers need to know about their requirements around providing notice.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 44: COBRA Rate Change & Open Enrollment

M3 Insurance — Tue, 16 Aug 2022 10:39:00 GMT

Am I required to make premium adjustments to COBRA at any time? And how do I handle open enrollment for COBRA participants?

These are great questions as we are heading into fourth quarter, which for many is also the renewal season around calendar year plans. This is the time to look at your COBRA rates and make sure that you are making any necessary adjustments.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 20: Does COBRA need to be offered for an HRA?

M3 Insurance — Tue, 01 Mar 2022 11:40:00 GMT

Does COBRA need to be offered for an HRA?

COBRA must be offered for HRAs upon a COBRA-qualifying event. It can get rather complicated to offer COBRA for an HRA, but this episode of Comply on the Fly covers the key points of compliance.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 43: ACA 2023 Affordability Percentage Adjustment

M3 Insurance — Tue, 09 Aug 2022 10:45:00 GMT

Do you know the ACA, or Affordable Care Act, shared responsibility affordability percentage for 2023?

On August 1st, 2022, the IRS issued revenue procedure 2022-34, which included an adjusted affordability percentage for 2023. The percentage was reduced to 9.12% for 2023, a substantial decrease from the 9.61% in 2022. This episode of Comply on the Fly covers how this change will affect offers of coverage for plan years beginning on or after January 1st, 2023.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep3: ACA - Variable Hour & Full Time Employee Status

M3 Insurance — Tue, 15 Nov 2022 11:45:00 GMT

We hire many variable hour employees and we move them to full-time status when they work more than 30 hours per week. Is this correct?

In this Comply on the Fly Karen B. addresses a client concern around proper classification of employees in regard to the Affordable Care Act Shared Responsibility rules. If you are an employer subject to these ACA rules, tune in to learn how to avoid penalties for non-compliance.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 45: COBRA - Late Election Notice

M3 Insurance — Tue, 23 Aug 2022 10:45:00 GMT

I forgot to provide the COBRA election paperwork to a terminated employee several months ago. What should I do?

Failing to provide the required COBRA election notices can lead to significant consequences for non-compliance. This episode of Comply covers corrective actions to take around missed COBRA election notices.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 12: OSHA ETS Implementation of Requirements

M3 Insurance — Tue, 04 Jan 2022 12:30:00 GMT

How do I implement the testing requirement for the OSHA vaccination and testing ETS for 100 plus employers?

A great question and one that's on everyone's mind these days. This episode of Comply on the Fly covers what employers with 100 or more employees need to know to comply with the testing and masking requirements under the OSHA ETS.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep22: COBRA & Divorce

M3 Insurance — Tue, 04 Apr 2023 10:50:00 GMT

I have an employee who was recently divorced. He has removed his ex-spouse and dependents from the health coverage. In this situation, who do we send the COBRA election paperwork to?

This episode of Comply explores the nuances of COBRA-qualifying events triggered by divorce. Tune in to ensure your organization knows how to meet COBRA election paperwork provision requirements in situations of divorce.

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Ep 31: HSA - 2023 Limits

M3 Insurance — Tue, 17 May 2022 10:45:00 GMT

What are the HSA limits for calendar year 2023?

The IRS recently issued revenue procedure 2022-24, covering pertinent information around HSA-compatible plan offerings for 2023. This episode of Comply on the Fly covers the increased limits so employers can be prepared.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep28: Non-FMLA Leave of Absence

M3 Insurance — Tue, 16 May 2023 10:45:00 GMT

I have an employee who has only been with us for six months and needs leave for a surgery. Can I keep this person on the benefits?

This episode of Comply on the Fly covers how to handle a leave of absence for an employee who does not meet the eligibility requirements for FMLA.

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S2-Ep30: ACA Temps & Interns Refresher

M3 Insurance — Tue, 30 May 2023 10:45:00 GMT

How do I handle temporary employees or interns for Affordable Care Act (ACA) purposes?

Just in time for the summer months, this refresher episode of Comply on the Fly reminds large employers of how to remain compliant with their ACA shared responsibility provisions around seasonal employees & interns.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 11: OSHA ETS Stay Lifted

M3 Insurance — Tue, 21 Dec 2021 12:15:00 GMT

Is the OSHA Emergency Temporary Standard or ETS regarding mandatory COVID vaccination and testing masking requirements for 100 plus employers now in effect?

On December 17, 2021, a three judge panel of the US Court of Appeals, 6th Circuit lifted the stay on the OSHA Emergency Temporary Standard (ETS) which mandates COVID-19 vaccinations/testing in private employer organizations with 100 or more employees. This episode covers what employers need to know as they begin or continue their compliance of the OSHA ETS requirements, including the new implementation dates.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 6: OSHA ETS Vaccination Mandate - Creating a Compliance Policy

M3 Insurance — Mon, 15 Nov 2021 18:20:00 GMT

What are my two policy options under the vaccine mandate or OSHA ETS? This episode covers the options employers have in implementing a policy to comply with the OSHA ETS. On 11/4/21 the Occupational Safety and Health Administration (OSHA) released its emergency temporary standard (ETS), mandating COVID-19 vaccinations/testing in private employer organizations with 100 or more employees.

Get the answer to this question in under five minutes in this episode of Comply on the Fly. Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 21: COBRA & Medicare - what about dependents?

M3 Insurance — Tue, 08 Mar 2022 11:25:00 GMT

Is COBRA offered to a spouse and dependents if an employee enrolls in Medicare?

This episode of Comply on the Fly explains why a scenario in which an employee decides to voluntarily terminate coverage and enroll in Medicare would cause loss of coverage with no COBRA rights for any spouses and dependents on their plan.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep20: Medicaid Redetermination

M3 Insurance — Mon, 20 Mar 2023 10:45:00 GMT

Do I have to offer enrollment to a person who loses eligibility for Medicaid due to a recent redetermination?

The Consolidated Appropriations Act of 2023 could result in some of your employees losing their Medicaid coverage. This episode of Comply on the Fly can help you, as an employer plan sponsor, prepare for this special enrollment event.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 19: Are the COVID deadline extensions for group health plans still in place?

M3 Insurance — Tue, 22 Feb 2022 11:15:00 GMT

Are the deadline extensions due to COVID for group health plans still in place? And if so, can you tell me more about that?

This has been one of the more confusing COVID requirements and quite frankly, often forgotten. This episode of Comply on the Fly covers how COVID extensions impact HIPAA special enrollment and COBRA notice deadlines.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 27: COBRA & Special Enrollment for Newborn Dependents

M3 Insurance — Tue, 19 Apr 2022 10:45:00 GMT

If an employee does not return to work after having a baby, and if offered COBRA, can the baby be enrolled on her COBRA plan?

When it comes to COBRA & special enrollment rules regarding newborn dependents, it's all about timing. This episode of Comply on the Fly covers considerations around this topic.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 48: FMLA & Wisconsin Workers’ Compensation

M3 Insurance — Tue, 13 Sep 2022 10:45:00 GMT

Can you please verify if it's mandatory in Wisconsin to run workers' compensation benefits and FMLA concurrently?

This episode of Comply on the Fly helps employers understand how to handle situations where an employee qualifies for both federal FMLA and Wisconsin state leave concurrently.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 39: 2022 PCORI Fees Refresher

M3 Insurance — Tue, 12 Jul 2022 10:45:00 GMT

As the 2022 PCORI fees deadline approaches, this episode of Comply on the Fly provides a refresher on how to determine if - and what - you owe. What are the PCORI fees for 2022 and when are they due?

This episode of Comply on the Fly reviews what PCORI fees are and when they apply, and provides information around them for 2022.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 10: Vaccine Mandates - Current Status

M3 Insurance — Tue, 14 Dec 2021 12:45:00 GMT

What is the current situation regarding all of these vaccine mandates? There are currently four different vaccine mandates: The CMS Vaccination Mandate, the Federal Employee Vaccination Mandate, the Federal Contractor/Subcontractor Vaccination Mandate, and the OSHA ETS. This episode of the Comply on the Fly offers an update the current status of each.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2 Ep13: ACA and Controlled Group Acquisition

M3 Insurance — Tue, 31 Jan 2023 11:45:00 GMT

We had two companies with common ownership. However, in June 2022, one of the companies was sold off to a separate entity and therefore we are no longer part of a controlled group. As per the ACA requirements - Affordable Care Act requirements - we included both entities in determining whether or not we were over 50 full-time and full-time equivalents. Each entity separately now has 35 and 40 employees, respectively. What do we do for 2023?

When a business moves between being a single entity or part of a controlled group within a calendar year, adhering to the ACA Shared Responsibility requirements can become complicated. This episode of Comply on the Fly covers what employers need to know.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep6: ACA - Affordability Based on Rate of Pay

M3 Insurance — Tue, 06 Dec 2022 11:45:00 GMT

How do we ensure that an employee working seven and a half hours per day for 180 days per year and making $15 and 25 cents an hour is offered affordable coverage for both single and family coverage?

In this Comply on the Fly Karen B. helps employers with 50 or more employees determine if their offers of coverage are affordable according to the ACA (Affordable Care Act) Shared Responsibility requirements.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 2: The ACA in 2022 - Shared Responsibility Calculations

M3 Insurance — Fri, 15 Oct 2021 14:00:00 GMT

What do I need to know for the ACA shared responsibility calculations for 2022?

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 3: Annual Notices - Your Delivery Requirements

M3 Insurance — Thu, 21 Oct 2021 19:03:10 GMT

What are the notices I should include in my open enrollment materials - and can I deliver them electronically?

Get the answer to this question in under six minutes in this episode of Comply on the Fly. Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 24: Section 125 Plan Basics

M3 Insurance — Tue, 29 Mar 2022 10:45:00 GMT

What is a section 125 plan?

Section 125 refers to the section of the internal revenue code that allows employers to provide employees with a choice between cash and certain qualified non taxable benefits. Tune in to this episode of Comply on the Fly to better understand the basics of Section 125 plans.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 4: ERISA SPD

M3 Insurance — Wed, 27 Oct 2021 19:26:00 GMT

What is an ERISA SPD - and when do I need to provide it?

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 23: FMLA Notices

M3 Insurance — Tue, 22 Mar 2022 10:39:00 GMT

What are the basic notice requirements under federal FMLA?

FMLA administration can get rather complicated, but the federal notice requirements are pretty straightforward. This episode of Comply on the Fly provides a solid foundation and understanding of the federal requirements around FMLA Notices.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 50: ACA Part-Time Employee Eligibility

M3 Insurance — Tue, 27 Sep 2022 10:45:00 GMT

I need help regarding eligibility for a part-time employee. The employee was hired in may of 2022. And for the past 10 weeks, he has worked 30 or more hours per week. We use the look back measurement method. Without a full year of data, should we be offering him benefit?

The answer to this question requires a grasp of the ACA (Affordable Care Act) shared responsibility requirements, proper categorization of employees, and an understanding of initial and ongoing measurement periods. This episode of Comply on the Fly covers it all!

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 33: ACA - Monthly Measurement Method

M3 Insurance — Mon, 06 Jun 2022 16:16:40 GMT

How do I determine if an employee is full-time for ACA purposes?

This episode of Comply on the Fly covers the monthly measurement method in determining the number full time and full time equivalent employees for ACA compliance purposes.

(Episode 34 covers the look back measurement method.)

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2 Ep 9: Special Enrollment vs. Section 125 Qualifying Events

M3 Insurance — Tue, 03 Jan 2023 11:45:00 GMT

What is the difference between special enrollment and Section 125 qualifying events?

Special enrollment quite often gets confused with Section 125 qualifying events. Karen B. outlines the difference for employers in this refresher episode of Comply on the Fly.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep27: End of PHE and Notice Requirements

M3 Insurance — Tue, 09 May 2023 10:29:00 GMT

Do I have any notice obligations in relation to the end of the National Emergency or Public Health Emergency as it relates to COVID?

This episode of Comply on the Fly covers employer obligations around notice requirements associated with the end of the COVID National and Public Health Emergency (PHE).

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S2-Ep45: COBRA - Reduction in Hours

M3 Insurance — Tue, 03 Oct 2023 10:45:00 GMT

Must an employer offer COBRA to an employee that has been on the medical or dental insurance, but the group or the employer has not paid this employee for almost two years? Therefore, if they terminate this employee from the plan, will they be able to offer COBRA?

This episode of Comply on the Fly highlights a unique case of an employee who carried coverage without compensation for two years. As Karen B. deliberates on the nuances of this situation, employers will gain a better understanding of the rules around offering COBRA coverage.

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Ep 51: FMLA - New Hire Leave for Birth/Adoption

M3 Insurance — Thu, 29 Sep 2022 13:09:00 GMT

Can a new employee take federal FMLA to bond with a child following birth or placement for adoption?

Answers to FMLA eligibility questions such as this one are always very fact-specific. This episode of Comply on the Fly covers what you need to know to correctly determine FMLA leave for your employees' with growing families.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 49: Medicare Part D Creditable & Non-Creditable Coverage Notices

M3 Insurance — Tue, 20 Sep 2022 10:41:00 GMT

What is the Medicare Part D creditable or non-creditable coverage notice, who do I need to provide it to, and how?

Get the answer to this question in just three and a half minutes in this episode of Comply on the Fly. The Medicare Part D Creditable or Non-Creditable Coverage notice must be provided prior to October 15th every year, the annual start of Medicare Part D open enrollment.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 40: ERISA Summary Annual Reports

M3 Insurance — Tue, 19 Jul 2022 10:45:00 GMT

What is a SAR and what do I do with it?

This Comply on the Fly covers ERISA and Summary Annual Report (SAR), and offers guidelines for delivering the report to your plan participants.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep17: FMLA and Remote Employees

M3 Insurance — Tue, 28 Feb 2023 11:45:00 GMT

What did the Department of Labor, or DOL, recently say about FMLA and remote workers?

On February 9th, 2023, the Department of Labor Wage and Hour Division issued Field Assistance Bulletin 2023-1 addressing the application of FMLA eligibility requirements to remote employees. This episode of Comply on the Fly provides covers what employers need to know about this bulletin.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

COBRA Basics

M3 Insurance — Tue, 16 Jul 2024 11:00:00 GMT

Dive into the essentials of COBRA on this episode of "Comply on the Fly." Whether you're a COBRA expert, deal with it occasionally, or are just curious, this episode covers everything you need to know about COBRA basics. From identifying qualifying events to understanding when COBRA should be offered, don’t miss out on this invaluable knowledge that will empower you to navigate COBRA like a pro. Tune in now for an informative and engaging episode that could make all the difference in your compliance journey!

Tune to M3 and Karen B for quick and timely answers to the most common employee benefits compliance questions.

Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 14: Supreme Court Rulings on COVID-19 Vaccination Mandates

M3 Insurance — Tue, 18 Jan 2022 11:45:00 GMT

Did the Supreme court block the OSHA ETS vaccine mandate and the CMS healthcare vaccine mandate?

On Thursday, January 13th, the Supreme court ruled on both mandates. This episode covers the details of those rulings.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 36: Upcoming Transparency Requirements

M3 Insurance — Tue, 21 Jun 2022 10:45:00 GMT

Can you tell me a bit more about those transparency requirements that go into effect July 1st, 2022?

The requirements around transparency can be complicated. This episode of Comply on the Fly covers the transparency in coverage rules found in the Affordable Care Act (ACA) as well as those found in the Consolidated Appropriations Act (CAA).

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 34: ACA - Look Back Measurement Method

M3 Insurance — Mon, 06 Jun 2022 16:17:16 GMT

How do I determine if an employee is full-time for ACA purposes?

This episode of Comply on the Fly covers the look back measurement method in determining the number full time and full time equivalent employees for ACA compliance purposes.

(Episode 33 provides an overview of the monthly measurement method.)

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 52: HSAs - Can an Employee Contribute to the HSA of a Spouse?

M3 Insurance — Tue, 11 Oct 2022 10:39:00 GMT

Our employee is covered under his spouse's high deductible health plan at another employer. Our employee is not enrolled in our high deductible health plan. The employee's spouse has an HSA or Health Savings Account. The question is, can our employee contribute to the HSA of the spouse?

This final episode of Comply on the Fly, Season 1 covers three scenarios around an employee contributing to the HSA of the spouse - with three different answers. Tune in so you know how to respond if your employee comes to you with a similar question. Comply on the Fly will resume, with Season 2, on November 1st.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 8: ACA Reporting for 2021

M3 Insurance — Tue, 30 Nov 2021 11:45:00 GMT

What do I need to know for ACA reporting for 2021? It's the time of year when employers with 50 or more full-time/full-time equivalent employees need to start thinking about annual ACA reporting requirements. This episode includes a few reminders as we head into that season.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

EP 26: HSAs & Medicare

M3 Insurance — Tue, 12 Apr 2022 10:45:00 GMT

Can our Medicare eligible employees contribute to an HSA? Or can we, as the employer continue to contribute to the HSA of a Medicare eligible employee?

The relationship between Medicare and HSAs is confusing, but this episode of Comply on the Fly breaks down what employers need to know.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 29: HIPAA Non-Discrimination

M3 Insurance — Tue, 03 May 2022 10:45:00 GMT

What are the HIPAA non-discrimination rules and how do I apply them to my plans?

HIPAA Non-discrimination rules can be confusing because there are non-discrimination rules that apply in the taxation context and rules that don't. This episode of Comply on the Fly can help employers clear confusion around HIPAA non-discrimination rules.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep26: ERISA & Voluntary Plans

M3 Insurance — Tue, 02 May 2023 10:45:00 GMT

Are voluntary plans that an employer sponsors subject to ERISA?

This episode of Comply on the Fly explains the four ERISA voluntary plan safe harbor requirements and what employer plans sponsors are responsible for if those requirements are not met.

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Ep 47: Medicare & Group Health Plans

M3 Insurance — Tue, 06 Sep 2022 10:45:00 GMT

We have an employee who is nearing age 65. Can we require that the employee drop our group health plan coverage and go on Medicare?

Well, the simple answer is no, however, it is extremely important for your retirement age employees to fully understand their options surrounding Medicare. This episode of Comply on the Fly can help.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 32: PCORI Fees for 2022

M3 Insurance — Tue, 24 May 2022 10:45:00 GMT

What are the PCORI fees for 2022 and when are they due?

This episode of Comply on the Fly reviews what PCORI fees are and when they apply, and provides information around them for 2022.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep1: 1095Cs & Coverage Waivers

M3 Insurance — Tue, 01 Nov 2022 10:45:00 GMT

When I am completing my 1095Cs, do I need to enter a code on part II, line 16 when someone waives coverage?

Karen B. is back with Season 2 of Comply on the Fly! This episode covers how to properly fill out 1095c forms in regard to full time employees who waive your offers of coverage. Tune in to learn how to avoid errors that could result in an IRS penalty letter.

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Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

Season 2 of Comply on the Fly is focused primarily on actual client questions, so send your compliance question to AskKarenB@m3ins.com and we'll do our best to cover it in an upcoming episode!

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep12: HSAs for Dependents of Employees

M3 Insurance — Tue, 24 Jan 2023 11:45:00 GMT

Can a dependent of an employee open their own HSA or health savings account?

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 41: Refresher on ACA - Temporary Employees & Interns

M3 Insurance — Tue, 26 Jul 2022 10:45:00 GMT

How do I handle temporary employees or interns for Affordable Care Act (ACA) purposes?

This refresher episode of Comply on the Fly reminds large employers of how to remain compliant with their ACA shared responsibility provisions around seasonal employees & interns.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 38: FMLA and State Leave Laws

M3 Insurance — Tue, 05 Jul 2022 10:45:00 GMT

What do I do if an employee qualifies for both federal FMLA and leave provided by state law?

This episode of Comply on the Fly can help you determine leave eligibility under federal FMLA and state law - and what to do when an employee qualifies for both.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 22: ERISA 5500 Basics

M3 Insurance — Tue, 15 Mar 2022 10:45:00 GMT

How, and when, do I need to file form 5500's for my welfare benefit plans?

If you are a private sector employer, ERISA SPDs and the required 5500s are an important part of remaining compliant with your federal obligations and avoiding unnecessary fees. This episode of Comply on the Fly covers the basics of ERISA 5500 compliance.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Employer HSA Contributions

M3 Insurance — Tue, 22 Apr 2025 11:00:00 GMT

On this episode of Comply on the Fly, host Karen B unpacks the ins and outs of employer contributions to Health Savings Accounts (HSAs)—a benefit that can offer significant value to both employees and organizations. She breaks down what makes an employee eligible to receive HSA contributions, what employers are (and aren’t) responsible for verifying, and how timing and contribution limits can affect both compliance and employee tax liability.

Whether you're already offering HSA contributions or just exploring the option, this quick episode is packed with practical tips and compliance clarity.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Self-Funded Plan Considerations

M3 Insurance — Tue, 06 May 2025 13:25:00 GMT

On this episode of Comply on the Fly, host Karen B covers the core compliance considerations for employers moving from a fully insured to a self-funded health plan. While self-funding can offer greater cost control, it also brings added compliance responsibilities.

Karen walks through high-level obligations under ERISA, HIPAA, and the ACA—such as the need for updated plan documentation, direct handling of PHI, and obligations like PCORI fee payments and 1095-C reporting. She also touches on new transparency requirements, including prescription drug data reporting and gag clause attestations.

If you're exploring or implementing self-funding, this episode offers a helpful compliance overview to keep you on track.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Open Enrollment Notices

M3 Insurance — Tue, 13 Aug 2024 11:00:00 GMT

In this episode of "Comply on the Fly," get up to speed on crucial open enrollment reminders as the season approaches for many organizations with calendar year plans. Dive into the must-include federal notices, such as the Summary of Benefits and Coverage (SBC) and HIPAA notices, that are essential for your enrollment materials. You'll also gain practical tips on how to effectively distribute these notices, whether electronically or by mail, to ensure full compliance. Tune in to keep your open enrollment process smooth, timely, and fully compliant.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S3-Ep12: COBRA & Medicare Refresher

M3 Insurance — Tue, 23 Apr 2024 10:45:00 GMT

I have an employee spouse that will be going on Medicare soon. Should I offer COBRA?

This refresher episode of Comply on the Fly reminds employers of the interaction between Medicare entitlement and COBRA, which can be particularly complicated with Medicare’s Secondary Payer Rules.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S3-Ep11: 105(h) Nondiscrimination Testing for Self-Funded Plans

M3 Insurance — Tue, 09 Apr 2024 10:45:00 GMT

What is Section 105(h) nondiscrimination testing and who does it apply to?

The 105(h) nondiscrimination requirements apply to self-funded health plans. Employers who self-fund their dental or medical offerings, including HRAs and FSAs, should conduct annual two-part eligibility and benefit testing. Tune into to this episode of Comply on the Fly to learn more.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 13: FMLA & Mental Health

M3 Insurance — Tue, 11 Jan 2022 14:35:00 GMT

Can a mental impairment or condition qualify for FMLA?

If you are an employer subject to FMLA, you may have questions on the requirements around mental health conditions. This episode covers whether or not an employee's mental condition or impairment qualifies under FMLA's definition of a serious health condition and, in turn, triggers FMLA leave.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep29: HSA Contribution Changes

M3 Insurance — Tue, 23 May 2023 10:39:00 GMT

If I allow my employees to contribute to their own HSA health savings accounts, do I have to let them change the amount they wish to contribute throughout the year?

This episode of Comply on the Fly includes the newly released HSA contribution limits, and covers a Section 125 qualifying event that allows for employees to make HSA contribution changes in the middle of a plan year.

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S2-Ep2: Benefit Documents & SPDs

M3 Insurance — Tue, 08 Nov 2022 11:45:00 GMT

Do we need an SPD for dental coverage as well as medical?

In this Comply on the Fly Karen B. answers this client question, covering alignment of SPDs & benefit plan documents in medical, dental and self-funded plan scenarios. Tune in to learn how to keep the plan documentation for your unique situation compliant.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep11: ACA-Temporary Employees

M3 Insurance — Tue, 17 Jan 2023 11:45:00 GMT

By policy, our limited term employees can only work 1,200 hours in a calendar year, which is less than the 30 hours per week, which is 1,560. If an LTE, meaning 'Limited Term Employee', begins work in the second half of the calendar year and then continues to work in the first half of the next year, are we required to offer insurance since they have worked more than 30 hours per week during the look back period? Please expand on seasonal versus temporary employment.

In this episode of Comply on the Fly Karen B. answers a client question around properly classifying employees for ACA reporting purposes.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep7: 2022 ACA Reporting

M3 Insurance — Tue, 13 Dec 2022 11:45:00 GMT

As an employer, what do I need to know about the coding and forms around Affordable Care Act (ACA) reporting for 2022?

In this Comply on the Fly Karen B. responds to an influx of questions she is currently receiving as employers prepare to do their ACA reporting for 2022. Tune in to find answers to your questions on this topic.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep16: End of COVID-19 National Emergency and the Impact on Employer-Sponsored Health Plans

M3 Insurance — Tue, 21 Feb 2023 11:45:00 GMT

It's not really a question per se, but you may be wondering about the end of the COVID National Emergency or public health emergency and how this will affect your group health plans.

The President of the United States recently issued a "statement of administration policy" declaring the discontinuation to the COVID-19 national emergency. This episode of Comply on the Fly provides information on how this will impact employer-sponsored health plans.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Section 125 Plan Document

M3 Insurance — Tue, 10 Sep 2024 11:00:00 GMT

Dive into the essentials of Section 125 plans, also known as cafeteria plans, and why having a written plan document isn’t just a formality—it’s a must. COTF’s Karen B breaks down the key components employers need to include, from benefit options and participation guidelines to mid-year qualifying events. Understand the critical need to have the plan document in place before the new plan year begins, ensuring it stays IRS-compliant to safeguard those valuable tax advantages for both employers and employees. Whether you’re offering health premiums, flexible spending accounts, or dependent care programs, this episode equips you with everything you need to keep your Section 125 plan running smoothly.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep40: Dependent Care Assistance Program Election Changes

M3 Insurance — Tue, 08 Aug 2023 10:45:00 GMT

When can an employee make a change to a dependent care election?

The episode of Comply on the Fly covers Dependent Care Assistance Programs (DCAPs), including the difference to Section 129 and Section 125 requirements, and what criteria qualifies an employee for a mid-year election change.

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Post Open Enrollment Considerations

M3 Insurance — Tue, 03 Dec 2024 13:00:00 GMT

Open enrollment may be wrapping up, but the questions are coming in. In this episode of Comply on the Fly, Karen B breaks down essential post-enrollment tips, including aligning administrative periods, navigating Section 125 rules, and handling pre-tax election changes. Tune in for practical advice to help you avoid compliance pitfalls and keep your benefits administration running smoothly.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep33: ACA Lookback Measurement Method - Refresher Episode

M3 Insurance — Tue, 20 Jun 2023 10:49:00 GMT

How do I determine if an employee is full-time for ACA purposes?

This episode of Comply on the Fly covers the look back measurement method in determining the number full time and full time equivalent employees for ACA compliance purposes.

(Season 1 - Episode 33 provides an overview of the monthly measurement method.)

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S3-Ep10: ACA Applicable Large Employer Status

M3 Insurance — Tue, 26 Mar 2024 10:45:00 GMT

What are the shared responsibility requirements under the Affordable Care Act for new employers and for employers whose businesses are part of a controlled group?

The ACA advises employers to utilize the look-back measurement method for tracking full-time and full-time equivalent (FTE) employees. However, what what if the employer didn't exist in the previous calendar year? How should businesses, even those with fewer than 50 full-time/FTE employees, handle the ACA's applicable large employer (ALE) requirements when they're part of a larger group of businesses? Proactively addressing these issues now can save time and prevent problems later. Tune in to this episode of Comply on the Fly as Karen explores IRS guidelines around these scenarios.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2025 ACA Affordability Percentage

M3 Insurance — Tue, 08 Oct 2024 12:00:00 GMT

In this episode of Comply on the Fly, Karen B covers the newly released ACA affordability percentage for 2025, which has increased to 9.02%. Learn what this change means for large employers and how to ensure your health coverage remains affordable under the ACA’s shared responsibility provisions. Karen breaks down the key safe harbor methods—federal poverty level, rate of pay, and W-2 wages—making it easy to understand how to avoid penalties in 2025. Don’t miss this quick, insightful breakdown!

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Medicare Financial Incentives

M3 Insurance — Tue, 25 Feb 2025 12:00:00 GMT

In this episode of Comply on the Fly, host Karen B tackles a common employer question: Can we pay for an employee’s Medicare or Medicare supplement premiums? The short answer? No.

Doing so would violate Medicare Secondary Payer (MSP) rules, which prevent employers from incentivizing employees to switch from their group health plan to Medicare. Understand the key MSP restrictions, the rare exceptions, and what employers can do.

If you're an employer navigating Medicare eligibility in the workplace, this episode delivers the critical do’s and don’ts, saving you from costly compliance missteps.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S3-Ep13: Association Health Plan Update

M3 Insurance — Tue, 07 May 2024 10:45:00 GMT

What do I need to know about the guidance the Department of Labor recently issued around association health plans?

In April 2024, the Department of Labor issued guidance which return association health plan rules to their pre-2018 three-criteria test. This episode of Comply on the Fly revisits those three criteria for groups forming as one employer to offer an association health plan.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S3-Ep8: FMLA & Premium Payments

M3 Insurance — Tue, 20 Feb 2024 11:49:00 GMT

What is the correct approach for employers to manage the continuation of employee health coverage and premium payments during extended FMLA leave periods?

During the 12-week FMLA period, employers must maintain employees' group health insurance benefits as if they were actively at work. Employees are still responsible for paying their portion of the premium during this time.

Employers can gain insights into various methods for collecting premiums from employees during FMLA periods, along with guidance on proper documentation, by tuning in to this episode of Comply on the Fly.

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S2-Ep19: ERISA SPD - What It Is and When You Need to Provide It

M3 Insurance — Tue, 14 Mar 2023 10:45:00 GMT

What is an ERISA SPD - and when do I need to provide it?

As a plan sponsor you are required to provide an SPD (Summary Plan Description) to your organization's employee benefit plan participants and beneficiaries informing them of their rights and benefits in relation to the plan offerings. This refresher episode of Comply on the Fly can help you, as an employer plan sponsor, better understand your ERISA SPD obligations.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep18: Gag Clause Attestation for Group Health Plan Agreements

M3 Insurance — Tue, 07 Mar 2023 11:48:00 GMT

Can you tell me a bit more about the recent transparency guidance on gag clauses?

This episode of Comply on the Fly covers recent transparency guidance issued by the federal government pertaining to the prohibition of gag clauses in any agreements group health plans enter into with providers, TPAs (Third Party Administrators), and other network or associations of healthcare providers.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep15: Opt-Out Arrangements

M3 Insurance — Tue, 14 Feb 2023 11:45:00 GMT

What is the difference between a conditional opt-out arrangement and an unconditional opt-out arrangement?

Opt-out arrangements (historically called cash-in-lieu arrangements) provide a taxable cash payout if an employee waives employer-sponsored health insurance. This episode of Comply on the Fly covers both unconditional and conditional opt-out arrangements and the additional compliance obligations employers face surrounding them.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep24: The End of the COVID-19 National Emergency

M3 Insurance — Tue, 18 Apr 2023 10:45:00 GMT

Did the COVID-19 National Emergency end? I thought it was supposed to end in May.

On April 10th, 2023, the federal government ended COVID-19 National Emergency. Allowing 60 days to the end of the outbreak period, this makes June 9, 2023 the official end date for deadline extensions. Tune in to this episode of Comply on the Fly to learn what this means for group health plan benefit purposes.

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Ep 30: ACA - Temporary Employees & Interns

M3 Insurance — Tue, 10 May 2022 10:45:00 GMT

How do I handle temporary employees or interns for Affordable Care Act (ACA) purposes?

As we head into the summer months, many employers are looking to hire seasonal employees and interns. This episode of Comply on the Fly can help large employers remain compliant with their obligations under ACA shared responsibility provisions.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 42: HIPAA Non-Discrimination

M3 Insurance — Tue, 02 Aug 2022 10:45:00 GMT

What non-discrimination rules apply to my health plans?

This is a seemingly easy question with a pretty complex and multifaceted answer. This episode of Comply on the Fly explores HIPAA non-discrimination requirements.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Ep 35: ACA - Initial Measurement Period

M3 Insurance — Tue, 14 Jun 2022 10:45:00 GMT

How do I handle new employees if I am subject to the Affordable Care Act employer shared responsibility provisions, and I'm utilizing the look back measurement method?

This episode of Comply on the Fly covers how to assign the right status to new employees when using the look back measurement method for ACA compliance purposes.

(Episode 34 covers the look back measurement method.)

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

E2-Ep14: FMLA & Pre-Birth Absences

M3 Insurance — Tue, 07 Feb 2023 11:45:00 GMT

This week's episode features another client-direct FMLA question: "I have an employee who is pregnant and due in August. She is having complications with her pregnancy and missing work. I have sent her the FMLA paperwork, however, she has not returned any of it. She indicated that she's off due to being sick from the pregnancy and has brought in notes from her doctor taking her off of work. Can I designate FMLA even though she hasn't returned the paperwork?

Employees sometimes mistakenly believe it is up to them to decide when FMLA applies and when it doesn't. It is really up to the employer to understand when a situation might be FMLA-qualifying and to get the process going. This episode of Comply on the Fly covers what employers need to know.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep23: COBRA & Medicare

M3 Insurance — Tue, 11 Apr 2023 10:45:00 GMT

I have an employee's spouse that will be going on Medicare soon. Should I offer COBRA?

This episode of Comply on the Fly helps employers understand the interaction between Medicare entitlement and COBRA, which can be particularly complicated with Medicare's Secondary Payer Rules.

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S2-Ep5: When FMLA Leave Rolls into a New Calendar Year

M3 Insurance — Tue, 29 Nov 2022 11:45:00 GMT

I have a couple of people that will be using FMLA leave and won't go through it all before January 1st. Is there anything I need to do since we run FMLA on a calendar year basis? Or do I just keep tracking it?

In this Comply on the Fly Karen B. answers a timely client question on if FMLA leave rolls over or resets with the change of the calendar year. Tune in to learn how to track and maintain proper paperwork around employee FMLA periods that extend into the new year.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2 Ep8: Should I provide a 1095C in ACA Reporting?

M3 Insurance — Tue, 20 Dec 2022 11:45:00 GMT

I was wondering for an employee that starts in December and doesn't become benefit-eligible until January 1st, 2023, do I still need to create a 1095C for them showing a 1H/2D?

In this Comply on the Fly Karen B. responds to this client question pertaining to ACA reporting pertaining to 1095Cs. If you also have questions on this, tune in to find answer.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep4: Open vs. Special Enrollment

M3 Insurance — Tue, 22 Nov 2022 11:45:00 GMT

Our employee and the spouse are on the spouse's health plan. We, as the employer, have an open enrollment period for July 1 start date, and the spouse's employer has an open enrollment period for a January 1 start date. Our open enrollment period is over, but the spouse's open enrollment period is now open. Can the spouse drop all enrollments during their open enrollment, and can the family now jump onto our plan?

In this Comply on the Fly Karen B. answers a client question on open vs. special enrollment periods. She covers how involuntary and voluntary loss of coverage impact eligibility under special enrollment differently. Tune in gain a better understanding of this complex coverage situation.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

S2-Ep21: Air Ambulance Reporting - Part 1

M3 Insurance — Tue, 28 Mar 2023 10:45:00 GMT

Do I need to do anything about air ambulance reporting?

The Air Ambulance Data Collection, or AADC, requirement seeks to give lawmakers and regulators a better understanding of the cost drivers behind large, surprise medical bills associated with air ambulance services. This episode of Comply covers the transparency and reporting requirements pertaining to air ambulance data.

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PCORI Fees

M3 Insurance — Tue, 03 Jun 2025 10:45:00 GMT

On this episode of Comply on the Fly, host Karen B breaks down the 2025 PCORI (Patient Centered Outcomes Research Institute) fees—what they are, who owes them, and how to pay. While fully insured employers may be off the hook, those with HRAs and other self-funded plans should take note.

Karen explains how the fees apply based on plan type and coverage year and details the updated per-covered-life amounts for plans ending in 2024. She also outlines the acceptable methods for calculating covered lives and walks through the process of filing the IRS Form 720, including important dates and notices.

If you are sponsoring a self-insured or HRA-integrated plan, this episode offers a practical and timely guide to filing your PCORI correctly.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

Avoiding Common Missteps in 2025 ACA Reporting

M3 Insurance — Tue, 13 Jan 2026 12:00:00 GMT

ACA reporting hasn’t gotten simpler—it’s gotten quieter and more nuanced. Between changes to how 1095-Cs are distributed, increased reliance on accurate measurement methods, and growing complexity in hybrid plan designs, small missteps now carry bigger consequences. This latest Comply on the Fly episode focuses on the judgment calls employers are actually making in 2025—not just the deadlines—so you can avoid avoidable errors and reduce last-minute stress.

Karen also unpacks one of the most misunderstood updates: the shift away from automatically distributing 1095-Cs—and what “clear, conspicuous, and accessible” really means when employees request their forms.

If ACA reporting feels more complex each year, this episode explains why—and how a proactive approach throughout the year can make compliance far less painful when deadlines hit.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.

2026 FSA Limits

M3 Insurance — Tue, 21 Oct 2025 13:12:16 GMT

The IRS has announced new FSA contribution limits for 2026, and they’re climbing again. In COTF episode, host Karen Breitnauer walks through what’s changing, including updates to the health FSA contribution cap, reminders on dependent care FSAs, and what employers should do next.

Staying current on these annual limits helps ensure your organization’s benefit offerings remain both compliant and compelling heading into 2026.

COTF: 2026 ACA Out-of-Pocket Limits

M3 Insurance — Tue, 26 Aug 2025 11:00:00 GMT

Did you catch the update? HHS (the U.S. Department of Health and Human Services) raised the 2026 ACA out-of-pocket maximums. What does that mean for your group health plan, and your employees? Comply on the Fly has the quick compliance insight you need to stay ahead of 2026 requirements.

EP 16: HIPAA & Group Health Plans

M3 Insurance — Tue, 01 Feb 2022 11:47:00 GMT

How does HIPAA apply to my group health plans?

Sometimes the topic of HIPAA can be confusing to employers. This episode of Comply on the Fly covers what invokes HIPAA, which information is protected, and the documentation required for compliance.

Turn to M3 and Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compliance questions.

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Please note: This podcast and the contents herein do not constitute legal advice. Seek the advice of counsel for any benefit compliance related implementation guidance or strategy.