Tag Archives: ACA

The Basics of Health Savings Accounts and Health Flexible Spending Accounts

In a recent webinar, Jake Mattinson and Sarah Raaii discussed the basics of health savings accounts (HSAs) and health flexible spending accounts. They provided an overview of the various regulations surrounding HSA, such as eligibility requirements, high deductible health plans, and contributions and distributions, and cafeteria plans. Additionally, they analyzed the differences between HSAs and … Continue Reading

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified health plan application submissions, adopted a good faith compliance standard for 2018 and delegated additional plan certification responsibilities to states. While … Continue Reading

Executive Order Regarding Contraceptive Mandate Directed toward Religious Employers

Late last week, President Donald Trump signed an executive order directing federal agencies to look into exempting religious employers from the Affordable Care Act’s (ACA) contraceptive mandate. Qualifying religious employers (e.g. houses of worship) are already exempt from providing contraceptive coverage under their benefit plans, and an accommodation process is provided for certain non-profit employers … Continue Reading

IRS Implementation of ACA’s Employer Shared Responsibility Provision Falls Short Based on the Results of a Recent Audit

Based on a recent audit conducted by the Treasury Inspector General for Tax Administration (TIGTA), the IRS’ processes and procedures to ensure compliance with the employer information reporting requirements mandated by the employer shared responsibility provision (the play or pay rules) of the Affordable Care Act (ACA), have fallen short of their intended goals. (see … Continue Reading

The Challenges of the Trump Administration’s Vow to “Repeal and Replace” the Affordable Care Act

The presentation “ACA Repeal/Replace Under the Trump Administration,” discusses the implications of President Trump and the GOP’s immediate vow to “repeal and replace” the Affordable Care Act (ACA), which was enacted in 2010 by the Obama Administration to reform the health care system in the US. A complete repeal is unlikely since many ACA changes … Continue Reading

Northern District of Texas Blocks Enforcement of the Non-Discrimination Regulations of the ACA

On December 31, 2016, the US District Court for the Northern District of Texas issued an opinion and order in Franciscan Alliance, Inc. et al v. Burwell, which preliminarily enjoins the US Department of Health and Human Services from enforcing, on a nationwide basis, certain portions of the regulations under Section 1557 of the Affordable … Continue Reading

IRS Adjusted ACA Fee Amounts for the 2017 Policy or Plan Years

Patient-Centered Outcomes Research Institute (PCORI) Fee The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance policies and sponsors of self-insured health plans. The fees are calculated using the average number of lives covered … Continue Reading

Wellness Incentive Programs: Navigating Legal Landmines and Designing Effective Employee Communication Strategies

This year’s Employer Healthcare & Benefits Congress featured a presentation that addressed the many shapes and sizes of wellness programs today. Programs are typically designed to promote health and to educate employees about prevention, but some are disease management oriented, while others are designed to improve the general overall health of an employee population. Presentation … Continue Reading

Affordable Care Act Compliance: IRS Releases Draft 2016 Employer Reporting Forms and Instructions

On August 2, the Internal Revenue Service (IRS) released revised draft Forms 1094-C and 1095-C, and draft instructions for completing these forms for the 2016 reporting year (see here). Although these are not final versions, it is important for employers to review the updates and changes from the 2015 forms and instructions as they prepare for the 2016 filings. … Continue Reading

Proposed Changes to Form 5500 Would Significantly Increase Reporting Obligations for Health and Welfare Plan Sponsors

On July 11, 2016, the Department of Labor (DOL) and Internal Revenue Service (IRS) announced a proposal to implement significant changes to the forms and regulations that govern annual employee benefit plan reporting on Form 5500. The proposed changes, which were published in the Federal Register on July 21, 2016, would considerably increase the annual … Continue Reading

HHS Issues Final ACA Nondiscrimination in Health Programs and Activities Regulation

On Friday, May 13, 2016, the US Department of Health and Human Services Office for Civil Rights finalized regulations that provide explicit protections from discrimination on the basis of gender identity in health care and insurance under Section 1557 of the Affordable Care Act. Read the full article.… Continue Reading

How to Determine Full-Time Employment Status of Employees for the ACA Employer Shared Responsibility Mandate

As part of the insurance market reforms enacted under the ACA, large employers are required to maintain a certain level of health insurance for their common law employees (and only their common law employees) or pay a penalty — the so-called pay or play or employer shared responsibility rules.  The rules for determining which workers … Continue Reading

Recent Government-Issued FAQs Cause Plan Sponsors to Clarify Preventive Care and Wellness in Health Plan Communications

On October 23, 2015, the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and Treasury issued frequently asked questions (FAQs) on the implementation of preventive care and wellness provisions of the Affordable Care Act (ACA) and mental health parity disclosure, adding to the existing list of 28 previous editions of FAQs on the … Continue Reading

New Legislation Extends Future Form 5500 and 990 Deadlines, Affects Veterans Health Benefits and Extends Excess Pension Asset Transfer Rules

The recently enacted Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 includes provisions that will extend the deadlines for filing future Form 5500 and Form 990 series information returns. In addition, the legislation modifies rules relating to the ability of veterans to participate in health savings accounts (HSAs), allows employers to disregard … Continue Reading

IRS Adjusted ACA Fee Amounts for the 2015/2016 Policy or Plan Years and Additional Payment Options

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance policies and sponsors of self-insured health plans. The fees are calculated using the average number of lives covered under the policy or plan, and … Continue Reading

Further Guidance on the ACA’s Cadillac Tax

Effective for tax years beginning on or after January 1, 2018, an excise tax of 40 percent will be imposed on the cost of employer-sponsored health coverage that exceeds an annual limit. This tax is informally known as the “Cadillac Tax” and will impose a penalty on employers, health insurers and “persons who administer plan … Continue Reading

EEOC Proposed Rules Provide Long-Awaited Guidance for Wellness Programs

Corporate Wellness Magazine published an article about the Equal Employment Opportunity Commission’s (EEOC) long-awaited guidance on when it will enforce the Americans with Disabilities Act (ADA) against employers who sponsor certain types of employee wellness programs. Read the full article in Corporate Wellness Magazine.… Continue Reading

IRS Issues Q&As on Information Reporting under Code Section 6055 and 6056

Yesterday the U.S. Internal Revenue Service issued new Questions & Answers regarding the Affordable Care Act’s reporting rules under Code Section 6055 and 6056. The categories under the guidance include: Basics of the Reporting, Who is Required to Report, Methods of Reporting (for employers), What Information Must be Reported (for providers), and How and When to … Continue Reading

EEOC Issues Guidance on Employer Provided Wellness Programs

The Equal Employment Opportunity Commission (EEOC) released a long-awaited proposed rule amending regulations implementing Title I of the Americans with Disabilities Act to provide guidance regarding the extent to which employers may use incentives to encourage employees to participate in wellness programs that include disability-related inquiries and/or medical examinations. The proposed rule provides insight into … Continue Reading

Sharp Questions Dominate Supreme Court Oral Arguments Regarding the Challenge to the Availability of ACA Premium Tax Credits

On March 4, 2015, the Supreme Court of the United States heard oral arguments in King v. Burwell, the highest profile challenge to the Affordable Care Act (ACA) since the Supreme Court’s 2012 decision to uphold the law.  The oral arguments featured sharp questioning of both sides.  A decision is anticipated in June to determine … Continue Reading
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