
Articles
Supreme Court Rules Subsidies Are Available Through the Federal Marketplace (Exchange)
Thursday, June 25, 2015
In a 6-3 decision, the Supreme Court has ruled that Affordable Care Act (ACA) subsidies will continue to be available to certain individuals who purchase health insurance plans in states that use the Federal Marketplace. This decision is important for employers as they work to implement the strategies necessary to comply with ACA employer requirements.
PCORI Fees Due July 31
Monday, June 22, 2015
Employers who sponsor self-funded medical plans must report and pay the ACA Patient-Centered Outcomes Research Institute (PCORI) fees no later than July 31, 2015. Health insurance carriers/insurers will pay the fee directly in the case of fully-insured plans.
Employer Reporting Requirements
Monday, May 18, 2015
Beginning in early 2016, employer reporting will be required for the first time based on data from the 2015 calendar year.
EEOC issues regulations addressing ADA requirements for employer wellness programs
Wednesday, April 29, 2015
The Equal Employment Opportunity Commission (EEOC) has issued long awaited proposed regulations on how employers can structure their wellness programs in relation to the American with Disabilities Act (ADA).
Out-of-Pocket Maximums
Wednesday, March 25, 2015
In final regulations published in February 2015, the Department of Health and Human Services and Centers for Medicare and Medicaid Services (CMS) set forth various limits and coverage requirements for 2016. In regards to the out-of-pocket (OOP) maximum that applies to essential health benefits the agencies not only set forth the 2016 limits, but also […]
Notice of Coverage through the Benefit Exchange
Wednesday, February 18, 2015
Starting in 2015, the employer mandate is being phased in and employers with 100 or more full-time equivalents (FTEs) may pay an additional tax on any eligible individuals who are not offered coverage or for whom coverage is unaffordable. In 2016, employers with 50 or more FTEs will be required to comply as well.
The Longshore and Harbor Workers’ Compensation Act Coverage
Wednesday, February 18, 2015
One of the great benefits of living near oceans, rivers or lakes is the beautiful waterfront vistas we get to enjoy. However, for those involved in the world of construction, those waters can also be dangerous to navigate in terms of Workers’ Compensation insurance.
IRS Releases Final Reporting Forms and Instructions
Thursday, February 12, 2015
The IRS has released final forms and instructions for the ACA employer reporting requirement. Applicable large employers (ALEs, generally those with 50 or more FTEs), and small employers with self-funded group health plans, are required to report certain plan information to the IRS and to provide statements to employees, beginning in 2016 for calendar year 2015 health plan and coverage data.
SBC and Uniform Glossary Modifications
Thursday, January 15, 2015
On Dec. 22, 2014, the Department of Labor (DOL), Health and Human Services (HHS) and the Treasury (IRS) jointly released proposed rules regarding the requirements relating to the Summary of Benefits and Coverage (SBC) and the accompanying uniform glossary. Most notably, these proposed rules shorten the template to 2½ pages; add a new example to illustrate coverage; add new definitions to the uniform glossary; and provide updated templates, instructions, and other related documents.
CMS Extends the Deadline to Report Membership Data for the Transitional Reinsurance Contribution
Monday, November 17, 2014
On Friday November 14th the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) announced an extension of the deadline for submission of plan membership data for the transitional reinsurance program (TRP). Employer/plan sponsors of self-funded plans were originally required to report membership by November 17th, 2014, but the filing deadline has now been extended to December 5th, 2014.
Supreme Court to Hear ACA Case
Thursday, November 13, 2014
On Friday Nov. 7th the Supreme Court announced they plan to consider challenges to the government’s policy of providing subsidies to individuals who purchase health insurance through Healthcare.gov, the federally run Marketplace. The case will be heard early in 2015, with a decision likely at the end of the Court’s term early in the summer of 2015.
Background
Employer Can Not Pay for Employee’s Individual Health Insurance
Tuesday, November 11, 2014
In the most direct guidance released to date, the DOL has issued new FAQs that make it clear employers are not permitted to pay for the cost of individual health insurance for employees, even if the payments are made on an after-tax basis.
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