by Amy M. Gordon, Susan M. Nash and Jacob Mattinson
Recently issued guidance clarifies annual information reporting requirements for insurers and employers under the Affordable Care Act (ACA). The required reporting enables the Internal Revenue Service to determine compliance with the employer and individual mandates and individual eligibility for premium tax credits under the ACA.
To read the full article please click here.
In a brief Frequently Asked Question (FAQ) document quietly issued yesterday, the U.S. Department of Labor formally clarified there is no penalty associated with provision of the Exchange Notice. The guidance states that employers “should provide a written notice to its employees about the Health Insurance Marketplace by October 1, 2013, but there is no fine or penalty under the law for failing to provide the notice.” Therefore, employers should send out the Exchange Notice, but there would be no penalty if someone is missed. (This FAQ does not state or imply that employers no longer have to send out the notice.)
by Amy M. Gordon and Jamie A. Weyeneth
The final regulations retain the definition of a religious employer, modify the accommodations provided for eligible organizations that object to contraception coverage on religious grounds, and describe how contraceptives will be provided and paid for under both a fully insured and a self-insured group health plan.
To read the full article, click here.
by Amy M. Gordon, Joanna C. Kerpen, Megan Mardy and Jamie A. Weyeneth
The Internal Revenue Service has provided transition relief for 2014 from the information reporting requirements under Internal Revenue Code Sections 6055 and 6056, and from the employer pay-or-play penalties under Code Section 4980H.
To read the full article, click here.
by Amy Gordon and Jamie Weyeneth
On May 29, the U.S. Departments of the Treasury, Labor (DOL) and Health and Human Services issued final regulations amending the 2006 HIPAA nondiscrimination wellness regulations to implement the employer wellness program provisions of the Affordable Care Act. In their article “Final ACA Wellness Rules Issued,” published by Employee Benefits Advisor, Amy Gordon and Jamie Weyeneth discuss the updated and expanded requirements for health-contingent wellness programs.
To read the full article, click here.
by Amy M. Gordon, Jamie A. Weyeneth and Megan Mardy
Recently issued Affordable Care Act guidance clarifies the prohibition on waiting periods in excess of 90 days and eliminates the requirement to issue HIPAA group health plan certificates of creditable coverage after December 31, 2014.
To read the full article, click here.
by Anne W. Hance and Amy M. Gordon
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) released on January 30, 2013, two proposed rules and a final rule relating to the Affordable Care Act’s (ACA) requirement that individuals maintain “minimum essential coverage” (MEC) or be subject to a “shared responsibility” payment.
Next Steps
Health insurance issuers will want to consider whether the various products they offer or administer will meet the MEC requirements set forth in HHS’s proposed rule, in order to respond to inquiries from customers, to meet notice requirements (including inserting model statements into existing plan documents, as applicable), and potentially to respond to exchanges making eligibility determinations. If a product does not constitute MEC, issuers may want to consider whether to continue to offer the product in its current form or revise the coverage to meet the MEC requirements.
Sponsors of group health plans will need to consider the separate affordability standards for employees and for related individuals and the implications for group health plan participants, and either modify coverage to meet the MEC standards, or consider the consequences of the shared responsibility payment.
by Amy M. Gordon, Jacob Mattinson and Susan M. Nash
As part of the Patient Protection and Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) recently released proposed regulations regarding the estimated amount of annual contributions that are required to be paid to HHS from employer-sponsored group health plans to finance state transitional reinsurance programs. The reinsurance programs are intended to help stabilize premiums for coverage in the individual market during the first three years the state health insurance exchanges are operational (2014 through 2016). HHS is estimating the annual contribution rate for 2014 will be $63 per covered life (employees and their dependents). This will undoubtedly impact the overall cost of providing coverage under an employer-sponsored group health plan and should be taken into account by employers for purposes of estimating cost trends.
by Amy Gordon, Susan Nash, Maureen O’Brien
Recent guidance issued by the Departments of Health and Human Services and Labor and the Internal Revenue Service clarifies health care reform rules regarding waiting periods and the definition of full-time employee for purposes of the employer requirement to provide health care coverage beginning in 2014. The Internal Revenue Service has also issued guidance relating to the determination of wages for purposes of determining affordability of health care coverage under the Affordable Care Act.
Click here to see IRS Notice 2012-58 and here for Technical Release 2012-02. McDermott will be releasing a detailed analysis of the new guidance soon.
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