Alden J. Bianchi

Alden J. Bianchi

Mintz Levin

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The Future of the Affordable Care Act Week 6: Focus on the Individual Health Insurance Market

A recent report from the nation’s top actuaries takes a sobering look at the challenges policy makers face in creating a viable individual (i.e., non-group) health insurance market—a critical component of any plan to replace...more

2/17/2017 - Actuaries Affordable Care Act Health Insurance Healthcare Reform Medicaid

EEOC v. Flambeau, Judicial Restraint, and the (Uncertain) Future of Employer-Sponsored Wellness Programs

On January 25, the Seventh Circuit Court of Appeals issued it much-anticipated decision in EEOC v. Flambeau, Inc. This case involved the regulation of employer-sponsored wellness plans and programs. Since 2006, the rules...more

1/31/2017 - ADA Affordable Care Act EEOC HRA Safe Harbors Wellness Programs

The Future of the ACA Week 4: The Ryan Plan, “A Better Way”

The recent Republican election victories appear to ensure that the Affordable Care Act’s (ACA) days are numbered. But with nearly a fifth of the U.S. economy, and the health care coverage for some tens of millions of U.S....more

12/29/2016 - Affordable Care Act ERISA Health Savings Accounts Healthcare Healthcare Reform HIPAA HSA Medical Stop-Loss Rules Medicare MEWAs Wellness Programs

The Future of the ACA (Week 3): The Trump Plan, “Healthcare Reform to Make America Great Again”

The Trump campaign promised to “repeal and replace” the Affordable Care Act. On the campaign trail, candidate Trump was particularly critical of the ACA’s individual mandate, the subsidization of premium charges to older...more

12/14/2016 - Affordable Care Act Health Savings Accounts Healthcare Reform Medicaid Medicare Presidential Elections Trump Administration

The Future of the Affordable Care Act (Week 2): A Framework for Handicapping Proposals to Replace the ACA

The Affordable Care Act made fundamental and important changes to the way the United States finances health care. The law did not represent a radical departure from prior law or policy, however. The ACA instead worked within,...more

12/7/2016 - Affordable Care Act Healthcare Reform Medicaid

The Future of the Affordable Care Act (Week 1): Assessing the New Normal

The Affordable Care Act was—at least until the election of Donald J. Trump as President—the single most important piece of Federal social legislation in the United States in more than a generation. The law’s fate is now...more

11/29/2016 - Affordable Care Act Healthcare Reform Presidential Elections Trump Administration

ACA Reporting on Forms 1094-C and 1095-C, AIRTN500 Error Messages, and Incorrect and Missing Taxpayer Identification Numbers...

Employer-sponsored group health plans and health insurance issuers (or carriers) are subject to information reporting requirements under the Affordable Care Act (ACA), including the obligation to report taxpayer...more

9/22/2016 - Affordable Care Act Covered Employees Form 1094 Form 1095 IRS Minimum Essential Coverage Proposed Regulation Solicitation Taxpayer Identification Number

Hospital and Fixed Indemnity Policies; Excepted Benefits; Supplemental Coverage under Recently Proposed Treasury Regulations; and...

We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more

8/27/2016 - Affordable Care Act Employer Group Health Plans ERISA Health and Welfare Plans Health Insurance HHS Hospitals Indemnity Minimum Essential Coverage NAIC Supplemental Insurance

Hospital and Fixed Indemnity and Disease-Specific Policies in the Cross Hairs: Tri-Agency Proposed Rule Portends Some Disruption

On June 10, the Departments of Treasury, Labor, and Health and Human Services (The “Departments”) issued a set of proposed regulations dealing with expatriate health plans, excepted benefits, lifetime and annual limits, and...more

6/15/2016 - Affordable Care Act DOL Employee Benefits Employer Group Health Plans HHS HIPAA Indemnity Insurance Proposed Regulation U.S. Treasury

The Affordable Care Act’s Reporting Electronic Backbone—The AIR System

For the last half of 2015, we spent a good deal of time explaining the Affordable Care Act reporting requirements that applied to carriers and large employers. This post examines the how of ACA reporting. In particular, it...more

2/12/2016 - Affordable Care Act Applicable Large Employers (ALE) Electronic Filing Employer Group Health Plans Health Insurance IRS Registration Requirement Reporting Requirements

Staffing Firms, Educational Organizations, and Breaks-in-Service under the Affordable Care Act Employer Shared Responsibility...

In Q&A format, recently issued Notice 2015-87 addresses a number of pressing issues that have arisen under the Affordable Care Act (ACA), including that law’s employer shared responsibility rules, information reporting...more

2/12/2016 - Affordable Care Act Applicable Large Employers (ALE) Comment Period Educational Institutions Full-Time Employees IRS Look-Back Measurement Period Reporting Requirements Shared Responsibility Rule Staffing Agencies

Integrated Health Reimbursement Accounts, Coordination with Family Coverage, and Notice 2015-87—Something’s Missing

Issued at the end of last year, Notice 2015-87 provided detailed guidance on a host of topics. The notice has been referred to colloquially in some quarters as the “pot luck” notice. Among other things, the notice, in Q&A 4,...more

2/3/2016 - Affordable Care Act Dependents Employer Group Health Plans HRA IRS Spouses U.S. Treasury

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 24 of 24): 5 Predictions

This post concludes our half-year series of posts focusing on the Affordable Care Act’s reporting requirements. These requirements are challenging in the extreme. Carriers and employers, and their vendors, service providers...more

1/4/2016 - Affordable Care Act Applicable Large Employers (ALE) Filing Deadlines IRS Minimum Essential Coverage Reporting Requirements

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 23 of 24): Notice 2016-4 Postpones Reporting and...

Under the Affordable Care Act’s reporting requirements that have been the subject of this series, statements to responsible individuals (a/k/a “employees”)—i.e., Forms 1095-B and 1095-C—must be furnished on or before January...more

12/29/2015 - Affordable Care Act Filing Deadlines IRS Reporting Requirements Time Extensions U.S. Treasury

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 22 of 24): Affordability, HRA Contributions,...

The Treasury Department and the IRS this week issued Notice 2015-87 that addresses, among other things, the effect of Health Reimbursement Account (HRA) contributions, cafeteria plan flex credits and opt-out payments on...more

12/23/2015 - Affordable Care Act Benefit Plan Sponsors Cafeteria Plans HRA Reporting Requirements

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 21 of 24): Reporting for “MEC” Plans

It took a while, but most employers and their advisors have finally gotten the hang of the Affordable Care Act’s employer shared responsibility rules. That is, they understand generally that: 1. “Applicable Large...more

12/14/2015 - Affordable Care Act Employer Group Health Plans IRS Minimum Essential Coverage Reporting Requirements Shared Responsibility Rule

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 20 of 24): Reporting Affordability on Form...

Affordability—i.e., whether health coverage is “affordable”—occupies an important place in the Affordable Care Act’s (ACA) regulatory scheme. Under that law’s individual mandate, no penalties are imposed for failure to...more

12/4/2015 - Affordable Care Act Employer Group Health Plans Reporting Requirements Safe Harbors Shared Responsibility Rule

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 19 of 24): Terminations, Changes in Status and...

Last week we examined the reporting challenges associated with employee terminations, changes in status, and breaks in service under the monthly measurement method. As we explained, “[t]he final regulations under Code § 4980H...more

12/4/2015 - Affordable Care Act Full-Time Employees IRS Look-Back Measurement Period Reporting Requirements Termination

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 18 of 24): Terminations, Changes in Status and...

The final regulations under Code § 4980H establish two—and only two—methods for determining an employee’s status as full-time: the monthly measurement method and the look-back measurement method. Under the former (as the name...more

11/20/2015 - Affordable Care Act COBRA Form 1095 Full-Time Employees Reporting Requirements Termination

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 17 of 24): Reporting for Offers of Coverage and...

The recently enacted Bipartisan Budget Act of 2015 repealed Section 1511 of the Affordable Care Act (ACA), which generally would have required employers with more than 200 full-time employees to automatically enroll new...more

11/12/2015 - Affordable Care Act Applicable Large Employers (ALE) Automatic Enrollment Employer Group Health Plans Form 1095 Reporting Requirements

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 16 of 24): Reporting for, and Clearing Up...

In an earlier post, we reported on a troubling development in the draft 2015 instructions for Forms 1094-B and 1095-B which, if adopted, would have required sponsors of Health Reimbursement Arrangements (“HRA”) to issue...more

11/3/2015 - Affordable Care Act Employer Group Health Plans Final Rules Form 1094 Form 1095 HRA IRS Medicaid Medicare Medicare Advantage Medicare Part B Minimum Essential Coverage Reporting Requirements State Medicaid Programs Supplemental Insurance TRICARE U.S. Treasury

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 14 of 24): Coding Form 1095-C, Part II for...

When reporting offers of coverage to full-time employees under the Affordable Care Act’s (ACA) employer shared responsibility rules, much of the detail appears in Part II of IRS Form 1095-C, Lines 14, 15 and 16. For the most...more

10/23/2015 - Affordable Care Act Employer Mandates Full-Time Employees Health Insurance Hiring & Firing IRS Minimum Value Plans New Hires Part-Time Employees Penalties Reporting Requirements Shared Responsibility Rule

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 13 of 24): Coding Form 1095-C, Part II for...

Compliance with the Affordable Care Act’s (ACA) employer shared responsibility rules requires that applicable large employers identify their full-time employees. A “full-time employee” for this purpose is an employee who...more

10/14/2015 - Affordable Care Act Disability Leave Employer Mandates Excise Tax Full-Time Employees Health Insurance IRS Large Employer Penalties Reporting Requirements Safe Harbors U.S. Treasury

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 12 of 24): Deconstructing Form 1095-C, Parts II...

This series is devoted principally to the reporting requirements imposed by Internal Revenue Code §§ 6055 and 6056 as added by §§ 1502 and 1514 of the Affordable Care Act (ACA), respectively. The former reports offers of...more

10/6/2015 - Affordable Care Act Employer Liability Issues Employer Mandates Health Insurance Individual Mandate IRS Minimum Essential Coverage Popular Reporting Requirements

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