Patient Protection and Affordable Care Act (PPACA) Employer Group Health Plans

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

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

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

The Internal Revenue Service recently issued revised draft Forms 1094-C and 1095-C and related instructions for use for the 2016 reporting year. ...more

You Received a Health Insurance Marketplace Notice from HHS – Now What?

Take a deep breath. The HHS Health Insurance Marketplace Notice (the “Notice”) may seem to be a nuisance, but it does not necessarily mean that you will be subject to employer shared responsibility penalties....more

Are You Down With O.O.P.s?: Opt-Out Payments Under the Affordable Care Act

In Notice 2015-87, the IRS addressed the impact of employer opt-out payments — payments made to employees who decline enrollment in an employer’s group health plan — on affordability for ACA purposes. Employers who do not...more

IRS Issues Drafts of Forms 1094-C, 1095-B and 1095-C for 2016

Last month, the IRS issued proposed changes to the ACA reporting and disclosure forms for 2016. As a reminder, Forms 1094-B and 1095-B are used by insurance providers to report on the number of individuals enrolled in health...more

Client Alert: The Physics of Wellness at Work

Newton’s Third Law of Motion states that for every action, there is an equal and opposite reaction, and that Law is evident in the workplace wellness environment. Employers believe they are doing right by their employees by...more

Departments Finally Publish Updated SBC Template and Instructions

On April 6, 2016, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued an updated Summary of Benefits and Coverage (“SBC”) template. The latest template represents an effort by the...more

The Contraceptive Saga Continues

In Zubik v. Burwell, the justices vacated and remanded six federal appellate judgements on whether an accommodation (described below) for employers with religious objections to providing coverage for some or all contraception...more

ACA Reporting Update – 2016 Draft Forms & Instructions Released

Since our last ACA Reporting Update, the extended deadlines to distribute Forms 1095-B and 1095-C to covered individuals and employees and to file the forms with the IRS have passed. The IRS has stated, however, that late...more

Government Requests Information on ACA Contraceptive Mandate

In a recent Supreme Court case, Zubik v. Burwell, the justices vacated and remanded six federal appellate judgements on whether an accommodation (described below) for employers that object to providing contraceptive coverage...more

IRS Proposes Adjustments in Individual Mandate Reporting

The IRS has issued proposed regulations on the individual mandate reporting requirements under section 6055 of the Internal Revenue Code. To a significant degree, the new regulations reflect guidance previously published by...more

Manatt on Health Reform: Weekly Highlights - August 2016

Oregon’s hospitals see improved financial performance following the ACA; CMS denies Indiana’s request for an additional lockout period in the Medicaid expansion program; and a new Manatt Health report details Medicaid funding...more

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

Summary - 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...more

The EEOC's View of Wellness Programs

The EEOC’s regulations allayed many concerns over the permissible level of incentives/penalties, as well as the challenge of dealing with inconsistent requirements under the various laws. Originally published in The HR...more

Final ACA Nondiscrimination Rules Under Section 1557 Now Effective

This is the one hundred and first issue in our series of alerts for employers on selected topics on health care reform. (Click here to access our general Summary of Health Care Reform and other issues in this series.) This...more

Best in Law: Beware of In-Lieu-Of Payments to Employees

Employers who allow their employees to opt for taxable cash payments in lieu of health benefits must consider the value of the payments when calculating overtime rates, a federal appellate court has ruled. Originally...more

Waves of Guidance and Benefit Plan Developments Worth Watching

Notices on Second Round of Privacy and Security Audits are Out, Expat Plans, OON Surgery Center Billing Issues, and New Nondiscrimination Rules for Federal Contractors, New ERISA Civil Monetary Penalties, COBRA Notices and...more

GOP Unveils Obamacare Replacement

On June 22, House Speaker Paul Ryan (R-WI) and Republican House members released their official proposal to replace the Affordable Care Act. The proposal is the first comprehensive plan floated by congressional Republicans...more

More Clarity on Expatriate Health Plans and the ACA

Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more

Employee Benefits Advisory: ACA Forms 1095-C – June 2016 IRS Webinar Underscores Importance of Corrections

Clients often have questions about errors discovered during or after the filing of forms required by the IRS for purposes of complying with the pay or play mandate under the Affordable Care Act (ACA). In its recent June 14,...more

IRS Issues Proposed Regulations on Health Plan Opt-Out Payments

The Internal Revenue Service (“IRS”) has issued proposed regulations that include additional guidance on the treatment of employer-provided opt-out payments for purposes of affordability under the Affordable Care Act (“ACA”)....more

House Passes Small Business Healthcare Relief Act

Despite repeated guidance from the IRS that employer payment plans violate insurance reforms under the Affordable Care Act (the “ACA”), many small employers continue this arrangement of reimbursing employees for their cost of...more

Employee Benefits Developments - June 2016

The Equal Employment Opportunity Commission (EEOC) issued final regulations describing how the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) apply to employer wellness...more

EEOC Offers Guidance On Employee Wellness Program Notices Required Under New Rules

On the heels of at least two discrimination lawsuits over employer wellness programs, the Equal Employment Opportunity Commission (EEOC) issued two new rules on May 17, 2016 under the Americans with Disabilities Act (ADA) and...more

Transitioning to Coverage: Three Things to Know About the New Transgender Healthcare Regulations

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations implementing the nondiscrimination provisions of the Affordable Care Act. As we discussed in our March 30, 2016 blog, the rule...more

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