Minimum Essential Coverage

Health Care Reform Blog: Bare Bones" Health Plans- Are They Legal?

by Susan J. Freed | Davis Brown Law Firm on 5/21/2013

You may have woken up today to media reports of large employers exploring the idea of dropping traditional health plans in favor of very limited health care plans as a way to lessen the burden imposed on large employers for...more

IRS, Treasury Department Issue Proposed Rules Governing Minimum Value, Affordability, and Wellness Programs

by Alden J. Bianchi | Mintz Levin - Employment, Labor & Benefits on 5/17/2013

A key policy goal of the Patient Protection and Affordable Care Act (the “Act”) is the expansion of health insurance coverage to all Americans. The concepts of “minimum value” and its correlate “actuarial value” speak to the...more

Treasury Proposes Minimum Value Rules for Health Plans

by Kurt Anderson, Brian M. Pinheiro | Ballard Spahr LLP on 5/9/2013

The U.S. Department of the Treasury has published proposed regulations that provide guidance on how an employer may determine whether its group health plan provides “minimum value.”...more

Employer Responsibility – Will You Pay or Play?

by Kathryn Paradise, David L. Woodard | Poyner Spruill LLP on 5/7/2013

Starting in 2014, provisions of the Patient Protection and Affordable Care Act become effective known as “Pay or Play” or “Employer Shared Responsibility.” Large employers will be faced with the decision whether to offer...more

Affordable Care Act: New Requirements for Summary of Benefits and Coverage

by Andrew Elbon, B. David Joffe | Bradley Arant Boult Cummings LLP on 4/30/2013

The Departments of Labor, Treasury, and Health & Human Services have issued new guidance on the content requirements for health plan summaries of benefits and coverage (“SBCs”). Plan sponsors should ensure that the SBCs...more

Health Care Reform Blog: SBC Form Revised/New FAQs Released

by Susan J. Freed | Davis Brown Law Firm on 4/26/2013

Earlier this week the Agencies issued a revised Summary of Benefits & Coverage (“SBC”) template for use in describing health plan coverage that begins on or after January 1, 2014 and before January 1, 2015. ...more

The Affordable Care Act’s “Play-Or-Pay” Mandate: Who Is A Full-Time Employee For Purposes Of The Employer Shared Responsibility...

by Margret Warrick Truax | Perkins Coie on 4/23/2013

Recently, we published a Client Update explaining how the Play-or-Pay mandate, or Employer Shared Responsibility provision, under the Affordable Care Act (ACA) generally works. To summarize, we described how an employer...more

Healthcare Law -- Apr 22, 2013

by Manatt, Phelps & Phillips, LLP on 4/22/2013

In This Issue: The ACA’s Effects on the Employer Insurance Market; Using the Premium Assistance Option to Purchase Coverage for Medicaid Beneficiaries in the Exchange: A Review of the Legal, Policy and Operational Issues; and...more

Play or Pay and Minimum Essential Coverage: What, When and How (Much)?

by George Kasper, Ira Reifer | Pullman & Comley, LLC on 4/19/2013

Beginning in 2014, the Affordable Care Act’s employer shared responsibility rules, the so called “play or pay” rules, impose penalties on an employer with more than 50 “full-time equivalent” employees (a large employer) if...more

On the Manifold Meanings of "Affordability" According to the Patient Protection and Affordable Care Act

by Alden J. Bianchi | Mintz Levin - Employment, Labor & Benefits on 4/12/2013

The core policy goals of the Patient Protection and Affordable Care Act (the “Act”)—on which there is near universal consensus—are threefold: expand health care coverage; increase the quality of medical outcomes, and reduce...more

Controlling the “Play or Pay Penalty” under Healthcare Reform

by Lori Oliphant | Winstead PC on 4/11/2013

Proposed rules issued under the Affordable Care Act clarify the determination of “large employer” status and the calculation of the penalty for controlled groups of employers. This guidance confirms that the penalty is...more

Healthcare Law -- Mar 25, 2013

by Manatt, Phelps & Phillips, LLP on 3/26/2013

In This Issue: What Does the ACA Mean for Employers?; Manatt’s Attorneys Honored for Exceptional Client Service; and Manatt Health Solutions Expands Our Talent Base to Support Your Growing Range of Challenges....more

Healthcare Reform Compliance: Checklist of Next Steps

by Lori Oliphant | Winstead PC on 3/25/2013

It is impossible to ignore. Healthcare reform under the Affordable Care Act is on the minds, agendas and budgets of all employers, and now is the time for employers to review their health programs to address compliance with...more

Proposed And Final Rules Released Regarding The ACA's Individual Mandate

by Terry Brooks, Fred Entin, Ryan McAteer, Aaron Perry | Polsinelli on 2/28/2013

In This Issue: - Minimum Essential Coverage ..HHS Proposed Rule - Shared Responsibility Payments and Exemptions ..HHS Proposed Rule ..IRS Proposed Rule ..IRS Final Rule - Essential Health Benefits ...more

California Weighs In on Essential Health Benefits for Group Health Plans and Insurers

by Timothy G. Verrall | Ogletree, Deakins, Nash, Smoak & Stewart,... on 2/22/2013

As a reminder of the significant role that states will play in implementing the provisions of the Affordable Care Act (ACA), we wanted to highlight some recent legislative developments in California that will be of interest...more

IRS Issues Proposed Regulations for Employer-Shared Responsibility under ACA

by Baker, Donelson, Bearman, Caldwell &... on 2/18/2013

On December 28, 2012, the IRS issued proposed regulations with respect to employer-shared responsibility regarding health coverage under the Affordable Care Act of 2010 (ACA). Employers are permitted to rely on these proposed...more

The Affordable Care Act’s “Play Or Pay” Mandate: How It Works

by H. Vicky Chen, Margret Warrick Truax | Perkins Coie on 2/13/2013

The Affordable Care Act added the so-called “Play or Pay” mandate or “Employer Shared Responsibility” provisions to the Internal Revenue Code (the Code). Starting in 2014, certain employers may be subject to a penalty tax,...more

CMS and IRS Publish Proposed Rules on Exemption to Individual Mandate Financial Penalty

by King & Spalding on 2/7/2013

CMS and the Internal Revenue Service (IRS) issued two proposed rules on January 30, 2013 setting forth the exemptions an individual may satisfy to avoid financial penalties associated with the Patient Protection and...more

IRS Issues Proposed Regulations on Affordable Care Act's "Play or Pay" Requirements – What Employers Need to Know

by Douglas Schwartz | Nossaman LLP on 1/15/2013

Starting in 2014, "large" employers (essentially, those with 50 or more "full-time" employees) must offer minimum health insurance coverage to full-time employees or face hefty penalties. These provisions (a.k.a "shared...more

Health Care Reform – What Employers Should be Thinking About Now

by Jewelie Grape | Leonard, Street and Deinard - Employee... on 12/4/2012

Beginning in 2014, the Affordable Care Act will require employers employing 50 or more full-time equivalent employees to offer full-time employees affordable, minimum essential health coverage. If such health coverage is not...more

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