Minimum Essential Coverage

News & Analysis as of

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 6 of 24): Reporting Group Health Plan Opt-Out...

Under a common strategy for controlling group health care plan costs, employers sometimes adopt arrangements under which an employee is offered cash as an incentive to waive coverage. These arrangements are colloquially...more

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

As we reported last week, the IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C. These instructions are of interest to applicable large employers who must report their compliance with the Affordable Care...more

The ACA and Staffing Agency Workers

Companies that use staffing agencies to supply workers face special issues in determining their risk for the significant penalties under the Affordable Care Act’s “play or pay” rules....more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 4 of 24): Highlights from the Draft 2015...

The IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C (“2015 Instructions”). These are the forms that employers with 50 or more full-time employees (including full-time equivalent employees) in the...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers: The Basics (Part 3 of 24)

Alden Bianchi, Chair of Mintz Levin’s Employee Benefits & Executive Compensation Practice, will provide a weekly installment on the complex reporting obligations outlined by the Affordable Care Act for health insurance...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 2 of 24): Yikes! The Costs of Failing to Comply...

The Affordable Care Act (ACA) imposes information reporting rules on providers of minimum essential coverage, e.g., insurance carriers and self-funded plans, and on applicable large employers, i.e., those employers that are...more

Will § 4980H Require Judicial Amendment Too?

Absent applicable transitional relief, most of which vanishes after 2015, an ACA Applicable Large Employer that fails to offer Minimum Essential Coverage to at least 70% of its 2015 full-time employees and their dependents...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 1 of 24)

Alden Bianchi, Chair of the our Employee Benefits & Executive Compensation Practice, will provide a weekly installment on the complex reporting obligations outlined by the Affordable Care Act for health insurance carriers and...more

Agencies Issue Final Regulations on the Summary of Benefits and Coverage (SBC) Requirements

As promised in the FAQ issued on March 30, 2015, the U.S. Departments of the Treasury, Labor and Health and Human Services (the Departments) have issued final regulations regarding the summary of benefits and coverage (SBC)...more

Supreme Court Denies Significant Challenge to Affordable Care Act: Employers Should Continue to Follow the Act as Currently...

On June 25, 2015, the U.S. Supreme Court held in King v. Burwell that individual taxpayers who enroll in health plans through the federal government's health insurance exchange can be eligible for federal tax credits under...more

King v. Burwell – Will the Supreme Court Tip the ACA Dominos? Part 1

The health care industry has been closely watching four cases challenging whether federal subsidies could be used to reduce costs to consumers for health insurance purchased on an Affordable Care Act (ACA) Exchange in a state...more

Student Employees and the Affordable Care Act – Part 2 of 4: Can an offer of student coverage count as an applicable large...

In the previous installment of this series, we addressed whether student employees may be excluded from an employer’s offer of coverage. We concluded that a blanket exclusion of this nature could put an employer at risk for...more

Issue 92: IRS Releases Final Employer Reporting Forms and Instructions

As we previously reported in Issue 80, the Affordable Care Act (ACA) requires providers of minimum essential health coverage and applicable large employers to file annual reports with the IRS to report the coverage provided...more

New Regulations Permit Employers to Offer Limited Wraparound Health Coverage as Excepted Benefit - McGuireWoods Healthcare Reform...

This is the 48th in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

Employee Benefits: IRS Finalizes Affordable Care Act Reporting Forms (3/15)

The Internal Revenue Service (IRS) recently finalized reporting forms for employers and insurers to report information required by Internal Revenue Code (Code) Sections 6055 and 6056. ...more

BEST IN LAW: Employers need to heed Obamacare Reporting Rules

Compliance with reporting obligations is always important for any employer, but the employer reporting requirements under the Affordable Care Act pack a significant penalty that makes compliance particularly...more

CMS Finalizes 2016 ACA Marketplace Plan Benefit & Payment Parameters

The Centers for Medicare & Medicaid Services (CMS) has finalized its Affordable Care Act (ACA) Marketplace health plan payment parameters and essential benefit standards for 2016. ...more

Beware of Stop-Loss Coverage Gaps When Choosing a Self-Funded Major Medical Plan

The Affordable Care Act requires applicable large employers to make broad-based offers of group health insurance coverage to substantially all their full-time employees or face potential tax penalties. (The term “applicable...more

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

HHS Broadens Federal Controls Over Private Health Insurance Benefits and Operations

On November 21, 2014, the Obama administration released two proposed rules affecting health insurance issuers’ offering of private health insurance products both inside and outside of the public insurance exchanges...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 5: Health and Human Services (HHS) Wastes No Time Issuing...

Over the last couple of months, we have followed and reported on a particular ACA compliance strategy under which an employer subject to the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules...more

Manatt on Health Reform: Weekly Highlights: November 2014 #2

With the conclusion of the midterm elections last week and open enrollment just around the corner, this week’s news highlights both renewed pledges from the opposition and a flurry of implementation activity in the states....more

The Massachusetts Health Insurance Mandate: Some Good News for Massachusetts Taxpayers

Since 2007, most Massachusetts residents have been required to either obtain health insurance coverage meeting Massachusetts “minimum creditable coverage” standards, or pay a state tax penalty (for 2014, the penalty ranges...more

Government Kills Aggressive ACA Employer Planning Technique

Action Item: The government has struck down an important Affordable Care Act planning technique: so-called “middle” or “minimum value” plans. Employers that have implemented such plans or are significantly down the road on...more

Agencies Come Down Hard on Various Employer Health Plans and Arrangements

As we move into 2015, employers continue to grapple with numerous Health Care Reform concepts. Employers should be cautious regarding arrangements promoted to avoid health care penalties because the agencies are cracking...more

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