Pay or Play Patient Protection and Affordable Care Act (PPACA)

News & Analysis as of

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

Employee Benefits Developments - June 2015

Supreme Court: Plan Fiduciaries Have a Continuing Duty to Monitor Plan Investments. In 2007, participants and beneficiaries under a 401(k) plan sued the plan fiduciaries and the plan sponsor to recover damages for alleged...more

U.S. Supreme Court Upholds Obamacare Premium Tax Subsidies

Action Item: Yesterday's Supreme Court ruling to uphold the premium tax subsidy regime of the Affordable Care Act is of critical importance to individuals and employers alike regarding the availability of federal tax...more

Supreme Court Upholds Affordable Care Act Subsidies for Coverage Purchased on Federally Facilitated State Health Care Exchanges

The U.S. Supreme Court has upheld an IRS regulation authorizing tax subsidies for state health care exchanges established and run by the federal government. In King v. Burwell, the Court held that the language of the...more

ACA Update: Supreme Court Rules that Federal Insurance Exchanges May Issue Tax Subsidies

On June 25, 2015, the U.S. Supreme Court issued its decision in King v. Burwell, ruling that Section 36B of the Patient Protection and Affordable Care Act (“ACA”) authorizes insurance exchanges run by the federal government...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

ACA Countdown to Compliance - 52 Week Series For Employers

In this volume, we have collected the 52 weekly blog posts that comprise the series entitled, The Affordable Care Act—Countdown to Compliance for Employers. The series appeared in the Mintz Levin Employment Matters Blog...more

ACA Issues for Employers to Stay Aware of in 2015

With the Affordable Care Act's Employer Mandate (Pay-or-Play penalties) now officially in effect, employers with 50 or more full-time or full-time-equivalent employees should have already made all significant changes to their...more

The Affordable Care Act and Staffing: One Size Does Not Fit All

Since its enactment in 2010, the Affordable Care Act (ACA) has generated debate and questions about the law's impact on third-party staffing arrangements. With the effective date of the ACA's "pay-or-play" employer mandate...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 3: Group Health Plan, Cafeteria Plan and Health FSA...

As applicable large employers grapple with the Affordable Care Act’s (ACA) employer shared responsibility (pay-or-play) rules, two questions arise with notable frequency...more

The Affordable Care Act Part Two – Preparing for 2015

This is the second of a three part series on the Affordable Care Act (“ACA” or “Act”), commonly known as “ObamaCare.” This post discusses the Employer Mandate, which takes effect January 1, 2015, and certain reporting...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

The Affordable Care Act—Countdown to Compliance for Employers, Week 7: IRS Puts the Kibosh on Health Plans that Fail to Cover...

In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects...more

Feds Tighten the Belt on "Skinny Plans" and Other ACA Workarounds

On January 1, 2015, employers with 100 or more "full-time equivalents" will be subject to the "Pay or Play" regulations under the Affordable Care Act ("ACA"). Over the past few years, many consultants have sought to identify...more

IRS Seeks to Curb Popularity of ‘Skinny’ Health Plans

The Internal Revenue Service, in Notice 2014-69, has concluded that certain unconventional group health plan designs that offer limited or no coverage for in-patient hospitalization services and/or physician services will not...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 18: Emerging Strategies to Reduce or Eliminate Exposure for...

The Affordable Care Act’s employer shared responsibility, or “pay-or-play,” rules require “applicable large employers” (generally employers with 50 or more full-time and full-time equivalent employees) to offer group health...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 20: 9.5% ? 9.56% (And Why It Matters to Applicable Large...

While employers sometimes view the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules in isolation, they don’t operate that way. Instead, they exist side-by-side with other provisions of the Act. In...more

Affordable Care Act Update: Final Regulations Assist Employers With Identifying Full-Time Employees and Reporting Requirements

Earlier this year, the IRS issued final regulations implementing the employer shared responsibility provisions (the “Pay-or-Play Mandate”) of the Patient Protection and Affordable Care Act (“PPACA”). We issued a Client...more

Your Company Is a ‘Large Employer’ Under the Affordable Care Act—Now What? Requirements for Coverage and Potential Penalties

The Affordable Care Act (the ACA or the Act) requires ‘‘large employers’’ (90 DLR I-1, 5/9/14) with 50 or more full-time employees to offer health insurance coverage to their eligible employees and their dependents or face...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 30: The IRS Tells Us that Employer Payment Plans (Really,...

The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more

Monthly Benefits Update

Health & Welfare Plans - July 1 Deadline to Begin Measuring Employee Hours for ACA Employer Mandate/“Pay or Play” - As we have discussed in many previous alerts, the Affordable Care Act’s employer shared...more

Health Care Reform: Beware of Litigation Risks

As almost all employers know, one of the many requirements of health care reform is the so-called employer mandate. The employer mandate generally provides that large employers who fail to offer their full-time employees...more

Employee Benefits: Skinny Plans and Other Low-Cost Coverage Strategies Under the ACA

Beginning in 2015, an employer that employed at least 100 full-time employees (or full-time equivalents) during 2014 will become subject to the shared responsibility (employer mandate) provisions of the Patient Protection and...more

IRS' Final Employer Shared Responsibility Rules: Who is an "Applicable Large Employer"?

Earlier this year, the IRS issued final regulations that provide additional guidance on the employer shared responsibility rules (also called the “pay or play” rules) that will generally apply to employers’ group health plans...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 36: Hacking the Affordable Care Act’s $100/Day Penalties for...

Particularly with the issuance of final regulations under the Affordable Care Act’s employer shared responsibility rules, employers have been concerned—justifiably—with the pay-or-play penalties. ...more

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