News & Analysis as of

Shared Responsibility Rule Internal Revenue Service

Health Care Reform Weekly Roundup – Issue 1

Efforts to repeal and replace the Affordable Care Act (“ACA”) are in full swing as the U.S. Senate considers whether to modify the House of Representative’s American Health Care Act (“AHCA”) or draft its own ACA repeal...more

IRS Implementation of ACA’s Employer Shared Responsibility Provision Falls Short Based on the Results of a Recent Audit

by McDermott Will & Emery on

Based on a recent audit conducted by the Treasury Inspector General for Tax Administration (TIGTA), the IRS’ processes and procedures to ensure compliance with the employer information reporting requirements mandated by the...more

IRS Implementation of ACA’s Employer Shared Responsibility Provision Falls Short Based on the Results of a Recent Audit

by McDermott Will & Emery on

Based on a recent audit conducted by the Treasury Inspector General for Tax Administration (TIGTA), the IRS’ processes and procedures to ensure compliance with the employer information reporting requirements mandated by the...more

Employer Shared Responsibility: Have Penalties Been—or Will Penalties Ever Be—Assessed?

by Perkins Coie on

Are you an Applicable Large Employer (ALE) that has received rejected Forms 1095-C from the IRS? If so, you are not alone. ...more

Full Steam Ahead: IRS Moves Forward to Collect Affordable Care Act Penalties

by Snell & Wilmer on

As efforts to reform the Affordable Care Act (the “ACA”) stall in Congress, a recent government report suggests that the Internal Revenue Service is preparing to identify and collect employer shared responsibility penalties....more

IRS Will Not Require Response to Qualifying Health Coverage Line on 2016 Form 1040 Filings

by Dickinson Wright on

Individuals completing their 2016 IRS Form 1040s will recognize the question asking if they, their spouses and dependents had qualifying health care coverage in 2016 (Form 1040 line 61, Form 1040A line 38, Form 1040EZ line...more

IRS to Process Tax Returns That Lack Certification of ACA-Required Coverage

by Jackson Lewis P.C. on

In the wake of the President’s January 20, 2017 Executive Order directing a reduction in regulatory burdens imposed by the Affordable Care Act (ACA), the IRS has quietly announced that it will continue to process income tax...more

Will Employers’ ACA Obligations Change Under the Trump Administration?

by Perkins Coie on

During his campaign, President-elect Trump promised to make the repeal and replacement of the Affordable Care Act (ACA) a priority. Now that the election is over, what should employers expect? We don’t have a crystal ball,...more

Employee Classifications, Employer Shared Responsibility Tax and Medicare Collide

by Winstead PC on

Some employers have attempted to manage their risks related to the employer shared responsibility tax (a/k/a the pay or play penalty) by placing employees into classifications and indicating that particular classifications of...more

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

by Snell & Wilmer on

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

Marketplace Subsidy Notices – What Employers Should Know

As promised by the Centers for Medicare & Medicaid Services (CMS) in late-2015, the Federally-Facilitated Marketplaces (FFMs) have started sending notices informing employers that employees have enrolled in a FFM and were...more

Code § 4980H: The Tax The Beatles Missed

by Balch & Bingham LLP on

The Tax Man, it turns out, also may assess you for failing to offer substantially all your full-time employees and their dependents affordable, qualifying group health coverage during 2015. We’re swamped with employer...more

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

Employee Benefits Developments - January 2016

by Hodgson Russ LLP on

IRS Guidance Addresses Numerous ACA Issues Related to HRAs. Just before the New Year, the IRS issued Notice 2015-87 (Notice), addressing the application of Affordable Care Act (ACA) market reform rules to different...more

Health Care and the ACA: IRS Formalizes Position on Opt-Out Payments

by Hodgson Russ LLP on

On December 16, 2015, the IRS, the Department of Health and Human Services, and Department of Labor issued Notice 2015-87, which provides guidance on the application of various provisions of the Affordable Care Act (ACA) to...more

Manatt on Health Reform: Weekly Highlights - December 2015 #3

Guidance from HHS and Treasury sets a high bar for 1332 waiver approvals; Kentuckians support Medicaid expansion and their State Marketplace despite plans to change course; and South Dakota's executive budget includes funds...more

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

End of Year Issues Impacting Employer Health Plans

by Sherman & Howard L.L.C. on

With the end of 2015 fast approaching, employers should be aware of certain issues under the Patient Protection and Affordable Care Act (“ACA”), the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 15 of 24): Coding Form 1095-C, Part II for...

As we noted in a previous post, the recently issued final 2015 Instructions for Forms 1094-C and 1095-C changed certain of the rules relating to the reporting for offers of COBRA coverage where the COBRA qualifying event...more

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

Final Forms and Instructions for ACA Information Reporting Released

by Snell & Wilmer on

The IRS recently released the final forms and instructions for information reporting under the Affordable Care Act (“ACA”). The final forms and instructions will be used for reporting in 2016 concerning 2015 coverage. The...more

Do Seasonal Workers “Count” for Forms 1094-C and 1095-C?

by Balch & Bingham LLP on

We were asked that recently, proving that there is such a thing as a wrong question. Let’s break it down. The same person may be both a “seasonal worker” and a “seasonal employee,” but those terms are used to discuss separate...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 9 of 24): Unraveling the Mystery of Indicator...

The Affordable Care Act’s reporting rules—which are set out in Internal Revenue Code §§ 6055 and 6056—solicit the information needed by the Internal Revenue Service to enforce the individual and employer shared responsibility...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 8 of 24): Reporting Offers of Coverage “On...

The Affordable Care Act’s (ACA) employer shared responsibility rules provide applicable large employers (i.e., those with 50 or more full-time and full-time equivalent employees on business days during the preceding calendar...more

Updated Proposed Regulations Issued: Inpatient Hospital and Physician Services Must Be Covered

by Balch & Bingham LLP on

Tuesday the IRS issued proposed regulations that require an employer-sponsored health plan to include substantial coverage of inpatient hospital and physician services in order for the plan be considered as providing minimum...more

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