On June 13, 2019, the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of the Treasury (Treasury Department) and the Internal Revenue Service (IRS) (collectively, the “Departments”)...more
7/11/2019
/ Affordable Care Act ,
COBRA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HRA ,
IRS ,
Medicare ,
Public Health Service Act ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
TRICARE ,
U.S. Treasury
In a series of recent posts, we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we...more
Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health...more
1/17/2018
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Fair Share Contribution ,
Governor Baker ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Local Ordinance ,
Popular ,
Reporting Requirements
The recent Republican election victories appear to ensure that the Affordable Care Act’s (ACA) days are numbered. But with nearly a fifth of the U.S. economy, and the health care coverage for some tens of millions of U.S....more
12/29/2016
/ Affordable Care Act ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
Healthcare ,
Healthcare Reform ,
HSA ,
Medical Stop-Loss Rules ,
Medicare ,
MEWAs ,
Wellness Programs
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
7/27/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Liability Issues ,
Employer Mandates ,
Good Faith ,
Health Insurance ,
Healthcare ,
IRS ,
Minimum Essential Coverage ,
New Legislation ,
Penalties ,
Reporting Requirements ,
Section 6722 ,
Self-Funded Health Plans ,
Trade Preferences Extension Act (TPEA)
Under the Affordable Care Act’s employer shared responsibility rules, applicable large employers (those with 50 or more full-time and full-time equivalent employees on business days during the preceding calendar year) incur...more
Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more
Following up on our Week 22 ACA Countdown to Compliance post, the D.C. Court of Appeals granted the government’s petition for en banc review in Halbig v. Burwell, which held low income subsidies to purchase coverage through...more
With two seemingly simple and straightforward definitions in the final regulations implementing the Affordable Care Act’s pay-or-play rules—i.e., definitions of “employer” and “employee”— the Treasury Department and IRS have...more
An earlier post explained the two principle methods—the “monthly measurement method” and the “look-back measurement method”—available to applicable large employers to identify full-time employees for purposes of determining...more
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
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) ushered in broad national standards aimed at improving the efficiency and effectiveness of the U.S. health care system. Referred to generically as...more
On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more
The Departments of the Treasury/IRS, Labor and Health and Human Services (the “Departments”) recently issued a final regulation under the 90-day waiting period limitation, which is included among the Affordable Care Act’s...more
6/30/2014
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Mandates ,
Healthcare ,
Healthcare Reform ,
Internal Revenue Code (IRC) ,
IRS ,
PHSA ,
U.S. Treasury
Recent developments under the Affordable Care Act and COBRA, and existing rules governing mid-year election changes under cafeteria plans, have combined to make it challenging for certain terminating employees and those...more
It was just over a year ago that the Wall Street Journal published an article entitled, “Employers Eye Bare-Bones Health Plans Under New Law,” which highlighted a compliance strategy to minimize employer exposure for...more
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
In last week’s post, we examined the appropriateness of capping the annual hours of new “variable hour employees” as a way to limit exposure under the Affordable Care Act’s employer shared responsibility rules. (These rules...more
Whenever Congress draws a line in the sand—such as with exposure for assessable payments under the Affordable Care Act’s employer shared responsibly rules—entities subject to regulation (here, applicable large employers) will...more
Whether a group health plan provides minimum value is central to the application of the Affordable Care Act’s employer shared responsibility rules. The particulars of the role of minimum value in determining assessable...more
Commencing with plan and policy years beginning on or after January 1, 2014, the Affordable Care Act amends the Public Health Service Act (“PHS Act”) to make three important changes to the rules governing health insurance...more
With so much attention focused on the particulars of the employer shared responsibility and, to a slightly lesser extent, reporting rules, it’s easy to lose sight of other important changes—including final regulations issued...more
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
In a rare display of bipartisanship, Congress voted to eliminate the Affordable Care Act’s separate cap on deductibles that applies to individual and small group insurance products. (These limits never applied to large...more
Distinguishing employees who are full-time from those who are not takes up a good deal of real estate in final regulations published in the Federal Register on February 12 implementing the Act’s employer shared responsibility...more