On March 6, 2017, after years of promising, GOP lawmakers in the House of Representatives introduced the “American Health Care Act” (AHCA), the first concrete legislative proposal detailing the initial provisions designed to...more
3/22/2017
/ Affordable Care Act ,
Cadillac Tax ,
Congressional Budget Act of 1974 ,
Dependent Coverage ,
Employer Mandates ,
Flexible Spending Accounts ,
Health Insurance ,
Health Savings Accounts ,
Individual Mandate ,
Medicaid Expansion ,
Medical Device Tax ,
Medicare Part D ,
Minimum Essential Coverage ,
Over-the-Counter Sales ,
Premium Subsidies ,
Prescription Drugs ,
Proposed Legislation ,
Repeal ,
Small Business ,
Tax Credits
Employer-sponsored group health plans and health insurance issuers (or carriers) are subject to information reporting requirements under the Affordable Care Act (ACA), including the obligation to report taxpayer...more
We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more
8/27/2016
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Health Insurance ,
Hospitals ,
Indemnity ,
Minimum Essential Coverage ,
NAIC ,
Supplemental Insurance
This post concludes our half-year series of posts focusing on the Affordable Care Act’s reporting requirements. These requirements are challenging in the extreme. Carriers and employers, and their vendors, service providers...more
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
In an earlier post, we reported on a troubling development in the draft 2015 instructions for Forms 1094-B and 1095-B which, if adopted, would have required sponsors of Health Reimbursement Arrangements (“HRA”) to issue...more
11/3/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Final Rules ,
Form 1094 ,
Form 1095 ,
HRA ,
IRS ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part B ,
Minimum Essential Coverage ,
Reporting Requirements ,
State Medicaid Programs ,
Supplemental Insurance ,
TRICARE ,
U.S. Treasury
This series is devoted principally to the reporting requirements imposed by Internal Revenue Code §§ 6055 and 6056 as added by §§ 1502 and 1514 of the Affordable Care Act (ACA), respectively. The former reports offers of...more
In Notice 2014-69, the Treasury Department and the IRS clarified that a group health plan that fails to provide substantial coverage for in-patient hospitalization and physician services will not be treated as providing...more
9/30/2015
/ Affordable Care Act ,
Amended Regulation ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Hospitals ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Physicians ,
Proposed Regulation ,
Tax Credits ,
U.S. Treasury
The IRS recently issued final instructions for Forms 1094-B and 1095-B and Forms 1094-C and 1095-C . The 2015 Instructions for Forms 1094-B and 1095-B implement a suggestion we made in a previous post relating to the...more
9/22/2015
/ Affordable Care Act ,
COBRA ,
Employer Group Health Plans ,
Employer Liability Issues ,
Expatriates ,
Final Guidance ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HRA ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Multiemployer Plan ,
Proposed Regulation ,
Reporting Requirements ,
Self-Funded Health Plans ,
U.S. Treasury
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
9/15/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Mandates ,
Internal Revenue Code (IRC) ,
IRS ,
Large Employer ,
Look-Back Measurement Period ,
Minimum Essential Coverage ,
Reporting Requirements ,
Shared Responsibility Rule ,
Subsidies
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
8/25/2015
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Final Rules ,
Flexible Spending Accounts ,
Form 1095 ,
Health Insurance ,
Health Insurance Exchanges ,
Incentives ,
Individual Mandate ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Opt-Outs ,
Penalties ,
Reporting Requirements ,
Safe Harbors ,
Shared Responsibility Rule ,
Subsidies ,
Waivers
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
8/19/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Mandates ,
Form 1094 ,
Form 1095 ,
Health Savings Accounts ,
HRA ,
IRS ,
Large Employer ,
Minimum Essential Coverage ,
Reporting Requirements ,
Section 6055 ,
Shared Responsibility Rule ,
Supplemental Insurance
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
8/11/2015
/ Affordable Care Act ,
COBRA ,
Employer Mandates ,
Filing Deadlines ,
Form 1095 ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Internal Revenue Code (IRC) ,
IRS ,
Large Employer ,
Minimum Essential Coverage ,
Multiemployer Plan ,
PHI ,
Premiums ,
Reporting Requirements ,
Tax Credits ,
Tax Extensions ,
Tax Penalties ,
Trade Preferences Extension Act (TPEA) ,
Waivers
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 (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)
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
7/20/2015
/ Affordable Care Act ,
Compliance ,
Corporate Counsel ,
Employer Group Health Plans ,
Employer Liability Issues ,
Employer Mandates ,
Exceptions ,
Good Faith ,
Health Insurance ,
Individual Mandate ,
IRS ,
Minimum Essential Coverage ,
Penalties ,
Popular ,
Reporting Requirements ,
Self-Funded Health Plans
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
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
Applicable large employers faced with the prospect of complying with the Affordable Care Act’s employer shared responsibility rules must grapple with and understand what is means to make an offer of minimum essential coverage...more
The Obama administration's July 2013 announcement, delaying enforcement of the employer mandate under the Affordable Care Act by one year, has affected not only when employees must be offered health insurance coverage but...more
A May 10 Wall Street Journal article, “Employers Eye Bare-Bones Health Plans Under New Law” (see the associated video on WSJ Live), highlighted a compliance strategy to minimize employer exposure for assessable payments under...more
The Affordable Care Act’s employer shared responsibility rules will require large employers (50 or more full-time and full-time equivalent employees) to make an offer of minimum essential coverage to at least 95% of their...more
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
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