“From thirty feet away she looked like a lot of class. From ten feet away she looked like something made up to be seen from thirty feet away.” – Raymond Chandler, The High Window That’s typically true of legislation that...more
The Internal Revenue Service (IRS) decreased the Affordable Care Act (ACA) affordability percentage for 2024 to 8.39%. This percentage is used to assess whether an applicable large employer’s (ALE) lowest-premium health plan...more
The employee benefits 2024 open enrollment season is quickly approaching and, with newly released IRS guidance, employers should be careful to ensure the health plan they offer employees is considered affordable. According to...more
The public charge provisions in the Immigration Nationality Ac (INA) have been part of U.S. immigration law for decades. We recently reported that on December 23, 2022, the Department of Homeland Security (DHS) began using a...more
Since ACA reporting was first required by employers in 2015, the affordability component under the Employer Mandate was established each year by indexing the standard of 9.5%. This has always been the case, that is, until...more
On October 5, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion No. 22-19, finding that a proposal by an entity funded entirely by manufacturers of oncology...more
On August 19, 2022, the United States District Court for the Southern District of Georgia reinstated “Georgia Pathways,” a Section 1115 demonstration waiver which requires individuals, among other conditions, to complete 80...more
Seyfarth Synopsis: The IRS has announced adjustments decreasing the affordability threshold for plan years beginning in 2023, which may cause employers to have to pay more for ACA compliant coverage in 2023....more
John Peterson has created a 2022 Premium Tax Credit Chart, updated for the American Rescue Plan Act. 1. Locate line where estimated 2022 household income & household size intersect 2. First column shows household % of...more
Last week, President Biden presented an outline of a $1.75 trillion Build Back Better (BBB) social spending reconciliation framework resulting from months of negotiations with House and Senate Democrats. Congressional...more
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) on July 8, 2021, issued Advisory Opinion No. 21-08, a favorable opinion authorizing a manufacturer of gene therapy to provide...more
The Internal Revenue Service (IRS) has issued final regulations covering tax-free savings accounts that allow people with disabilities and their families to save and pay for disability-related expenses without jeopardizing...more
CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...more
This post is the second installment in our blog series looking back on the 10-year anniversary of the Affordable Care Act (ACA) and will examine Medicaid expansion under the ACA. Medicaid is joint federal-state program that...more
As 2020 approaches, employers in New England may want to review their noncompetition agreements to determine whether they comply with recently enacted laws in Rhode Island and New Hampshire. In 2019, both states passed laws...more
ACA plans scored a major victory last week when a federal court held that health plans participating on the ACA exchanges are entitled to unpaid cost sharing reduction (CSR) payments from the federal government. The case –...more
As open enrollment approaches for the 2019 calendar year, below are some items employers may want to consider: Wellness program changes – Many employers change their wellness programs during open enrollment. This is a...more
“BASEBALL IS LIFE. The rest is just details.” To members of the Green Valley High School (Henderson, Nevada) varsity baseball team in the mid-1990s, this wasn’t just a catchphrase on a t-shirt; it was gospel. We lived and...more
On June 7, 2018, Virginia joined 32 other states and the District of Columbia in expanding Medicaid under the Affordable Care Act to adults with incomes at or below 138% of the federal poverty level (FPL). After rejecting...more
In a previous blog, we reviewed pending and approved 1115 waivers in 11 states. These reviews provide an overview of 1115 waiver applications, including a focus on work requirements, lock-outs, changes in coverage structures,...more
The Massachusetts Department of Unemployment Assistance (DUA) has begun assessing Employer Medical Assistance Contribution (EMAC) supplemental payments for the first quarter. This post proposes a grounds for appealing DUA...more
2018 Poverty Guidelines - The 2018 Federal Poverty Guidelines (“FPG”) were published in the Federal Register on January 18. Customers may qualify for Lifeline if their gross total household income is at or below 135...more
In November 2017, Maine voters approved a referendum to implement expansion of MaineCare under the Affordable Care Act (ACA) to adults with incomes up to 138 percent of the federal poverty level (FPL). As Maine’s legislature...more
Happy New Year!?! 2017 was an eventful year for health care, and now we can all sit back and relax with very little concern that major health policy will be on the table in 2018. Right? Why must Speaker Ryan ruin our...more
As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more