Category Archives: Health Care Reform

Few Self-Insured Plans Will Escape Paying Reinsurance Fees

Only self-insured plans that completely self-administer claims payments and plan operations will avoid paying onerous transitional reinsurance fees. If a self-insured health plan does no more than determine eligibility, it will have to pay, according to Jeffrey Endick, an attorney with Slevin…

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Decisions Must be Made on How Employers Will Manage Section 6055/56 Reporting

Employers deciding how to comply with the Affordable Care Act’s reporting requirements have important housekeeping questions to decide, such as: (1) who will take phone calls from the IRS and employees about ACA forms; (2) whether electronic filing (for the…

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Rules Describe How Employers Will Identify Full-timers through Job Changes

New guidance from the IRS proposes new approaches to the application of the look-back measurement method, which employers use to determine if an employee is full-time or part-time for purposes of the employer mandate. Notice 2014-49 covers situations such as…

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IRS Lawyers Discuss Reporting on Offers of Coverage

IRS officials described when employers themselves have to fill out full information on all health plan enrollees along with months enrolled, and when employers can hand that over to another entity, such as an insurer. Most employers offer minimum essential…

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More IRS Guidance on ACA’s Health Coverage Reporting Rules

IRS on Aug. 29 issued two sets of questions and answers about reporting on health coverage for large employers under Section 6056 and for all employers under Section 6055 of the reform law. Section 6056 reporting is required by “applicable large employers” that provide…

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Learning How to Count: IRS Attorneys Discuss ACA’s Pay-or-play Provisions

Employer preparation for preparing for health care reform’s pay-or-play provisions, especially data reporting (under Sections 6055 and 6056) to the IRS, can be complicated by: (1) changes in workers’ employment status (from part-time to full-time); (2) an organization’s switching from…

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IRS Issues Info on Exchange Eligibility, Penalties and Subsidies

The IRS has issued final/temporary and proposed rules, and a raft of guidance and draft forms related to reporting requirements for employers and individuals under health care reform. The rules and guidance are designed to help individuals and businesses calculate…

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IRS Caps Individual Penalties at National Bronze-level Premium

A single individual who failed to get health insurance will face a tax penalty of no more than $204 for each month he or she lacked coverage in 2014, the IRS announced on July 25. The maximum amount for a…

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Appeals Courts Issue Opposite Rulings on Health Care Reform Subsidies

Two appeals court rulings with differing views on the availability of premium subsidies for policies purchased through state-based health insurance exchanges establish a circuit split that sets the stage for the U.S. Supreme Court to step in. One court ruled…

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Self-funded Plans and TPAs Affected by Top Court’s Hobby Lobby Ruling

The U.S. Supreme Court ruling that “closely held” for-profit companies can — on religious grounds — opt out of a federal requirement to provide certain contraception coverage is rife with implications for self-insured and other employer-sponsored health plans. The ruling…

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