Category Archives: Health Care Reform

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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Supreme Court Frees More For-profits from ACA’s Contraceptive Mandate

Closely held corporations with religious objections cannot be required to provide contraception coverage under health care reform regulations because that would violate the owners’ rights under the Religious Freedom Restoration Act, the U.S. Supreme Court today ruled in Burwell v. Hobby…

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Employers Can Stretch Waiting Periods beyond 90 Days Using HHS’s 30-day Orientation Period

Employers now can get an extra 30 days on top of the 90 days by which employers must have offered health coverage to eligible workers, under new final rules on orientation periods issued by the U.S. Departments of Labor, Health…

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FAQs Describe How Plans, Administrators Will Pay Reinsurance Contributions

On May 22, CMS issued guidance (registration required) describing how plans, third-party administrators and insurers will pay reinsurance contributions required under health care reform for the next three years. The guidance says a contributing entity can complete all required steps for the…

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CMS: Waiting Periods on Essential Benefits May Be Discrimination

Employer-sponsored health plans and insurers got a double dose of compliance advice on May 16 from the Centers of Medicare and Medicaid Services in the form of a set of Frequently Asked Questions. The first FAQ clarifies that insurers in the…

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Employers and Health Plans: Panelists Don’t See ACA Exodus

The jury’s still out on the impact of health care reform on employment‐based health benefits, but predictions of mass instability are certainly not materializing, reform experts said May 15 at a policy forum sponsored by the Employee Benefits Research Institute…

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