Category Archives: Health Care Reform

The ACA After Five Years: Disasters Did Not Materialize, But More Change Is Needed

Five years ago, in March 2010, the Affordable Care Act was signed into law by President Obama to resolve problems in the U.S. health system, including: the high number of uninsured Americans; Americans unable to get coverage due to pre-existing…

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High Court Sees Problems in King Petitioners’ Arguments

Petitioners in King v. Burwell could run up against the same logic that brought down Medicaid expansion under health care reform: it could be unconstitutional for the federal government to use draconian coercion to force states to set up exchanges. Justice Anthony…

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IRS Rules Further Define Payment of ACA Insurer Fees

New IRS regulations define the way health insurers will pay fees under Section 9010 of the Affordable Care Act. In the rules, the IRS applies Notice 2014-47 and provides further guidance on how covered entities will pay the fees for 2015 and subsequent…

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Employers must cover physician and hospital services to avoid ACA fines

On Feb. 23, the Centers for Medicare and Medicaid Services put on public display final rules that require employer health plans to cover physician and hospital services in order to meet health care reform’s minimum value requirement. The rules also set the…

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IRS Offers Temporary Safe Harbor for Some Premium Reimbursement Arrangements

Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the…

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Employees Not Helped by Slow Health Premium Growth

Employers have been shifting more premium costs to workers and increasing their deductibles. That, in addition to the fact that price growth in the health sector outpaces growth for the rest of the economy,  has resulted in a disproportionate increase…

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Rules Attempt to Streamline ACA Benefits Summary

Proposed changes to the Summary of Benefits and Coverage rules under health care reform include additions and subtractions to the SBC template, as well as clarifications on how plan sponsors and insurers may apportion the responsibility to furnish the SBC…

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Definition of ‘Excepted Benefits’ Would Expand under ACA Proposal

Two specific types of limited wraparound coverage could qualify as “limited excepted benefits,” under health care reform rules proposed Dec. 19 by the U.S. Departments of Labor, Health and Human Services and the Treasury. “Excepted” status would be available on a temporary…

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ACA Transitional Relief: What Employers Ought to Know

Leading employee benefits attorneys recently discussed rules on calculating workforces and identifying to whom the employer must make an offer of coverage. Vanessa Scott, a partner with Sutherland Asbill & Brennan, Washington, D.C., and Malcolm Slee, of Counsel at the Groom…

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Cafeteria Plans Can Help Employers Avoid Pay-or-Play Penalties

Employer contributions to a Section 125 cafeteria plan can be deducted from the employee’s cost of a health plan for purposes of determining the affordability of coverage, final IRS rules on minimum essential coverage published on Nov. 26 (79 Fed….

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