Tag Archives: Health plans

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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Employer Plan Entitled to $281K after Employee and Lawyer Lied about Settlement Funds

An employer-sponsored health plan was entitled to full recovery of more than $131,700 in funds, plus more than $149,000 in attorney’s fees, after it came to light that a plan participant and her attorneys tried to con the plan by…

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Signature Authority Can Trigger ERISA Fiduciary Responsibility

One of the most sensitive — and often misunderstood — aspects of being an executive of a company with a retirement plan is knowing when senior leaders are fiduciaries for the plan. A recent federal case added some clarity when…

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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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Plan Identifier Rules Not Written for Self-funded Plans

With the HIPAA deadline for obtaining a health plan identifier less than two months away, plan sponsors have encountered major problems trying to get one — if they’ve started at all, according to a poll conducted by the ERISA Industry…

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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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Ruling: Providers Are Not ERISA Beneficiaries

In a decision sharply at odds with a recent Illinois ruling, a federal district court in Arizona held that health care providers cannot be characterized as plan beneficiaries who can sue to compel payment of ERISA benefits. The court rejected…

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Employer Faces State-law Claims After False Promise Causes Beneficiary to Skip COBRA Coverage

A former employee left with more than $13,000 in unpaid medical bills after his employer retroactively terminated his employment and health benefits can sue for state-law claims, a federal district court ruled. The individual alleged that while he was hospitalized,…

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