Updates

PPACA Advisor

Interim Final Rules were released and became effective on October 6, 2017, allowing a greater number of employers to opt out of providing contraception to employees at no cost through their employer-sponsored health plan.
Author: United Benefit Advisors
Posted: December 8, 2017, 4:00 am
November was a busy month in the employee benefits world.
Author: United Benefit Advisors
Posted: December 4, 2017, 4:00 am
On the evening of October 12, 2017, President Trump announced that cost sharing reductions for low income Americans in relation to the Patient Protection and Affordable Care Act (ACA) would be stopped.
Author: United Benefit Advisors
Posted: October 13, 2017, 4:00 am
The order directs various federal agencies to explore options relating to association health plans, short term limited-duration coverage, and health reimbursement arrangements, within the next 60 to 120 days.
Author: United Benefit Advisors
Posted: October 12, 2017, 4:00 am
Reporting is required by employers with 50 or more full-time (or full-time equivalent) employees, insurers, or sponsors of self-funded health plans, on health coverage that is offered.
Author: United Benefit Advisors
Posted: October 10, 2017, 4:00 am
The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.
Author: United Benefit Advisors
Posted: August 14, 2017, 4:00 am
A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket health care costs for a participant as well as a participant's spouse and eligible dependents.
Author: United Benefit Advisors
Posted: August 14, 2017, 4:00 am
A dependent care flexible spending account (DCFSA) is a pre-tax benefit account used to pay for eligible dependent care services.
Author: United Benefit Advisors
Posted: August 14, 2017, 4:00 am
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits.
Author: United Benefit Advisors
Posted: July 21, 2017, 4:00 am
On June 22, 2017, the U.S. Senate released a “Discussion Draft” of the “Better Care Reconciliation Act of 2017” (BCRA), aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA).
Author: United Benefit Advisors
Posted: June 22, 2017, 4:00 am
The Department of Labor is requesting comment on a draft model form to request information regarding nonquantitative treatment limitations.
Author: United Benefit Advisors
Posted: June 21, 2017, 4:00 am
The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market.
Author: United Benefit Advisors
Posted: April 26, 2017, 4:00 am
A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations.
Author: United Benefit Advisors
Posted: March 15, 2017, 4:00 am
Entities such as employers with group health plans that provide prescription drug coverage to individuals that are eligible for Medicare Part D have two major disclosure requirements that they must meet at least annually.
Author: United Benefit Advisors
Posted: February 24, 2017, 4:00 am
On February 17, 2017, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to stabilize the health insurance market and address risks to the individual and small group markets.
Author: United Benefit Advisors
Posted: February 16, 2017, 4:00 am
Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.
Author: United Benefit Advisors
Posted: January 13, 2017, 4:00 am
On December 20, 2016, the Department of Labor, Department of Health and Human Services, and the Treasury issued FAQs About Affordable Care Act Implementation Part 35. The FAQ covers a new HIPAA special enrollment period, an update on women’s preventive services that must be covered, and clarifying information on qualifying small employer health reimbursement arrangements.
Author: United Benefit Advisors
Posted: December 21, 2016, 4:00 am
On October 31, 2016, the U.S. Department of the Treasury, Department of Labor, and Department of Health and Human Services issued final regulations regarding the definition of short-term, limited-duration insurance, standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits, and an amendment relating to the prohibition on lifetime and annual dollar limits.
Author: United Benefit Advisors
Posted: November 1, 2016, 4:00 am
A Summary of Benefits and Coverage (SBC) is two-and-a-half page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit’s coverage and limitations.
Author: United Benefit Advisors
Posted: October 4, 2016, 4:00 am
In a tri-agency proposed rule, the Department of Labor (DOL), Department of Health and Human Services (HHS), and Department of Treasury (Treasury) have published guidance discussing expatriate health plans (expat plans), excepted benefits, and essential health benefits (EHBs).
Author: United Benefit Advisors
Posted: July 8, 2016, 4:00 am
Answers question on coverage of preventive services, rescissions of coverage, out-of-network emergency services, clinical trial coverage, cost-sharing limitations, the Mental Health Parity Act, and the Women's Health and Cancer Rights Act.
Author: United Benefit Advisors
Posted: April 29, 2016, 4:00 am
Form 1094-C is used in combination with Form 1095-C to determine employer shared responsibility penalties.
Author: United Benefit Advisors
Posted: March 22, 2016, 4:00 am
IRS Form 1095-C will primarily be used to meet the Section 6056 reporting requirement. The Section 6056 reporting requirement relates to the employer shared responsibility/play or pay requirement.
Author: United Benefit Advisors
Posted: March 22, 2016, 4:00 am
The 2017 Benefit and Payment Parameters (BPP) rule is an annual rule that sets policies relating to the ACA.
Author: United Benefit Advisors
Posted: March 17, 2016, 4:00 am
In February 2016, the Department of Labor (DOL) issued proposed revisions to the Summary of Benefits template and related materials.
Author: United Benefit Advisors
Posted: February 26, 2016, 4:00 am
In December 2015, the Internal Revenue Service (IRS) issued a final rule that clarifies various topics relating to the Patient Protection and Affordable Care Act (ACA) and premium tax credit eligibility provisions. The rule finalizes regulations that were proposed years earlier.
Author: United Benefit Advisors
Posted: January 7, 2016, 4:00 am
On December 16, 2015, the Internal Revenue Service (IRS) and other federal agencies released IRS Notice 2015-87, which is a "potpourri" update that covers many different topics relating to the Patient Protection and Affordable Care Act (ACA), including some relating to market reforms.
Author: United Benefit Advisors
Posted: December 21, 2015, 4:00 am
President Obama has signed the omnibus legislation that includes the Consolidated Appropriations Act for 2016 and a tax extenders package. The agreement will keep the federal government running through September 2016. Within the legislation is language that significantly impacts provisions of the Patient Protection and Affordable Care Act (ACA), largely through delays of upcoming taxes.
Author: United Benefit Advisors
Posted: December 21, 2015, 4:00 am
Federal agencies have released the proposed rule for the 2017 Benefit Payment and Parameters. Among other items, it provides updates and annual provisions relating to risk adjustments, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; user fees for Federally-Facilitated Exchanges (FFEs); the standards for open enrollment for the individual market for the 2017 benefit year; updates to the Small Business Health Options Program (SHOP); definitions of large and small employer; guaranteed availability; and the medical loss ratio (MLR) program.
Author: United Benefit Advisors
Posted: November 24, 2015, 4:00 am
Following delays in the DOL regulation, the "Bipartisan Budget Act of 2015" which was signed by President Obama on November 2, 2015, repealed the auto-enrollment requirement. Employers are still free to use default or negative elections for employee enrollment.
Author: United Benefit Advisors
Posted: November 4, 2015, 4:00 am
In October 2015, the Department of Labor (DOL) provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and Patient Protection and Affordable Care Act (ACA) market reform provisions.
Author: United Benefit Advisors
Posted: November 2, 2015, 4:00 am
The U.S. Senate, following the House of Representatives, has passed House Resolution 1624, the “Protecting Affordable Coverage for Employees Act” or “PACE Act” which will be sent to President Obama’s desk for signature. It is anticipated the President will sign the Act into law.
Author: United Benefit Advisors
Posted: October 9, 2015, 4:00 am
The Affordable Care Act (ACA) implemented section 6055 of the Internal Revenue Code, which requires IRS reporting from any entity that provides "minimum essential coverage" (MEC) to individuals. Employers who are applicable large employers (ALEs) have related reporting obligations under section 6056.
Author: United Benefit Advisors
Posted: August 28, 2015, 4:00 am
Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer.
Author: United Benefit Advisors
Posted: August 14, 2015, 4:00 am
Federal agencies released final regulations on the preventive services mandate of the Patient Protection and Affordable Care Act (ACA) that requires non-grandfathered group health plans to provide coverage without cost-sharing for specific preventive services, which for women include contraceptive services.
Author: United Benefit Advisors
Posted: July 16, 2015, 4:00 am
The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA).
Author: United Benefit Advisors
Posted: June 26, 2015, 4:00 am
The Patient Protection and Affordable Care Act (PPACA) has had varying effects on the three account-based plans that employers often use in connection with their group health benefits. Health savings accounts (HSAs) are generally unaffected by PPACA, while the law has added several requirements for health reimbursement arrangements (HRAs) and health flexible spending accounts (HFSAs). Existing requirements for these plans still must be met; this article simply addresses changes or additional obligations imposed by PPACA.
Author: United Benefit Advisors
Posted: June 15, 2015, 4:00 am
After a few quiet months, regulatory agencies have picked up steam, leaving employers with a significant amount of new information to digest and work through.
Author: United Benefit Advisors
Posted: June 2, 2015, 4:00 am
The employer shared responsibility (i.e., “play or pay”) requirements went into effect in 2015 for large employers only (those with 100 or more full-time or full-time-equivalent employees). Even though they generally will not be liable for penalties until 2016, mid-size employers (employers with 50 to 99 full-time or full-time-equivalent employees) will need to report on the coverage they offered for 2015, so long as they meet the maintenance requirements for transition relief.
Author: United Benefit Advisors
Posted: June 1, 2015, 4:00 am
On May 26, 2015, federal agencies, including the Department of Labor (DOL), issued a short five-question FAQ on two PPACA-related issues: limitations on cost-sharing and provider discrimination.
Author: United Benefit Advisors
Posted: May 29, 2015, 4:00 am
In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) applicable large employers (ALEs) are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015.
Author: United Benefit Advisors
Posted: May 27, 2015, 4:00 am
On May 11, 2015, the Department of Labor (DOL) along with other federal agencies issued an FAQ regarding the implementation of the Patient Protection and Affordable Care Act (PPACA) that focused on coverage of preventive services. Non-grandfathered group health plans and health insurance offered in the individual or group markets must provide certain listed benefits with no cost-sharing to the beneficiary. The FAQ provided information on some commonly confusing or ambiguous requirements.
Author: United Benefit Advisors
Posted: May 21, 2015, 4:00 am
Guidance on identifying full-time employees in order to comply with the employer-shared responsibility (play or pay) requirements of the Patient Protection and Affordable Care Act (PPACA).
Author: United Benefit Advisors
Posted: May 15, 2015, 4:00 am
Employers that do not meet the requirements of the Patient Protection and Affordable Care Act (PPACA) need to be concerned about several potential penalties. Two significant penalties include the excise tax, which can be as much as $100 per affected individual per day, and the penalties that larger employers must pay if they do not meet their employer-shared responsibility/play or pay obligations.
Author: United Benefit Advisors
Posted: April 28, 2015, 4:00 am
Regulatory agencies were quiet during the month of April. The most significant guidance came from a variety of federal agencies that issued various documents regarding wellness programs.
Author: United Benefit Advisors
Posted: April 28, 2015, 4:00 am
On April 20, 2015, federal agencies released a Proposed Rule to amend regulations and provide guidance on implementing Title I of the Americans with Disabilities Act (ADA) as it relates to employer wellness programs.
Author: United Benefit Advisors
Posted: April 21, 2015, 4:00 am
Health reimbursement arrangements (HRAs), health savings accounts (HSAs) and health care flexible spending accounts (HFSAs) are generally referred to as account-based plans.
Author: United Benefit Advisors
Posted: April 10, 2015, 4:00 am
Coming off a busy February, regulatory agencies were noticeably quiet during the month of March.
Author: United Benefit Advisors
Posted: March 31, 2015, 4:00 am
Under federal regulations, Medicare is a secondary payer for many individuals who have an employer group health plan available to them, either as an employee or the dependent spouse or child of the employee.
Author: United Benefit Advisors
Posted: March 30, 2015, 4:00 am
The Employee Retirement Income Security Act (ERISA) was signed in 1974. The U.S. Department of Labor (DOL) is the agency responsible for administering and enforcing this law. For many years, most of ERISA's requirements applied to pension plans.
Author: United Benefit Advisors
Posted: March 24, 2015, 4:00 am
Health plan sponsors would be permitted to offer wraparound coverage to employees purchasing individual health insurance in the private market, including the Marketplace, in limited circumstances, under a new Final Rule issued by the Department of Labor (DOL) and other federal agencies.
Author: United Benefit Advisors
Posted: March 19, 2015, 4:00 am
In the Benefit and Payment Parameters for 2016 Final Rule issued in February of 2015, federal agencies included a clarification that annual cost-sharing limitations for self-only coverage apply to all individuals, regardless of whether the individual is covered by a self-only plan or is covered by another kind of plan.
Author: United Benefit Advisors
Posted: March 17, 2015, 4:00 am
On March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA).
Author: United Benefit Advisors
Posted: March 9, 2015, 4:00 am
Regulatory agencies were busy during the month of February, providing information on a variety of topics including: (1) reporting, (2) premium payment arrangements, (3) single benefit products and excepted benefits, (4) and benefit parameters. More information was also released on the "Cadillac tax" and on the definition of "spouse" as it relates to the Family Medical Leave Act (FMLA).
Author: United Benefit Advisors
Posted: March 2, 2015, 4:00 am
The regulatory agencies have recently issued guidance that may affect employers that have been reimbursing premiums for individual health coverage or Medicare Part B, Part D or Medigap premiums for active employees.
Author: United Benefit Advisors
Posted: February 26, 2015, 4:00 am
The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption.
Author: United Benefit Advisors
Posted: February 24, 2015, 4:00 am
IRS Releases Information and Forms for Satisfying the Individual Mandate and Claiming 2014 Premium Tax Credits
Author: United Benefit Advisors
Posted: February 2, 2015, 4:00 am
Author: United Benefit Advisors
Posted: February 1, 2015, 4:00 am
Author: United Benefit Advisors
Posted: January 22, 2015, 4:00 am
The excise tax on high cost plans (also referred to as the Cadillac tax and the 4980I tax) is scheduled to take effect in 2018. To date, regulations have not been issued, so many of the details about how the tax will operate are unclear.
Author: United Benefit Advisors
Posted: January 13, 2015, 4:00 am
During the month of December Congress passed a temporary increase to the transit pass and vanpooling benefit and the regulatory agencies released several cost-of-living increases, proposed relatively minor revisions to the Summary of Benefits and Coverage (SBC) requirement, and updated the list of counties in which foreign language versions of the SBC and other benefits notices may be required.
Author: United Benefit Advisors
Posted: January 6, 2015, 4:00 am
The month of November brought a new delay in reporting required from self-funded plans. It also brought several new notices and regulations that may affect sponsors of group health plans and an updated employer guide and health plan compliance checklist from the Department of Labor (DOL).
Author: United Benefit Advisors
Posted: December 3, 2014, 4:00 am
As we approach 2015, employers should be taking steps to ensure they are prepared to meet the Patient Protection and Affordable Care Act (PPACA) requirements that begin in 2015 and those which must be completed in 2014.
Author: United Benefit Advisors
Posted: December 3, 2014, 4:00 am
The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for group health plans to complete their 2014 transitional reinsurance fee (TRF) submission.
Author: United Benefit Advisors
Posted: November 17, 2014, 4:00 am
The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016.
Author: United Benefit Advisors
Posted: November 17, 2014, 4:00 am
The upcoming employer-shared responsibility ("play or pay") requirements have spawned a number of different approaches to meeting the requirement that large employers offer coverage or pay penalties.
Author: United Benefit Advisors
Posted: November 14, 2014, 4:00 am
2015 Annual Limits Card includes 2014 and 2015 limits for contributions and benefit limits, compensation amounts, social security, health Plan limits, Medicare, and more.
Author: United Benefit Advisors
Posted: November 5, 2014, 4:00 am
On Friday, October 31, 2014, the Department of Health and Human Services (HHS) quietly updated its Health Plan Identifier information page to delay the requirement that insurance carriers and self-funded health plans obtain a health plan identifier (HPID).
Author: United Benefit Advisors
Posted: November 3, 2014, 4:00 am
During the month of October, there were developments in the courts and new information from the regulatory agencies that may affect sponsors of group health plans.
Author: United Benefit Advisors
Posted: November 3, 2014, 4:00 am
In the past few weeks, the regulatory agencies have issued details on a number of items of interest to sponsors of group health plans.
Author: United Benefit Advisors
Posted: October 1, 2014, 4:00 am
On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55 which allows employers to amend their Section 125 plans to recognize several new change in status events.
Author: United Benefit Advisors
Posted: September 30, 2014, 4:00 am
In order for the Internal Revenue Service (IRS) to verify that individuals have the required minimum essential coverage, individuals who request premium tax credits are entitled to them, and large employers are meeting their shared responsibility (play or pay) obligations, employers and insurers will be required to provide reporting on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015
Author: United Benefit Advisors
Posted: September 25, 2014, 4:00 am
August 2014 brought a court case that will be of interest to employers that apply significant penalties to those who choose not to participate in wellness programs. The Department of Health and Human Services (HHS) has now provided an additional way for religious organizations that object to covering contraceptives to receive an exemption and has offered some insight into how it will allow closely-held for-profit organizations that object to covering contraceptives to receive an exemption.
Author: United Benefit Advisors
Posted: September 8, 2014, 4:00 am
The month of July brought court cases, draft forms, and a FAQ of interest to group health plans.
Author: United Benefit Advisors
Posted: August 6, 2014, 4:00 am
The following is a summary of draft forms. Some of this information may change when final forms, and the instructions, are released.
Author: United Benefit Advisors
Posted: August 1, 2014, 4:00 am
On July 22, 2014, two Courts of Appeals issued decisions that address whether only people who live in states that have state-run Marketplaces (which are also called exchanges) are eligible to receive premium tax credits or subsidies under the Patient Protection and Affordable Care Act (PPACA).
Author: United Benefit Advisors
Posted: July 24, 2014, 4:00 am
As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2013 experience by August 1, 2014. The rules for calculating and distributing these rebates are largely the same this year as they were last year.
Author: United Benefit Advisors
Posted: July 22, 2014, 4:00 am
June 2014 During the month of June, rules and decisions that potentially affect some or all group health plans were issued by the regulatory agencies and the Supreme Court of the United States.
Author: United Benefit Advisors
Posted: July 3, 2014, 4:00 am
Most of the major rules that affect 2014 and 2015 requirements under the Patient Protection and Affordable Care Act (PPACA) have been issued, so the regulatory agencies have begun addressing some of the details that need additional clarification. A number of notices were released during the month of May that address a wide range of open items that affect group health plans.
Author: United Benefit Advisors
Posted: May 30, 2014, 4:00 am
The IRS has released the 2015 minimums and maximums that apply to health savings accounts (HSAs) and related high-deductible health plans (HDHPs). These increases occur annually based on a cost-of-living formula. Because the inflation rate is fairly low, the amounts have not increased very much -- the out-of-pocket maximum is increasing by $100 for single coverage and by $200 for family coverage. Both the minimum deductible and the maximum contribution are increasing $50 for single coverage and $100 for family coverage.
Author: United Benefit Advisors
Posted: April 30, 2014, 4:00 am
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured mid-sized group plans.
Author: United Benefit Advisors
Posted: April 11, 2014, 4:00 am
As we approach the month of April, employers should be taking steps to ensure they are prepared to meet the Patient Protection and Affordable Care Act (PPACA) requirements that begin in 2014 and in 2015. In many instances, employers will need to begin tracking employees' hours in the next month or two. In addition, while some requirements vary based on employer size, other requirements apply to all employers. The most significant upcoming requirements and options for an employer include the following.
Author: United Benefit Advisors
Posted: March 31, 2014, 4:00 am
The regulatory agencies issued a number of documents during the month of March, as they have tried to provide needed information with respect to 2014 and 2015 obligations under the Patient Protection and Affordable Care Act (PPACA). Many employers will need to provide reporting on the coverage they offer during the 2015 calendar year; the IRS has now issued final regulations that provide details on this requirement.
Author: United Benefit Advisors
Posted: March 31, 2014, 4:00 am
In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer. The reporting requirements are in two separate sections of the Patient Protection and Affordable Care Act (PPACA) -- sections 6055 and 6056. Reporting will first be due early in 2016, based on coverage in 2015.
Author: United Benefit Advisors
Posted: March 13, 2014, 4:00 am
In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer.
Author: United Benefit Advisors
Posted: March 13, 2014, 4:00 am
On March 5, 2014, the Department of Health and Human Services (HHS) released a Bulletin that allows state insurance departments to permit the renewal through October 1, 2016, of individual and small group policies that do not meet the "market reform" requirements of the Patient Protection and Affordable Care Act (PPACA).
Author: United Benefit Advisors
Posted: March 11, 2014, 4:00 am
Frequently Asked Questions about Eligibility Waiting Periods - Updated February 2014
Author: United Benefit Advisors
Posted: February 28, 2014, 4:00 am
On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements.
Author: United Benefit Advisors
Posted: February 24, 2014, 4:00 am
On February 10, 2014, the IRS issued final regulations on the employer-shared responsibility requirements, often known as "play or pay." This is the requirement that large employers offer adequate coverage to their full-time employees or pay penalties. The final regulations follow the proposed regulations (which were issued in January 2013) in many respects, but also contain some surprises.
Author: United Benefit Advisors
Posted: February 17, 2014, 4:00 am
On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury (IRS) issued Frequently Asked Questions - Part XVIII that provides additional information about requirements in several areas.
Author: United Benefit Advisors
Posted: January 16, 2014, 4:00 am
Employers that issued 250 or more W-2s in the prior calendar year must include the value of "employer-sponsored group health coverage" on their employees' W-2s. This means that an employer that issued 250 or more W-2s during 2012 must include the value of employer-sponsored coverage on the employee's 2013 W-2 (to be issued in January 2014).
Author: United Benefit Advisors
Posted: December 23, 2013, 4:00 am
On December 12, 2013, the U.S. Department of Health and Human Services (HHS) released an Interim Final Rule that formally extends some of the marketplace (also known as the exchange) deadlines and encourages insurers to provide additional extensions if possible.
Author: United Benefit Advisors
Posted: December 20, 2013, 4:00 am
The wellness program rules provide an exception to the general rule that employers may not take a person's health status into account with respect to eligibility, benefits, or premiums under a group health plan. Wellness programs, therefore, are allowed if they are designed to help employees improve their health; if they are primarily punitive they will not be allowed.
Author: United Benefit Advisors
Posted: December 13, 2013, 4:00 am
The Internal Revenue Service (IRS) and the Department of Health and Human Services (HHS) have recently issued several final and proposed rules of interest to employers.
Author: United Benefit Advisors
Posted: December 10, 2013, 4:00 am
The Internal Revenue Service (IRS) published Final Regulations on the Additional Medicare Tax (AMT) on Nov. 29, 2013, and an updated and comprehensive FAQ on Dec. 2, 2013. There are few changes from the proposed requirements.
Author: United Benefit Advisors
Posted: December 5, 2013, 4:00 am
On Nov. 14, 2013) the White House announced that insurers will not be required to meet most of the provisions of the Patient Protection and Affordable Care Act (PPACA) if they renew individual or small group policies that were in effect on Oct. 1, 2013.
Author: United Benefit Advisors
Posted: November 16, 2013, 4:00 am
On Oct. 30, 2013, the Internal Revenue Service issued a notice that liberalizes the "use it or lose it" rule that applies to health flexible spending accounts (HFSAs) and clarifies that employers of all sizes may choose to amend their Section 125 plan to essentially treat the availability of the health marketplaces/exchanges as a one-time change in status event.
Author: United Benefit Advisors
Posted: November 4, 2013, 4:00 am
On Sept. 13, 2013, the IRS issued Notice 2013-54, which includes details on permissible health reim-bursement arrangements (HRAs), provides some clarification on minimum essential, minimum value and affordable coverage, and addresses payment of individual premiums through an employer-provided plan.
Author: United Benefit Advisors
Posted: October 8, 2013, 4:00 am
Open enrollment is scheduled to begin in the health marketplaces (also called the exchanges) on Oct. 1, and many employers and employees have questions about eligibility for coverage through the marketplace and premium subsidies. UBA has prepared a FAQ to address some of those questions.
Author: United Benefit Advisors
Posted: October 2, 2013, 4:00 am
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to self-funded plans.
Author: United Benefit Advisors
Posted: September 20, 2013, 4:00 am
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured small group plans provided inside and outside the SHOP exchange.
Author: United Benefit Advisors
Posted: September 20, 2013, 4:00 am
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured large group plans.
Author: United Benefit Advisors
Posted: September 20, 2013, 4:00 am
Very small employers with a high percentage of employees who earn low wages are eligible for a tax credit for employer contributions made to purchase health insurance. Non-profit organizations also are eligible - they will receive the credit as an offset to their payroll taxes. Governmental entities are not eligible unless they qualify as 501(c) organizations.
Author: United Benefit Advisors
Posted: September 19, 2013, 4:00 am
On Sept. 5, 2013 the Internal Revenue Service (IRS) released the long awaited rules that describe the reporting that plans, employers and insurers will need to provide in support of the individual shared-responsibility and employer shared-responsibility requirements of the Patient Protection and Affordable Care Act (PPACA). The rules are proposed, so some changes may occur when the rules are finalized.
Author: United Benefit Advisors
Posted: September 12, 2013, 4:00 am
PPACA requires employers covered by the Fair Labor Standards Act to provide a notice about the upcoming health marketplaces (also called exchanges) to their employees. The notice is due Oct. 1, 2013. On Sept. 11, 2013 the Department of Labor (DOL) announced that it will not penalize employers that do not provide this notice.
Author: United Benefit Advisors
Posted: September 12, 2013, 4:00 am
This FAQ is based on Department of Labor (DOL) Technical Release 2013-02, which does not provide specific guidance on many issues. Consequently, some of the answers in this FAQ are based on agency guidance provided in similar situations. The answers in this FAQ assume the employer is completing the model notice that applies to employers that offer coverage.
Author: United Benefit Advisors
Posted: September 4, 2013, 4:00 am
Most employers must give a notice about the upcoming health exchanges/marketplaces to all existing employees by Oct. 1, 2013. Employees hired after that date must receive the notice within 14 days following their start date.
Author: United Benefit Advisors
Posted: September 4, 2013, 4:00 am
As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option.
Author: United Benefit Advisors
Posted: August 27, 2013, 4:00 am
Although the employer shared responsibility requirements have been delayed to 2015, the individual responsibility requirement (also known as the individual mandate) is still scheduled to take effect in 2014.
Author: United Benefit Advisors
Posted: July 29, 2013, 4:00 am
UBA has prepared a Q&A to address recurring questions about the PCORI fee.
Author: United Benefit Advisors
Posted: June 27, 2013, 4:00 am
On May 29, 2013 the Department of Health and Human Services, the Internal Revenue Service and the Department of Labor jointly issued a final rule that addresses how wellness programs must operate under PPACA beginning in 2014. In many respects the final rules carry forward the rules that have been in effect for wellness programs since 2006, and most of the updates that were proposed last November have been adopted.
Author: United Benefit Advisors
Posted: May 31, 2013, 4:00 am
UBA has created an overview of the employee's responsibility to purchase coverage under PPACA (the individual mandate) and on the basics of the exchanges. The information in this piece is basic, but should provide a starting place for employers who want to educate their employees on this law.
Author: United Benefit Advisors
Posted: May 29, 2013, 4:00 am