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Employer Mandate

Posted November 7th, 2017 in Producers, Employers

The Employer Mandate guidelines state that coverage is affordable when an employee has to pay no more than 9.5% of their household income (inflation-adjusted to 9.56% for the 2018 plan year) for self-only coverage which is offered, but which employers know the household income of an employee? As a result, there are three alternative methods that an employer can rely upon when determining if the coverage they offer is affordable. These methods are explained below and some general examples on how to apply each method have also been provided. Assume in each example that the employer has a calendar plan year for 2018.

Posted November 1st, 2017 in Producers, Employers, Individuals
As you may have heard, the Trump administration discontinued funding for the cost-sharing reduction subsidies (CSR subsidies). Critics of this move believe it will create instability in the Exchange and individual marketplaces. Political efforts to restore the CSR subsidies are underway, but it appears Republican leadership has some demands as part of those restoration efforts.
Posted September 26th, 2017 in Producers, Employers, Individuals

Spoiler Alert: The answer is no.

Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have been spearheading efforts to repeal and replace substantial parts of the Affordable Care Act (ACA). While there are many changes that the so-called “Graham-Cassidy” bill would make to the ACA, there are really three main themes that stand out:
 
Posted May 30th, 2017 in Producers, Employers, Individuals

Unless or until the Affordable Care Act (ACA) is repealed, the Individual and Employer Mandates remain intact, and earlier this month the Internal Revenue Service (IRS) issued some regulatory guidance pertaining to the two mandates for 2018.

Posted April 25th, 2017 in Producers, Employers

The Treasury Inspector General for Tax Administration (TIGTA) issued a report dated April 7th and entitled “Affordable Care Act: Assessment of Efforts to Implement the Employer Shared Responsibility Provision.” In other words, TIGTA issued a report about the efforts of the Internal Revenue Service (IRS) to collect Employer Mandate penalties.

Posted December 5th, 2016 in Producers, Employers
The U.S. House of Representatives recently passed a bill that is being referred to as the 21st Century Cures Act. The bill is expected to be taken up by the Senate this week, and the belief is the Senate will pass it as well. If passed by the Senate, it appears President Obama would sign the bill into law. 
 
Posted November 30th, 2016 in Producers, Employers
The Internal Revenue Service (IRS) issued Notice 2016-70 on November 18, 2016 which provides some relief to insurers, employers and other entities subject to ACA reporting requirements under Code Section 6055 and 6056. The Notice does not extend the due date of the filing requirement for the 2016 year, but it does extend the due date in which copies of the reporting forms must be provided to employees and individuals. The due dates are now as follows:
 
Posted November 22nd, 2016 in Producers, Employers, Individuals
Last week, we posted a blog on the future of the Affordable Care Act (ACA). That blog focused on what types of things could potentially be repealed under President-elect Donald Trump. In this blog, the focus is on when things could start to get repealed, with an understanding that this is all speculation.
 
Posted November 10th, 2016 in Producers, Employers

People who have access to affordable coverage from their employer are ineligible to receive subsidies through the Health Insurance Marketplace, also known as the Exchange. For 2017, coverage is considered affordable if the employee’s share of premium for self-only coverage is 9.69% or less of their household modified adjusted gross income.

Posted October 11th, 2016 in Producers, Employers
The Affordable Care Act (ACA) requires certain entities to report information to the Internal Revenue Service (IRS) relative to health insurance coverage. The reporting is generally completed by insurance companies, government-run Exchanges and applicable large employers. The reporting helps the IRS enforce three key provisions of the ACA:
 
  1. Most U.S. citizens and lawfully present residents must have health insurance or pay a penalty. This is referred to as the Individual Mandate. The reporting helps the IRS understand who has health insurance coverage.