Employers

Posted February 23rd, 2015 in Employers, Producers

The IRS has released the final version of the forms and instructions as it relates to the new employer reporting requirements associated with the Employer Mandate and other Affordable Care Act (ACA) provisions. The forms are identical to the draft versions that were released last summer, but there have been revisions made to some of the instructions. The forms and instructions can be accessed below:

Section 6055 reporting (used to report which individuals are covered by the employer sponsored plan)

Posted February 13th, 2015 in Producers, Employers

The Affordable Care Act (ACA) defines a small employer as one with up to 100 employees, but the law gave states the ability of using a definition of up to 50 employees until the end of 2015. As a result, most states, including Illinois, used a definition of up to 50 employees. However, that will change in 2016, and all states will be required to classify their small group market as up to 100 employees.

Why does this matter?

Posted January 23rd, 2015 in Producers, Employers, Individuals

The IRS has released the maximum penalties that are payable by individuals who are without minimum essential coverage in 2015 and who do not qualify for an exemption from the Individual Mandate.

The maximum penalties for this year are the greater of:

  • $325 per uninsured adult or $162.50 per uninsured child under age 18. The maximum penalty using this method is capped at $975.

Posted January 16th, 2015 in Producers, Employers
February 15 is slated to be the final day for the 2015 open enrollment period. Luckily for small business owners there’s still time to take advantage of an affordable health care solution.
 
Posted January 9th, 2015 in Producers, Employers
The IRS has issued proposed regulations that will introduce a new excepted benefit available to some employees who purchase individual market coverage. Excepted benefits are exempt from most of the requirements and obligations under the Affordable Care Act (ACA).  
 
Posted December 19th, 2014 in Producers, Employers, Individuals
The U.S. House of Representatives and Senate have both voted and approved an extension of more than 50 different tax provisions that expired at the end of 2013. The actions taken would retroactively extend these tax provisions for 2014, but it does not extend them into 2015.  
 
Posted December 5th, 2014 in Producers, Employers
The High Cost Employer-Sponsored Health Coverage Excise Tax, more commonly known as the Cadillac Tax, is scheduled to take effect in 2018. The Cadillac Tax is described as an attempt to reduce health care usage and costs by encouraging employers to offer health plans that are more cost effective and that engage employees in the cost of care.  Experts estimate that the tax will raise $80 billion over a 10 year time period and will finance various components of the Affordable Care Act (ACA).
 
Posted October 31st, 2014 in Producers, Employers
Effective October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) Office of e-Health Standards and Services (OESS), the division of the Department of Health & Human Services (HHS) that is responsible for enforcement of compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions, code sets, unique identifiers and operating rules, announces a delay, until further notice, in enforcement of 45 CFR 162, Subpart E, the regulations pertaining to health plan enumeration and use of the Health Plan Identifier (HPID) in HIPAA transactions adopted in the HPID final rule (CMS-0040-F). 
 
This enforcement delay applies to all HIPAA covered entities, including healthcare providers, health plans, and healthcare clearinghouses.
Posted August 8th, 2014 in Producers, Employers, Individuals
The Affordable Care Act (ACA) limits the maximum waiting period that employers can use for health coverage to 90 calendar days. However, there is something also referred to as an orientation period which seems to have taken a back seat to the 90 day waiting period. The final ACA rules allow employers to use an orientation period of up to one month (in addition to the 90 day waiting period) for bona fide employment reasons.
 
What Does That Really Mean?
Posted August 1st, 2014 in Producers, Employers, Individuals

July 22nd was quite an eventful day as it relates to the Affordable Care Act (ACA). On the same day, two different U.S. Courts of Appeals came to opposite conclusions as it relates to the ability for federally-facilitated Exchanges to provide subsidies to enrollees. 

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