Employers
The Employer Mandate requires employers with 50 or more employees to offer “minimum essential coverage” to at least 95% of its full-time employees. Failure to do so can result in a penalty of $2,570 for each full-time with a break on the first 30 employees. Most employers assume minimum essential coverage must come in the form of a traditional group health insurance plan, but that is not the case.
Many employee benefit laws only apply to employers who have a certain number of employees. The challenging part is that each law has its own definition and rules on how to count the number of employees when determining if a law applies to an employer. Here are some key examples:
The regulatory agencies have been busy issuing guidance these last several weeks. Here are some important updates in case you missed them:
Individual Coverage Health Reimbursement Arrangements (ICHRAs) can be otherwise described as premium reimbursement plans. Employers establish a plan to reimburse employees for health insurance coverage they obtain on their own; either a plan obtained in the individual health insurance market or through Medicare. Reimbursements are tax-free to employees and tax-deductible to employers.
The Internal Revenue Service (IRS) recently released Notice 2020-29 and Notice 2020-33 which provide substantial changes to Cafeteria Plans, Health Flexible Spending Accounts (Health FSAs) and Dependent Care Assistance Programs (commonly referred to as Dependent Care FSAs).
Individual Coverage Health Reimbursement Arrangements (ICHRAs) are new premium reimbursement arrangements that allow employers to reimburse employees for personal health insurance coverage they obtain on their own. Plans such as those offered on the Health Insurance Marketplace or Medicare plans are eligible for reimbursement. An employer may optionally choose to reimburse out-of-pocket medical expenses too.
The U.S. Department of Labor (DOL) has issued guidance that will impact COBRA procedures, special enrollment periods, and claims procedures. The guidance will extend the length of certain time periods applicable to group health plans, disability plans and other welfare plans regulated by the ERISA law. Plan participants and beneficiaries will have additional time to do the following:
As a reminder, the Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices.
If you’re familiar with the individual health insurance market, you should be aware that the Affordable Care Act (ACA) made significant changes to the application and enrollment processes starting in 2014.
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