ACA

Posted January 29th, 2016 in Producers, Employers, Individuals

Insurance companies are concerned that some people are abusing the Special Enrollment Period (SEP) that is available in the individual marketplace. They have indicated at least some people are delaying enrollment in coverage until they get sick, applying for coverage only once they need it, and then canceling the coverage after treatment. They further argue that there aren’t enough rules in place to verify if a person actually experienced a qualifying event which would trigger a SEP.

Posted December 30th, 2015 in Producers, Employers
The Internal Revenue Service (IRS) recently issued Notice 2016-4 which extends the deadlines to complete the new Affordable Care Act (ACA) reporting requirements. The reporting is used to help the IRS enforce the Individual and Employer Mandates, and it’s also used to help the IRS administer subsidies in the Exchange. It applies to insurers and certain employers effective for the 2015 calendar year and moving forward. The new deadlines are as follows:
 
Posted December 23rd, 2015 in Producers, Employers, Individuals
You may have heard that President Obama recently signed into law the Consolidated Appropriations Act of 2016, a $1.1 trillion spending bill, avoiding a shutdown and funding the federal government through September 30, 2016. The President also signed the Protecting Americans from Tax Hikes (PATH) Act of 2015 which provides nearly $700 billion in tax breaks. Here’s what it means to the Affordable Care Act (ACA) and transit reimbursement plans.   
 
Cadillac Tax
  • The Cadillac Tax has been delayed by two years until 2020.
Posted December 10th, 2015 in Producers, Employers, Individuals
Below is a list of some key Affordable Care Act (ACA) changes and facts that will be effective in 2016:
 
  1. The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater. 
  2. The Employer Mandate expands to include all employers who have 50 or more employees. 
  3. The Employer Mandate offer rate increases from 70% to 95%. 
  4. Employer reporting related to the offer of coverage is due for the first time during Q1 2016. 
Posted December 4th, 2015 in Producers, Employers, Individuals
The Senate needed 51 votes to pass the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (HR 3762), a budget reconciliation bill which would repeal several key parts of the Affordable Care Act (ACA).  They got 52 when they voted on December 3rd.  The bill, which was previously passed by the House of Representatives (House), was approved by the Senate with some amendments.  That means the bill will have to go back to the House for another vote, where most expect it will be passed.
Posted November 25th, 2015 in Producers, Employers

You may have thought the penalty for applicable large employers who fail to offer minimum essential coverage was $2,000 per employee. You may have also thought that if you offered coverage, but it was unaffordable and/or didn’t provide minimum value, then the penalty was $3,000 per employee who waived coverage and received a subsidy in the Exchange.

Posted November 13th, 2015 in Producers, Employers

The new reporting requirements that some employers will be subject to starting next year, as required by the Affordable Care Act (ACA), will be used to help the Internal Revenue Service (IRS) enforce the Individual and Employer Mandates, and it will also help the IRS administer subsidy eligibility in the Exchanges.
 

The following reporting forms will be the responsibility of the employer to complete:

Posted October 23rd, 2015 in Producers, Employers

The Protecting Affordable Coverage for Employees (PACE) Act, signed into law by President Obama on October 7, 2015 gives states the ability to continue to determine the size of their small group market rather than conforming to a national standard.

Most states currently define their small group market as employers with up to 50 employees, but the Affordable Care Act (ACA) was set to expand that definition in 2016 to include employers with up to 100 employees. The PACE Act allows each state to independently decide what small group market definition makes the most sense.

Posted August 14th, 2015 in Producers, Employers
It appears that the Internal Revenue Service (IRS) is having some trouble with formulating guidance as it relates to the Excise Tax on High Cost Employer-Sponsored Health Coverage, also known as the Cadillac Tax. Earlier this year the IRS released Notice 2015-16 which sought public comment on the types of coverage that should (or shouldn’t) be included when calculating the value of coverage.  
 
Posted July 17th, 2015 in Producers, Employers
All eyes are back on the Employer Mandate as expectations of major changes or delays to this provision are quickly fading in light of the King vs. Burwell ruling.

Benefits Buzz

Enter Your Email

Tag Cloud

Archives