Employee Benefits

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 October 14th, 2015 in Producers, Employers

The 2016 Medicare Part D annual enrollment period will begin on October 15, 2015 and run through December 7, 2015. Medicare beneficiaries can enroll in a Part D drug plan or make changes to existing coverage during this time period. Enrollment can be done through a stand-alone drug plan or a Medicare Advantage plan that integrates coverage for medical and drug expenses.      

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.
Posted July 10th, 2015 in Producers, Employers
On June 26, 2015, the Supreme Court of the United States (SCOTUS) provided a ruling on same-sex marriage which is impactful to the health insurance industry. In a 5-4 ruling, the court determined that all states in the country must issue marriage certificates to same-sex couples, and states must also recognize same-sex marriages that are performed in other states.  
 
Posted June 19th, 2015 in Producers, Employers, Individuals

What happens to Health and Dependent Care FSAs when a merger or acquisition occurs?  

 
Of course the Cafeteria Plan regulations do not specify how this should be treated, but the IRS has provided some guidance in the form of Revenue Ruling 2002-32. Fortunately, for employees, the IRS has taken a position that employees should not be punished as a result of a merger or acquisition, and the guidance suggests two possible options that would be acceptable in their eyes. Both options maintain the salary reduction of the employee and preserve the annual election.
Posted May 15th, 2015 in Producers, Employers
The third installment of the Patient-Centered Outcomes Research Institute (PCORI) fees will be due on July 31, 2015. As its name suggests, PCORI is a research institute, and it was created by the Affordable Care Act (ACA) as a way to improve clinical effectiveness. It is partially funded by fees charged to health plans. Here is information and some reminders about the upcoming fee that is due.
 
  • The fee is paid on the average number of covered lives for the plan year ending in 2014.
Posted May 8th, 2015 in Producers, Employers, Individuals
On May 4, 2015, the Internal Revenue Service (IRS) has released Revenue Procedure 2015-30 which details the inflation-adjusted amounts that impact qualified high deductible health plans and Health Savings Accounts (HSAs) for the 2016 calendar year, as outlined below:
 

These limits are updated annually and reflect cost-of-living adjustments.

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 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 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.

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