Employee Benefits

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.
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 July 25th, 2014 in Producers, Employers

The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) as a way to help improve clinical effectiveness. The research institute is partially funded by fees charged to health plans, including some Health Reimbursement Arrangements (HRAs) and some Flexible Spending Accounts (FSAs). The fees are payable over a seven year time period and started for the first time last year.

The next round of PCORI fees are due to the IRS by July 31, 2014 and are payable via Form 720 by applicable employers for plan years ending in 2013

Posted April 17th, 2014 in Producers
Congratulations on making it through the craziness of the first individual open enrollment period and small group early renewal process. Some of you may still be finalizing the clean up and reconciliation process for any newly sold business. As you are finishing this task and the weather finally improves it may be tempting to play lots of golf or escape for a long vacation during the Spring/Summer months. This "off-season," however, is the time to remain the most disciplined.
 

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