IRS
By now, you’ve probably heard about the Employer Mandate on several different occasions. Without reiterating all of the specific details, applicable large employers (ALEs) must offer health insurance coverage to full-time employees that has minimum value and is considered affordable or risk paying penalties.
According to a DOL website, “The Form 5500 Series is an important compliance, research, and disclosure tool for the Department of Labor, a disclosure document for plan participants and beneficiaries, and a source of information and data for use by other Federal agencies, Congress, and the private sector in assessing employee benefit, tax, and economic trends and policies.
The Internal Revenue Service (IRS), Social Security Administration (SSA), and the Centers for Medicare & Medicaid Services (CMS) are required to share information that each agency has about whether Medicare beneficiaries or their spouses are working. This sharing of information is referred to as the IRS-SSA-CMS Data Match, and the purpose of the Data Match is to identify situations where another group health plan may be primary to Medicare. In general, a group health will be primary to Medicare when:
Posted July 7th, 2016 in Producers, Employers, Individuals
It should be pretty clear by now that two of the biggest provisions of the Affordable Care Act (ACA) are the Individual and Employer Mandates. The Individual Mandate requires all Americans to have a health insurance plan or pay a penalty, unless an exemption applies. Factors that may influence the amount of the Individual Mandate penalty include household size and income. The Employer Mandate requires employers with 50 or more employees to offer health insurance coverage to at least 95% of its full-time employees or risk penalties.
The Department of Health and Human Services (HHS) recently issued a final rule which effectively implements Section 1557 of the Affordable Care Act (ACA). The new rule prohibits certain discriminatory acts from occurring for health programs or activities that are administered by HHS, including plans that are sold on federal and state Marketplaces.
Posted June 7th, 2016 in Producers, Employers, Individuals
Telemedicine can generally be defined as a way to provide a broad range of health-related services by phone or through an online platform. Several employers and insurance carriers offer telemedicine services in conjunction with their health plan(s) as a way to provide a cheaper alternative of diagnosing and treating common illnesses, such as the cold or flu.
What happens to beneficiaries who are enrolled in COBRA when a merger or acquisition occurs?
The Internal Revenue Service (IRS) has some rather thorough and complex guidelines that address COBRA issues when business reorganizations occur, including mergers and acquisitions. In an effort to simplify an otherwise complex situation, we can generally break down the guidance as follows:
Originally posted on January 2, 2015 and updated on April 10, 2015, June 19, 2015 and April 11, 2016.
Premium Only Plans (POP) can generally be defined as a type of Cafeteria Plan where the only pre-tax benefit available to employees are for those of insurance premiums. Now, whenever non-taxable benefits are involved, the IRS will usually have some strict rules in place that must be followed. For Cafeteria Plans, these are referred to as non-discrimination rules, and these rules are in place to ensure the plan doesn’t discriminate in favor of highly compensated and/or key employees.
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