In a summary of the recently issued Association Health Plan (AHP) final regulations, the U.S. Department of Labor (DOL) rightly observed that AHPs are a species of multi-employer welfare arrangements, or MEWAs, that are...more
10/3/2018
/ Affordable Care Act ,
Association Health Plans ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Independent Contractors ,
MEWAs ,
Preemption ,
Regulatory Reform ,
Reporting Requirements ,
Savings Clause ,
Supremacy Clause ,
Trump Administration
In a series of recent posts, we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we...more
Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health...more
1/17/2018
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Fair Share Contribution ,
Governor Baker ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Local Ordinance ,
Popular ,
Reporting Requirements
The Employee Retirement Income Security Act of 1974 (ERISA) made the regulation of employee benefit plans principally a matter of Federal concern. ERISA broadly and generally preempts—or renders inoperative—state laws that...more
For the last half of 2015, we spent a good deal of time explaining the Affordable Care Act reporting requirements that applied to carriers and large employers. This post examines the how of ACA reporting. In particular, it...more
In Q&A format, recently issued Notice 2015-87 addresses a number of pressing issues that have arisen under the Affordable Care Act (ACA), including that law’s employer shared responsibility rules, information reporting...more
This post concludes our half-year series of posts focusing on the Affordable Care Act’s reporting requirements. These requirements are challenging in the extreme. Carriers and employers, and their vendors, service providers...more
Under the Affordable Care Act’s reporting requirements that have been the subject of this series, statements to responsible individuals (a/k/a “employees”)—i.e., Forms 1095-B and 1095-C—must be furnished on or before January...more
The Treasury Department and the IRS this week issued Notice 2015-87 that addresses, among other things, the effect of Health Reimbursement Account (HRA) contributions, cafeteria plan flex credits and opt-out payments on...more
It took a while, but most employers and their advisors have finally gotten the hang of the Affordable Care Act’s employer shared responsibility rules. That is, they understand generally that:
1. “Applicable Large...more
Affordability—i.e., whether health coverage is “affordable”—occupies an important place in the Affordable Care Act’s (ACA) regulatory scheme. Under that law’s individual mandate, no penalties are imposed for failure to...more
Last week we examined the reporting challenges associated with employee terminations, changes in status, and breaks in service under the monthly measurement method. As we explained, “[t]he final regulations under Code § 4980H...more
The final regulations under Code § 4980H establish two—and only two—methods for determining an employee’s status as full-time: the monthly measurement method and the look-back measurement method. Under the former (as the name...more
The recently enacted Bipartisan Budget Act of 2015 repealed Section 1511 of the Affordable Care Act (ACA), which generally would have required employers with more than 200 full-time employees to automatically enroll new...more
In an earlier post, we reported on a troubling development in the draft 2015 instructions for Forms 1094-B and 1095-B which, if adopted, would have required sponsors of Health Reimbursement Arrangements (“HRA”) to issue...more
11/3/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Final Rules ,
Form 1094 ,
Form 1095 ,
HRA ,
IRS ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part B ,
Minimum Essential Coverage ,
Reporting Requirements ,
State Medicaid Programs ,
Supplemental Insurance ,
TRICARE ,
U.S. Treasury
As we noted in a previous post, the recently issued final 2015 Instructions for Forms 1094-C and 1095-C changed certain of the rules relating to the reporting for offers of COBRA coverage where the COBRA qualifying event...more
10/29/2015
/ Affordable Care Act ,
American Bar Association (ABA) ,
COBRA ,
Employer Group Health Plans ,
Employer Liability Issues ,
Final Rules ,
Form 1094 ,
Form 1095 ,
Full-Time Employees ,
Health Insurance ,
IRS ,
Part-Time Employees ,
Reporting Requirements ,
Safe Harbors ,
Self-Funded Health Plans ,
Shared Responsibility Rule ,
Termination ,
U.S. Treasury
When reporting offers of coverage to full-time employees under the Affordable Care Act’s (ACA) employer shared responsibility rules, much of the detail appears in Part II of IRS Form 1095-C, Lines 14, 15 and 16. For the most...more
10/23/2015
/ Affordable Care Act ,
Employer Mandates ,
Full-Time Employees ,
Health Insurance ,
Hiring & Firing ,
IRS ,
Minimum Value Plans ,
New Hires ,
Part-Time Employees ,
Penalties ,
Reporting Requirements ,
Shared Responsibility Rule
Compliance with the Affordable Care Act’s (ACA) employer shared responsibility rules requires that applicable large employers identify their full-time employees. A “full-time employee” for this purpose is an employee who...more
10/14/2015
/ Affordable Care Act ,
Disability Leave ,
Employer Mandates ,
Excise Tax ,
Full-Time Employees ,
Health Insurance ,
IRS ,
Large Employer ,
Penalties ,
Reporting Requirements ,
Safe Harbors ,
U.S. Treasury
This series is devoted principally to the reporting requirements imposed by Internal Revenue Code §§ 6055 and 6056 as added by §§ 1502 and 1514 of the Affordable Care Act (ACA), respectively. The former reports offers of...more
The IRS recently issued final instructions for Forms 1094-B and 1095-B and Forms 1094-C and 1095-C . The 2015 Instructions for Forms 1094-B and 1095-B implement a suggestion we made in a previous post relating to the...more
9/22/2015
/ Affordable Care Act ,
COBRA ,
Employer Group Health Plans ,
Employer Liability Issues ,
Expatriates ,
Final Guidance ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HRA ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Multiemployer Plan ,
Proposed Regulation ,
Reporting Requirements ,
Self-Funded Health Plans ,
U.S. Treasury
The Affordable Care Act’s reporting rules—which are set out in Internal Revenue Code §§ 6055 and 6056—solicit the information needed by the Internal Revenue Service to enforce the individual and employer shared responsibility...more
9/15/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Mandates ,
Internal Revenue Code (IRC) ,
IRS ,
Large Employer ,
Look-Back Measurement Period ,
Minimum Essential Coverage ,
Reporting Requirements ,
Shared Responsibility Rule ,
Subsidies
The Affordable Care Act’s (ACA) employer shared responsibility rules provide applicable large employers (i.e., those with 50 or more full-time and full-time equivalent employees on business days during the preceding calendar...more
9/10/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Excise Tax ,
Health Insurance ,
IRS ,
MEWAs ,
Multiemployer Plan ,
Professional Employer Organization ,
Reporting Requirements ,
Shared Responsibility Rule ,
Staffing Agencies ,
Taft-Hartley Act ,
Tax Credits
When it comes to mergers and acquisitions involving at least one applicable large employer (ALE), the substantive rules governing employer shared responsibility (under Internal Revenue Code § 4980H) and the corresponding...more
9/1/2015
/ Affordable Care Act ,
Asset Purchaser ,
COBRA ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance ,
IRS ,
Large Employer ,
Reporting Requirements ,
Shared Responsibility Rule ,
Social Security Taxes ,
Stock Deals ,
Successors ,
U.S. Treasury ,
Wages
Under a common strategy for controlling group health care plan costs, employers sometimes adopt arrangements under which an employee is offered cash as an incentive to waive coverage. These arrangements are colloquially...more
8/25/2015
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Final Rules ,
Flexible Spending Accounts ,
Form 1095 ,
Health Insurance ,
Health Insurance Exchanges ,
Incentives ,
Individual Mandate ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Opt-Outs ,
Penalties ,
Reporting Requirements ,
Safe Harbors ,
Shared Responsibility Rule ,
Subsidies ,
Waivers
As we reported last week, the IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C. These instructions are of interest to applicable large employers who must report their compliance with the Affordable Care...more
8/19/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Mandates ,
Form 1094 ,
Form 1095 ,
Health Savings Accounts ,
HRA ,
IRS ,
Large Employer ,
Minimum Essential Coverage ,
Reporting Requirements ,
Section 6055 ,
Shared Responsibility Rule ,
Supplemental Insurance