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Plan Your Changes Before Changing Your Plans

There’s a comically profound scene in the second “Madagascar” movie. Penguin (management) and monkey (union) committees are negotiating a labor contract. After the monkeys seem to have secured what they want, they add a...more

Association Health Plans … Someday … Maybe

The October 12, 2017 “Executive Order Promoting Healthcare Choice and Competition Across the United States” gets things rolling, but this ball will have to roll up hill for months before it can roll downhill. Here’s...more

Get Ready for “On The Motion to Amend the Amendment of the Amendment of the Amendment …”

The “Discussion Draft” released June 22, 2017 by the Senate Budget Committee carries the House Bill number (H.R. 1628) of the American Health Care Act, and kills taxes like the House bill, but there are major differences,...more

“But Officer, He Came Out of Nowhere!”

Lots of wrecks happen because drivers, staring at what’s directly in front of them, are unaware of dangers coming from other directions. This is an ACA blog, so right now we’re staring at the ACA changes being proposed by the...more

Code § 4980H: The Tax The Beatles Missed

The Tax Man, it turns out, also may assess you for failing to offer substantially all your full-time employees and their dependents affordable, qualifying group health coverage during 2015. We’re swamped with employer...more

Questionable Retaliation Theory Gets Traction

Since our earliest postings, we have warned of a notion, prevalent among employee counsel, that an employer plan sponsor unlawfully retaliates against an employee by reducing her work hours in order to deprive her of ACA...more

Coming Down Your Chimney: Market Reform Guidance, Information Reporting Penalty Relief and Cadillac Tax Delay

It’s the “silly season” on the Hill and a busy season for ACA regulators. This article gives you brief notes about Notice 2015-87, information reporting relief and the § 4980I delay buried in the omnibus spending bill....more

“Make It a Triple”: EEOC Supersizes Wellness Program Rules, Again

In June 2013, DOL, HHS and IRS explained that they view employer-sponsored wellness programs as narrow exceptions to the ACA’s health status discrimination prohibition. Early this year, the EEOC slathered-on its own rules,...more

PCORI Fee Inflation Adjustment

In Notice 2015-60 (October 9, 2015), the IRS announced that the PCORI fee will rise to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. For plan years ending on or after...more

Do Seasonal Workers “Count” for Forms 1094-C and 1095-C?

We were asked that recently, proving that there is such a thing as a wrong question. Let’s break it down. The same person may be both a “seasonal worker” and a “seasonal employee,” but those terms are used to discuss separate...more

House Passes Significant ACA Amendment by Voice Vote

With little apparent Democrat opposition, the U.S. House of Representatives on September 28 routinely passed a bill to allow employers of 50 to 100 employees to avoid the ACA’s especially heavy regulation of small group...more

Outside Counsel Should Handle Healthcare.gov Subsidy Appeals

Here’s the coming dilemma: let IRS assess employer mandate taxes based on errant Healthcare.gov subsidy certifications or appeal those errors to prevent those assessments.  “Where’s the dilemma?” you say.  Here:  once you...more

Draft 2015 Forms and Instructions for ACA Coverage Offer Information Reporting: Forms 1094-B, 1095-B, 1094-C, 1095-C and 8809

At about the same time as last year, the IRS has released draft ACA coverage information reporting Forms and Instructions to be used early next year. There are many small differences and one HUGE difference. The IRS decided...more

More Cadillac Plan Tax Guidance from IRS

Code § 4980I (a/k/a/ the “Cadillac Plan tax”) was added by the ACA so that taxpayers with average group health plans would not subsidize, by tax preference, rich plans benefitting chiefly the rich. Section 4980I imposes a...more

Will § 4980H Require Judicial Amendment Too?

Absent applicable transitional relief, most of which vanishes after 2015, an ACA Applicable Large Employer that fails to offer Minimum Essential Coverage to at least 70% of its 2015 full-time employees and their dependents...more

Simple ACA Rules for Simple (But Not Small) Employers

If you had at least 50 but less than 100 full-time employees (on an aggregated basis, including full-time equivalents) in an average month in 2014, then you are an ACA “Applicable Large Employer” with ALE reporting...more

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