• STatus of Court Case Challenging ACA Constitutionality

    12/17/2018

    On Dec. 14, 2018, the U.S. District Court for the Northern District of Texas declared that the ACA individual mandate is unconstitutional and declared that the rest of the ACA is unconstitutional.

  • DOL and IRS Release Additional Information on Association Health Plans

    09/20/2018

    On August 20, 2018, the Department of Labor (DOL) posted the Association Health Plans ERISA Compliance Assistance fact sheet.

  • Final Rule on Short-Term Limited-Duration Insurance

    08/02/2018

    Short-term, limited-duration insurance is a type of health insurance coverage designed to fill temporary gaps in coverage when an individual is transitioning from one plan or coverage to another plan or coverage.

  • Court Modifies Order Regarding EEOC Wellness Rules

    01/26/2018

    In January 2018, the EEOC asked the court to reconsider the portion of the court’s order that required the EEOC to issue new proposed rules by August 31, 2018.

  • 2018 IRS Reporting Tip 1 - Reporting Offers of COBRA Coverage

    01/17/2018

    Under the ACA, applicable large employers are required to offer health benefits to their full-time employees and report on the health coverage they offer.

  • Federal Tax Credit for Employer-Provided Paid Family and Medical Leave

    01/11/2018

    The Tax Cuts and Jobs Act includes a new federal tax credit for employers that provide paid family and medical leave to their employees.

  • Business Deduction Elimnation for Mass Transit and Parking Benefits

    01/11/2018

    The Tax Cuts and Jobs Act eliminates the business deduction for qualified mass transit and parking benefits starting in 2018.

  • Contraception Mandate Rolled Back for Employers

    12/08/2017

    Interim Final Rules were released and became effective on October 6, 2017, allowing a greater number of employers to opt out of providing contraception to employees at no cost through their employer-sponsored health plan.

  • Compliance Recap - November 2017

    12/04/2017

    November was a busy month in the employee benefits world.

  • President Trump Ends ACA CSRs

    10/13/2017

    On the evening of October 12, 2017, President Trump announced that cost sharing reductions for low income Americans in relation to the Patient Protection and Affordable Care Act (ACA) would be stopped.

  • October 2017 Executive Order on Healthcare

    10/12/2017

    The order directs various federal agencies to explore options relating to association health plans, short term limited-duration coverage, and health reimbursement arrangements, within the next 60 to 120 days.

  • IRS Releases Final forms and Instructions for 2017 ACA Reporting

    10/10/2017

    Reporting is required by employers with 50 or more full-time (or full-time equivalent) employees, insurers, or sponsors of self-funded health plans, on health coverage that is offered.

  • The COBRA Payment Process

    08/14/2017

    The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

  • What You Need to Know about Dependent Care Flexible Spending Accounts

    08/14/2017

    A dependent care flexible spending account (DCFSA) is a pre-tax benefit account used to pay for eligible dependent care services.

  • What You Need to Know about Health Flexible Spending Accounts

    08/14/2017

    A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket health care costs for a participant as well as a participant's spouse and eligible dependents.

  • Determining COBRA Premiums

    07/21/2017

    The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits.

  • Senate Releases Proposed Healthcare Bill

    06/22/2017

    On June 22, 2017, the U.S. Senate released a “Discussion Draft” of the “Better Care Reconciliation Act of 2017” (BCRA), aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA).

  • DOL Asks for MHPAEA Related Comments

    06/21/2017

    The Department of Labor is requesting comment on a draft model form to request information regarding nonquantitative treatment limitations.

  • ACA Market Stabilization Final Rule

    04/26/2017

    The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market.

  • SBC Template and Required Addendums for Covered Entities under ACA Section 1557

    03/15/2017

    A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations.

  • Medicare Part D: Creditable Coverage Disclosures

    02/24/2017

    Entities such as employers with group health plans that provide prescription drug coverage to individuals that are eligible for Medicare Part D have two major disclosure requirements that they must meet at least annually.

  • CMS' Proposed Rule on ACA Market Stabilization

    02/16/2017

    On February 17, 2017, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to stabilize the health insurance market and address risks to the individual and small group markets.

  • IRS Reporting Tip 1 - 2016 Form 1094-C, Line 22

    01/13/2017

    Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.

  • FAQs on ACA Implementation

    12/21/2016

    On December 20, 2016, the Department of Labor, Department of Health and Human Services, and the Treasury issued FAQs About Affordable Care Act Implementation Part 35. The FAQ covers a new HIPAA special enrollment period, an update on women’s preventive services that must be covered, and clarifying information on qualifying small employer health reimbursement arrangements.

  • Short-Term Insurance, Excepted Benefits, Annual Limits

    11/01/2016

    On October 31, 2016, the U.S. Department of the Treasury, Department of Labor, and Department of Health and Human Services issued final regulations regarding the definition of short-term, limited-duration insurance, standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits, and an amendment relating to the prohibition on lifetime and annual dollar limits.

  • Final Summary of Benefits and Coverage Template and Updates

    10/04/2016

    A Summary of Benefits and Coverage (SBC) is two-and-a-half page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit’s coverage and limitations.

  • Proposed Rule on Expatriate Health Plans, Excepted Benefits, and Essential Health Benefits

    07/08/2016

    In a tri-agency proposed rule, the Department of Labor (DOL), Department of Health and Human Services (HHS), and Department of Treasury (Treasury) have published guidance discussing expatriate health plans (expat plans), excepted benefits, and essential health benefits (EHBs).

  • DOL Issues Another FAQ on ACA Implementation

    04/29/2016

    Answers question on coverage of preventive services, rescissions of coverage, out-of-network emergency services, clinical trial coverage, cost-sharing limitations, the Mental Health Parity Act, and the Women's Health and Cancer Rights Act.

  • IRS Reporting Tip 1 -- Form 1094-C, Line 22

    03/22/2016

    Form 1094-C is used in combination with Form 1095-C to determine employer shared responsibility penalties.

  • IRS Reporting Tip 2 -- Form 1095-C, Line 14, Code 1A versus 1E, and When To Use 1I

    03/22/2016

    IRS Form 1095-C will primarily be used to meet the Section 6056 reporting requirement. The Section 6056 reporting requirement relates to the employer shared responsibility/play or pay requirement.

  • Benefit and Payment Parameters Rule and HIP FAQ

    03/17/2016

    The 2017 Benefit and Payment Parameters (BPP) rule is an annual rule that sets policies relating to the ACA.

  • Proposed Summary of Benefits and Coverage Template and Updates

    02/26/2016

    In February 2016, the Department of Labor (DOL) issued proposed revisions to the Summary of Benefits template and related materials.

  • IRS Final Rule on MInimum Value

    01/07/2016

    In December 2015, the Internal Revenue Service (IRS) issued a final rule that clarifies various topics relating to the Patient Protection and Affordable Care Act (ACA) and premium tax credit eligibility provisions. The rule finalizes regulations that were proposed years earlier.

  • IRS Notice 2015-87: HRAs, Affordability, and More

    12/21/2015

    On December 16, 2015, the Internal Revenue Service (IRS) and other federal agencies released IRS Notice 2015-87, which is a "potpourri" update that covers many different topics relating to the Patient Protection and Affordable Care Act (ACA), including some relating to market reforms.

  • Omnibus Bill Signed Into Law; Delays Cadillac Tax

    12/21/2015

    President Obama has signed the omnibus legislation that includes the Consolidated Appropriations Act for 2016 and a tax extenders package. The agreement will keep the federal government running through September 2016. Within the legislation is language that significantly impacts provisions of the Patient Protection and Affordable Care Act (ACA), largely through delays of upcoming taxes.

  • Proposed Benefit Payment and Parameters Rule Released

    11/24/2015

    Federal agencies have released the proposed rule for the 2017 Benefit Payment and Parameters. Among other items, it provides updates and annual provisions relating to risk adjustments, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; user fees for Federally-Facilitated Exchanges (FFEs); the standards for open enrollment for the individual market for the 2017 benefit year; updates to the Small Business Health Options Program (SHOP); definitions of large and small employer; guaranteed availability; and the medical loss ratio (MLR) program.

  • ACA's Auto-Enrollment Requirement Repealed

    11/04/2015

    Following delays in the DOL regulation, the "Bipartisan Budget Act of 2015" which was signed by President Obama on November 2, 2015, repealed the auto-enrollment requirement. Employers are still free to use default or negative elections for employee enrollment.

  • DOL Issues FAQ on Mental Health Parity and ACA Market Reform Provisions

    11/02/2015

    In October 2015, the Department of Labor (DOL) provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and Patient Protection and Affordable Care Act (ACA) market reform provisions.

  • PACE Act Passes House, Senate

    10/09/2015

    The U.S. Senate, following the House of Representatives, has passed House Resolution 1624, the “Protecting Affordable Coverage for Employees Act” or “PACE Act” which will be sent to President Obama’s desk for signature. It is anticipated the President will sign the Act into law.

  • 6055 Reporting, HRAs, and "Supplemental Coverage"

    08/28/2015

    The Affordable Care Act (ACA) implemented section 6055 of the Internal Revenue Code, which requires IRS reporting from any entity that provides "minimum essential coverage" (MEC) to individuals. Employers who are applicable large employers (ALEs) have related reporting obligations under section 6056.

  • IRS Releases Draft 2015 Instructions for 6055/6056 Reporting

    08/14/2015

    Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer.

  • Preventive Services Final Rules

    07/16/2015

    Federal agencies released final regulations on the preventive services mandate of the Patient Protection and Affordable Care Act (ACA) that requires non-grandfathered group health plans to provide coverage without cost-sharing for specific preventive services, which for women include contraceptive services.

  • U.S. Supreme Court Upholds ACA Subsidy Eligibility on Federal Exchanges

    06/26/2015

    The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA).

  • HRAs, HSAs, and HFSAs under PPACA

    06/15/2015

    The Patient Protection and Affordable Care Act (PPACA) has had varying effects on the three account-based plans that employers often use in connection with their group health benefits. Health savings accounts (HSAs) are generally unaffected by PPACA, while the law has added several requirements for health reimbursement arrangements (HRAs) and health flexible spending accounts (HFSAs). Existing requirements for these plans still must be met; this article simply addresses changes or additional obligations imposed by PPACA.

  • Compliance Recap - May 2015

    06/02/2015

    After a few quiet months, regulatory agencies have picked up steam, leaving employers with a significant amount of new information to digest and work through.

  • Mid-Size Employers: Transition Relief and Community Rating

    06/01/2015

    The employer shared responsibility (i.e., “play or pay”) requirements went into effect in 2015 for large employers only (those with 100 or more full-time or full-time-equivalent employees). Even though they generally will not be liable for penalties until 2016, mid-size employers (employers with 50 to 99 full-time or full-time-equivalent employees) will need to report on the coverage they offered for 2015, so long as they meet the maintenance requirements for transition relief.

  • Cost-Sharing Limits; Provider Discrimination FAQ Released

    05/29/2015

    On May 26, 2015, federal agencies, including the Department of Labor (DOL), issued a short five-question FAQ on two PPACA-related issues: limitations on cost-sharing and provider discrimination.

  • IRS Issues Additional FAQs and Hosts Webinar to Assist with Reporting Requirements under PPACA’s Play or Pay

    05/27/2015

    In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) applicable large employers (ALEs) are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015.

  • Preventive Services Requirement FAQ

    05/21/2015

    On May 11, 2015, the Department of Labor (DOL) along with other federal agencies issued an FAQ regarding the implementation of the Patient Protection and Affordable Care Act (PPACA) that focused on coverage of preventive services. Non-grandfathered group health plans and health insurance offered in the individual or group markets must provide certain listed benefits with no cost-sharing to the beneficiary. The FAQ provided information on some commonly confusing or ambiguous requirements.

  • FAQ about Tracking Full Time Employees under Play or Pay

    05/15/2015

    Guidance on identifying full-time employees in order to comply with the employer-shared responsibility (play or pay) requirements of the Patient Protection and Affordable Care Act (PPACA).

  • Potential Employer Penalties under the Patient Protection and Affordable Care Act

    04/28/2015

    Employers that do not meet the requirements of the Patient Protection and Affordable Care Act (PPACA) need to be concerned about several potential penalties. Two significant penalties include the excise tax, which can be as much as $100 per affected individual per day, and the penalties that larger employers must pay if they do not meet their employer-shared responsibility/play or pay obligations.

  • Compliance Recap - April 2015

    04/28/2015

    Regulatory agencies were quiet during the month of April. The most significant guidance came from a variety of federal agencies that issued various documents regarding wellness programs.

  • Proposed Rule on Wellness Programs Under the Americans with Disabilities Act

    04/21/2015

    On April 20, 2015, federal agencies released a Proposed Rule to amend regulations and provide guidance on implementing Title I of the Americans with Disabilities Act (ADA) as it relates to employer wellness programs.

  • HRAs, HSAs, and Health FSAs - What's the Difference?

    04/10/2015

    Health reimbursement arrangements (HRAs), health savings accounts (HSAs) and health care flexible spending accounts (HFSAs) are generally referred to as account-based plans.

  • UBA Compliance Recap March 2015

    03/31/2015

    Coming off a busy February, regulatory agencies were noticeably quiet during the month of March.

  • What You Need To Know About Medicare Secondary Payer Rules

    03/30/2015

    Under federal regulations, Medicare is a secondary payer for many individuals who have an employer group health plan available to them, either as an employee or the dependent spouse or child of the employee.

  • What Plan Sponsors of Group Plans Need To Know About ERISA

    03/24/2015

    The Employee Retirement Income Security Act (ERISA) was signed in 1974. The U.S. Department of Labor (DOL) is the agency responsible for administering and enforcing this law. For many years, most of ERISA's requirements applied to pension plans.

  • Wraparound Excepted Benefits to Launch with Two Pilot Programs

    03/19/2015

    Health plan sponsors would be permitted to offer wraparound coverage to employees purchasing individual health insurance in the private market, including the Marketplace, in limited circumstances, under a new Final Rule issued by the Department of Labor (DOL) and other federal agencies.

  • Cost Sharing Limits Changing for 2016

    03/17/2015

    In the Benefit and Payment Parameters for 2016 Final Rule issued in February of 2015, federal agencies included a clarification that annual cost-sharing limitations for self-only coverage apply to all individuals, regardless of whether the individual is covered by a self-only plan or is covered by another kind of plan.

  • Supreme Court Hears Oral Argument in Subsidy Eligibility Battle

    03/09/2015

    On March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA).

  • UBA Compliance Recap February 2015

    03/02/2015

    Regulatory agencies were busy during the month of February, providing information on a variety of topics including: (1) reporting, (2) premium payment arrangements, (3) single benefit products and excepted benefits, (4) and benefit parameters. More information was also released on the "Cadillac tax" and on the definition of "spouse" as it relates to the Family Medical Leave Act (FMLA).

  • Employer Payment Plans

    02/26/2015

    The regulatory agencies have recently issued guidance that may affect employers that have been reimbursing premiums for individual health coverage or Medicare Part B, Part D or Medigap premiums for active employees.

  • Highlights of Employer and Insurer Reporting Requirements

    02/24/2015

    The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption.

  • UBA Compliance Recap January 2015

    02/02/2015

    IRS Releases Information and Forms for Satisfying the Individual Mandate and Claiming 2014 Premium Tax Credits

  • Changes Affecting Employers and Group Health Plans -- 2015 and Beyond

    02/01/2015

  • IRS Provides Process to Address Retroactive Increase in Excludable Transit Benefits

    01/22/2015

  • Highlights of the Excise Tax on High-Cost Plans (the "Cadillac Tax")

    01/13/2015

    The excise tax on high cost plans (also referred to as the Cadillac tax and the 4980I tax) is scheduled to take effect in 2018. To date, regulations have not been issued, so many of the details about how the tax will operate are unclear.

  • UBA December Compliance Recap

    01/06/2015

    During the month of December Congress passed a temporary increase to the transit pass and vanpooling benefit and the regulatory agencies released several cost-of-living increases, proposed relatively minor revisions to the Summary of Benefits and Coverage (SBC) requirement, and updated the list of counties in which foreign language versions of the SBC and other benefits notices may be required.

  • UBA November Compliance Recap

    12/03/2014

    The month of November brought a new delay in reporting required from self-funded plans. It also brought several new notices and regulations that may affect sponsors of group health plans and an updated employer guide and health plan compliance checklist from the Department of Labor (DOL).

  • Preparing for 2015 - Key PPACA Requirements

    12/03/2014

    As we approach 2015, employers should be taking steps to ensure they are prepared to meet the Patient Protection and Affordable Care Act (PPACA) requirements that begin in 2015 and those which must be completed in 2014.

  • Transitional Reinsurance Fee Filing Date Extended to December 5

    11/17/2014

    The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for group health plans to complete their 2014 transitional reinsurance fee (TRF) submission.

  • Self-Funded Plans Must File Transitional Reinsurance Program Form By December 5

    11/17/2014

    The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016.

  • Agencies Disallow Several Plan Designs; Other Federal Developments

    11/14/2014

    The upcoming employer-shared responsibility ("play or pay") requirements have spawned a number of different approaches to meeting the requirement that large employers offer coverage or pay penalties.

  • 2015 Annual Limits Card

    11/05/2014

    2015 Annual Limits Card includes 2014 and 2015 limits for contributions and benefit limits, compensation amounts, social security, health Plan limits, Medicare, and more.

  • Requirement to Obtain a Health Plan Identifier (HPID) Delayed

    11/03/2014

    On Friday, October 31, 2014, the Department of Health and Human Services (HHS) quietly updated its Health Plan Identifier information page to delay the requirement that insurance carriers and self-funded health plans obtain a health plan identifier (HPID).

  • UBA Compliance Recap October 2014

    11/03/2014

    During the month of October, there were developments in the courts and new information from the regulatory agencies that may affect sponsors of group health plans.

  • UBA Compliance Recap September 2014

    10/01/2014

    In the past few weeks, the regulatory agencies have issued details on a number of items of interest to sponsors of group health plans.

  • IRS Allows Additional Section 125 Change in Status Events

    09/30/2014

    On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55 which allows employers to amend their Section 125 plans to recognize several new change in status events.

  • IRS Issues Drafts of Instructions for Employer and Individual Responsibility Reporting Forms

    09/25/2014

    In order for the Internal Revenue Service (IRS) to verify that individuals have the required minimum essential coverage, individuals who request premium tax credits are entitled to them, and large employers are meeting their shared responsibility (play or pay) obligations, employers and insurers will be required to provide reporting on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015

  • Compliance Recap August 2014

    09/08/2014

    August 2014 brought a court case that will be of interest to employers that apply significant penalties to those who choose not to participate in wellness programs. The Department of Health and Human Services (HHS) has now provided an additional way for religious organizations that object to covering contraceptives to receive an exemption and has offered some insight into how it will allow closely-held for-profit organizations that object to covering contraceptives to receive an exemption.

  • Compliance Recap July 2014

    08/06/2014

    The month of July brought court cases, draft forms, and a FAQ of interest to group health plans.

  • IRS Issues Drafts of Individual Responsibility Reporting Forms

    08/01/2014

    The following is a summary of draft forms. Some of this information may change when final forms, and the instructions, are released.

  • Courts Issue Opposite Rulings in PPACA Subsidies Cases

    07/24/2014

    On July 22, 2014, two Courts of Appeals issued decisions that address whether only people who live in states that have state-run Marketplaces (which are also called exchanges) are eligible to receive premium tax credits or subsidies under the Patient Protection and Affordable Care Act (PPACA).

  • MLR Rebate Considerations - Private Plans

    07/22/2014

    As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2013 experience by August 1, 2014. The rules for calculating and distributing these rebates are largely the same this year as they were last year.

  • Compliance Recap June 2014

    07/03/2014

    June 2014 During the month of June, rules and decisions that potentially affect some or all group health plans were issued by the regulatory agencies and the Supreme Court of the United States.

  • Compliance Recap May 2014

    05/30/2014

    Most of the major rules that affect 2014 and 2015 requirements under the Patient Protection and Affordable Care Act (PPACA) have been issued, so the regulatory agencies have begun addressing some of the details that need additional clarification. A number of notices were released during the month of May that address a wide range of open items that affect group health plans.

  • Compliance Recap April 2014

    04/30/2014

    The IRS has released the 2015 minimums and maximums that apply to health savings accounts (HSAs) and related high-deductible health plans (HDHPs). These increases occur annually based on a cost-of-living formula. Because the inflation rate is fairly low, the amounts have not increased very much -- the out-of-pocket maximum is increasing by $100 for single coverage and by $200 for family coverage. Both the minimum deductible and the maximum contribution are increasing $50 for single coverage and $100 for family coverage.

  • Mid-Sized Group (50 to 99 Employees) Insured Plans and PPACA

    04/11/2014

    PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured mid-sized group plans.

  • Preparing for PPACA -- A Readiness Checklist

    03/31/2014

    As we approach the month of April, employers should be taking steps to ensure they are prepared to meet the Patient Protection and Affordable Care Act (PPACA) requirements that begin in 2014 and in 2015. In many instances, employers will need to begin tracking employees' hours in the next month or two. In addition, while some requirements vary based on employer size, other requirements apply to all employers. The most significant upcoming requirements and options for an employer include the following.

  • Compliance Recap March 2014

    03/31/2014

    The regulatory agencies issued a number of documents during the month of March, as they have tried to provide needed information with respect to 2014 and 2015 obligations under the Patient Protection and Affordable Care Act (PPACA). Many employers will need to provide reporting on the coverage they offer during the 2015 calendar year; the IRS has now issued final regulations that provide details on this requirement.

  • IRS Releases Final Reporting Regulations

    03/13/2014

    In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer.

  • IRS Releases Final Reporting Regulations

    03/13/2014

    In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer. The reporting requirements are in two separate sections of the Patient Protection and Affordable Care Act (PPACA) -- sections 6055 and 6056. Reporting will first be due early in 2016, based on coverage in 2015.

  • Option for Some to Renew Policies That Do Not Fully Meet PPACA Standards

    03/11/2014

    On March 5, 2014, the Department of Health and Human Services (HHS) released a Bulletin that allows state insurance departments to permit the renewal through October 1, 2016, of individual and small group policies that do not meet the "market reform" requirements of the Patient Protection and Affordable Care Act (PPACA).

  • Frequently Asked Questions about Eligibility Waiting Periods

    02/28/2014

    Frequently Asked Questions about Eligibility Waiting Periods - Updated February 2014

  • Eligibility Waiting Periods

    02/24/2014

    On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements.

  • IRS Issues Final Regulations on Employer Shared Responsibility (Play or Pay)

    02/17/2014

    On February 10, 2014, the IRS issued final regulations on the employer-shared responsibility requirements, often known as "play or pay." This is the requirement that large employers offer adequate coverage to their full-time employees or pay penalties. The final regulations follow the proposed regulations (which were issued in January 2013) in many respects, but also contain some surprises.

  • Additional PPACA Details Released

    01/16/2014

    On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury (IRS) issued Frequently Asked Questions - Part XVIII that provides additional information about requirements in several areas.

  • Frequently Asked Questions about the W-2 Reporting Requirement

    12/23/2013

    Employers that issued 250 or more W-2s in the prior calendar year must include the value of "employer-sponsored group health coverage" on their employees' W-2s. This means that an employer that issued 250 or more W-2s during 2012 must include the value of employer-sponsored coverage on the employee's 2013 W-2 (to be issued in January 2014).

  • HHS Announces Extensions to Enrollment and Premium Deadlines for Marketplace Coverage and Eligibility for Catastrophic Coverag

    12/20/2013

    On December 12, 2013, the U.S. Department of Health and Human Services (HHS) released an Interim Final Rule that formally extends some of the marketplace (also known as the exchange) deadlines and encourages insurers to provide additional extensions if possible.

  • Highlights of the Wellness Program Requirements

    12/13/2013

    The wellness program rules provide an exception to the general rule that employers may not take a person's health status into account with respect to eligibility, benefits, or premiums under a group health plan. Wellness programs, therefore, are allowed if they are designed to help employees improve their health; if they are primarily punitive they will not be allowed.

  • Thanksgiving Smorgasbord Of Regulations

    12/10/2013

    The Internal Revenue Service (IRS) and the Department of Health and Human Services (HHS) have recently issued several final and proposed rules of interest to employers.

  • PPACA Advisor - Additional Medicare Withholding

    12/05/2013

    The Internal Revenue Service (IRS) published Final Regulations on the Additional Medicare Tax (AMT) on Nov. 29, 2013, and an updated and comprehensive FAQ on Dec. 2, 2013. There are few changes from the proposed requirements.

  • Insurers Given Permission to Renew Policies That Don't Meet PPACA Requirements

    11/16/2013

    On Nov. 14, 2013) the White House announced that insurers will not be required to meet most of the provisions of the Patient Protection and Affordable Care Act (PPACA) if they renew individual or small group policies that were in effect on Oct. 1, 2013.

  • Health FSA Rules Liberalized

    11/04/2013

    On Oct. 30, 2013, the Internal Revenue Service issued a notice that liberalizes the "use it or lose it" rule that applies to health flexible spending accounts (HFSAs) and clarifies that employers of all sizes may choose to amend their Section 125 plan to essentially treat the availability of the health marketplaces/exchanges as a one-time change in status event.

  • Guidance on HRAs and Premium Reimbursement Arrangements

    10/08/2013

    On Sept. 13, 2013, the IRS issued Notice 2013-54, which includes details on permissible health reim-bursement arrangements (HRAs), provides some clarification on minimum essential, minimum value and affordable coverage, and addresses payment of individual premiums through an employer-provided plan.

  • UBA Provides FAQ on Health Marketplace

    10/02/2013

    Open enrollment is scheduled to begin in the health marketplaces (also called the exchanges) on Oct. 1, and many employers and employees have questions about eligibility for coverage through the marketplace and premium subsidies. UBA has prepared a FAQ to address some of those questions.

  • Self-Funded Plans and PPACA

    09/20/2013

    PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to self-funded plans.

  • Small Group Insured Plans

    09/20/2013

    PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured small group plans provided inside and outside the SHOP exchange.

  • Large Group Insured Plans and PPACA

    09/20/2013

    PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured large group plans.

  • PPACA Advisor - Small Employer Tax Credit

    09/19/2013

    Very small employers with a high percentage of employees who earn low wages are eligible for a tax credit for employer contributions made to purchase health insurance. Non-profit organizations also are eligible - they will receive the credit as an offset to their payroll taxes. Governmental entities are not eligible unless they qualify as 501(c) organizations.

  • IRS Issues Reporting Rules

    09/12/2013

    On Sept. 5, 2013 the Internal Revenue Service (IRS) released the long awaited rules that describe the reporting that plans, employers and insurers will need to provide in support of the individual shared-responsibility and employer shared-responsibility requirements of the Patient Protection and Affordable Care Act (PPACA). The rules are proposed, so some changes may occur when the rules are finalized.

  • Marketplace/Exchange Notice

    09/12/2013

    PPACA requires employers covered by the Fair Labor Standards Act to provide a notice about the upcoming health marketplaces (also called exchanges) to their employees. The notice is due Oct. 1, 2013. On Sept. 11, 2013 the Department of Labor (DOL) announced that it will not penalize employers that do not provide this notice.

  • Highlights of Exchange Notice Requirement

    09/04/2013

    Most employers must give a notice about the upcoming health exchanges/marketplaces to all existing employees by Oct. 1, 2013. Employees hired after that date must receive the notice within 14 days following their start date.

  • PPACA Advisor - Exchange FAQ

    09/04/2013

    This FAQ is based on Department of Labor (DOL) Technical Release 2013-02, which does not provide specific guidance on many issues. Consequently, some of the answers in this FAQ are based on agency guidance provided in similar situations. The answers in this FAQ assume the employer is completing the model notice that applies to employers that offer coverage.

  • FAQ About Grandfathered Plans

    08/27/2013

    As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option.

  • Individual Shared Responsibility Requirement

    07/29/2013

    Although the employer shared responsibility requirements have been delayed to 2015, the individual responsibility requirement (also known as the individual mandate) is still scheduled to take effect in 2014.

  • UBA Prepares PCORI Q&A

    06/27/2013

    UBA has prepared a Q&A to address recurring questions about the PCORI fee.

  • Wellness Rules Alert

    05/31/2013

    On May 29, 2013 the Department of Health and Human Services, the Internal Revenue Service and the Department of Labor jointly issued a final rule that addresses how wellness programs must operate under PPACA beginning in 2014. In many respects the final rules carry forward the rules that have been in effect for wellness programs since 2006, and most of the updates that were proposed last November have been adopted.

  • PPACA Employee Guide

    05/29/2013

    UBA has created an overview of the employee's responsibility to purchase coverage under PPACA (the individual mandate) and on the basics of the exchanges. The information in this piece is basic, but should provide a starting place for employers who want to educate their employees on this law.