Tag: Affordable Care Act

The IRS has finalized the forms and instructions that employers will use for 2018 reporting under the Affordable Care Act (ACA). Applicable large employers (ALEs) will use the following: 2018 Form 1094-C (transmittal to IRS). 2018 Form 1095-C (statement to individual). 2018 Instructions for Forms 1094-C and 1095-C (instructions). Employers that self-fund a minimum essential…

The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play…

On June 19, 2018, the U.S. Department of Labor released its Final Rule regarding Association Health Plans (AHPs). AHPs are not new, but they have not been widely available in the past and, in some cases, they have not been successful. The Final Rule is designed to make AHPs available to a greater number of…

On May 21, 2018, the IRS announced that the affordability percentage under the Affordable Care Act’s play or pay rules will increase to 9.86% for 2019 plan years. This is an increase from 9.56% for 2018 plan years. By way of background, the ACA’s employer shared responsibility provision – often called the employer mandate or…

Do you offer coverage to your employees through a self-insured group health plan? Do you sponsor a Health Reimbursement Arrangement (HRA)? If so, do you know whether your plan or HRA is subject to the annual Patient-Centered Research Outcomes Institute (PCORI) fee? This article answers frequently-asked questions about the PCORI fee, which plans are affected,…

States that permit carriers to renew medical policies without adopting various Affordable Care Act (ACA) requirements may continue to do so through 2019, according to a bulletin released April 9, 2018, by the U.S. Department of Health and Human Services. The bulletin extends transitional relief for non-ACA-compliant policies for another year. The affected category of…

The Internal Revenue Service (IRS) has released final forms and instructions to be used for Internal Revenue Code § 6055 and § 6056 reporting. This material is for 2014 reporting, which is voluntary for employers. Reports for 2015 (due in early 2016) will be required, however, so employers and their advisors should review the material…

The new year came with notable compliance changes that may require updating group health plan materials. Employers should review these requirements and make the necessary changes to materials offered to participants at plan renewal. The Affordable Care Act’s (ACA) Employer Shared Responsibility provision, also referred to as “Play or Pay,” took effect January 1, 2015….

From the Hotline: Opt-Out Credit

Question: If an employer offers a $50/month “opt out credit” for any benefits-eligible employee not enrolling in the group medical plan due to coverage under a spouse’s group health plan, would that also include employees under age 26 who are covered under a parent’s plan? Are there any tax or ACA implications that need to be…