Tag: Affordable Care Act

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…

Update: See IRS Offers Relief for Small Employer Premium Reimbursement Arrangements for additional information. Question: Do you have any information that clearly states that employers cannot give stipends for health insurance in the individual market? Answer: Beginning in 2014, the Affordable Care Act (ACA) prohibits any form of “employer payment plan” with respect to individual health policies. (There…

The Internal Revenue Service (IRS) has released draft forms and instructions to be used for Internal Revenue Code § 6055 and § 6056 reporting, including IRS forms 1094-B, 1094-C, 1095-B, and 1095-C. The first reports will be due in early 2016 regarding employee information and health care coverage provided in 2015. Reporting Rules Internal Revenue Code § 6055 requires…

On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55, Additional Permitted Election Changes for Health Coverage under § 125 Cafeteria Plan, which allows employers to make specific changes to their plans. These changes will make it easier for employees to change their group plan elections and take advantage of individual health plans…

EDITOR’S NOTE — CORRECTION: On July 29th we reported the release of IRS Rev. Proc. 2014-37 where the Treasury Department announced adjustments increasing the affordability index from 9.5 percent to 9.56 percent for individual tax premium subsidies for 2015. Because the Affordable Care Act’s (ACA) rule that provides premium tax subsidies to lower-income individuals corresponds…

Question: We have less than 50 employees (including 50 FTE). Can we set eligibility at a level of an employee who works 40 or more hours a week, or does it have to be 30? Answer: An employer with less than 50 employees (including FTE) is not subject to the Employer Shared Responsibility Provision of…

Question: Is affordability under the Employer Shared Responsibility mandate based on the lowest cost plan? Answer: Yes. According to the final regulations: “In order to avoid a potential assessable payment under section 4980H(b), the coverage offered must be affordable, generally meaning that the employee portion of the self-only premium for the employer’s lowest cost coverage…