Compliance Alert – PCORI Fee due July 31 – Form 720

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Employer action is required if you maintain a self-funded plan and/or a standalone Health Reimbursement Arrangements (HRA) associated with a fully insured and/or self-funded plan.  If you have a fully insured health plan and do not have an HRA, you may disregard, as the insurance carrier is responsible for this reporting.   The Patient-Centered Outcomes Research […]

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Senate Releases Proposed Healthcare Bill; Differs from House AHCA

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On June 22, 2017, the United States Senate released a “Discussion Draft” of the “Better Care Reconciliation Act of 2017” (BCRA), which would substitute the House’s House Resolution 1628, a reconciliation bill aimed at “repealing and replacing” the Patient Protection and Affordable Care Act (ACA). The House bill was titled the “American Health Care Act […]

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Frequently Asked Questions about Employees’ Reduction in Hours

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The Section 125 cafeteria plan regulations and the Patient Protection and Affordable Care Act (ACA) require employers to take certain actions when an employee reduces hours. Below are answers to some common questions. Coverage During a Stability Period Q1: An employer has an employee who is reducing hours below 30 hours per week. The employee […]

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IRS Updates

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IRS Updates Health Coverage Affordability Calculation for Individuals for 2018 The Internal Revenue Service (IRS) issued Revenue Procedure 2017-36, adjusting the calculation determining whether an individual can afford employer-sponsored health coverage, which affects whether the individual would be eligible for a premium tax credit on the public health exchanges. This could affect employers who are […]

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House Passes AHCA Bill in First Step to Repeal and Replace the ACA

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On May 4, 2017, the U.S. House of Representatives passed House Resolution 1628, a reconciliation bill aimed at “repealing and replacing” the Patient Protection and Affordable Care Act (ACA). The bill, titled the “American Health Care Act of 2017” or “AHCA,” will now be sent to the Senate for debate, where amendments can be made, […]

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ACA Market Stabilization Final Rule

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On April 18, 2017, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) published its final rule regarding Patient Protection and Affordable Care Act (ACA) market stabilization. The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the […]

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

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Updated March 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. If an employer providing an SBC is a covered entity under the […]

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