Compliance Recap // June 2017

June was an active month in the employee benefits world. The U.S. Senate released a draft of the Better Care Reconciliation Act of 2017 which would substitute the U.S. House Resolution 1628 that aimed to repeal and replace the Patient Protection and Affordable Care Act (ACA). The U.S. Supreme Court decided an ERISA church plan […]

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Compliance Alert – PCORI Fee due July 31 – Form 720

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

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

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

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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ACA – Employer Mandate Reporting Reminder

The following applies to employer groups that are considered Applicable Large Employers (ALEs) for the 2015 calendar year and subject to ACA Employer Mandate reporting for 2016. MARCH 2, 2017: ACA Forms 1095-C to Employees Applicable Large Employers must submit Forms 1095-C to employees no later than March 2, 2017. FEBRUARY 28, 2017 or MARCH […]

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Compliance Recap // January 2017

January was a significant month in the employee benefits world because the new U.S. administration issued an Executive Order announcing its intent to repeal the Patient Protection and Affordable Care Act (ACA). However, January was a relatively inactive month for new laws and administrative rulemaking because the new administration placed a freeze on rulemaking until […]

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CMS’ Proposed Rule on ACA Market Stabilization

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. CMS proposes changes to guaranteed availability of coverage, network adequacy, essential community providers, open enrollment periods, special […]

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