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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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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ACA – Employer Mandate Reporting Reminder

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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

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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

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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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IRS Memo on Fixed Indemnity Health Plan Benefits Tax Treatment

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On January 20, 2017, the IRS released a Memorandum on the tax treatment of benefits paid by fixed indemnity health plans that addresses two questions: Are payments to an employee under an employer-provided fixed indemnity health plan excludible from the employee’s income under Internal Revenue Code ยง105? Are payments to an employee under an employer-provided […]

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Executive Order from President Trump on the ACA

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On Friday, January 20, 2017, President Trump signed his first Executive Order, titled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” The Executive Order instructs the Secretary of the Department of Health and Human Services (HHS) and the heads of all other executive departments and agencies with authority, or […]

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21st Century Cures Act

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On December 13, 2016, President Obama signed the 21st Century Cures Act into law. The Cures Act has numerous components, but employers should be aware of the impact the Act will have on the Mental Health Parity and Addiction Equity Act, as well as provisions that will impact how small employers can use health reimbursement […]

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