Veterans with TRICARE; VA Coverage Won't Count Toward Applicable Large Employer Status - Bim Group

Veterans with TRICARE; VA Coverage Won’t Count Toward Applicable Large Employer Status

The Surface Transportation and Veterans Health Care Choice Improvement Act (STVHCC) of 2015 was signed into law by President Obama on July 31, 2015. The Act, also known as H.R. 3236, is focused on surface transportation programs but affects rules regarding how to count employees under the Patient Protection and Affordable Care Act (ACA) as well as health savings account (HSA) eligibility for individuals receiving care through the Veterans Administration.

Applicable Large Employer Counting

The ACA requires applicable large employers (ALEs) to offer their full-time employees health coverage, or pay one of two employer-shared responsibility/play or pay penalties. ALEs are employers with 50 or more full time employees or full time equivalent employees. The STVHCC would allow employers (effective months beginning after December 31, 2013), solely for purposes of determining ALE status, to disregard in any month an employee that has medical coverage for that month through TRICARE or under a federal health care program through the Department of Veterans Affairs.

Employers with employees that have TRICARE or health coverage through the Department of Veterans Affairs should anticipate guidance from federal agencies on the practical process for disregarding these employees.

Employers who offer health coverage, regardless of their size, should offer health coverage to all eligible employees who have TRICARE or health coverage through the Department of Veterans Affairs. The STVHCC only affects the way an employer counts employees for determining ALE status under the ACA.

HSA Eligibility

In order to establish an HSA, an individual must be eligible to do so. Eligibility, generally, requires an individual to have a high deductible health plan (HDHP) and prohibits them from having any other coverage for any benefit already covered by the HDHP. This includes TRICARE and previously included Veterans medical benefits (during any month that the individual received VA medical benefits).

The STVHCC provides that individuals who receive hospital care or medical services under any law administered by the Secretary of Veterans Affairs for service-connected disability are still HSA-eligible for any months after December 31, 2015.

 

Recent Insights

April 22, 2024
News

Do You Know Where Your Employees Are? Managing Taxes for a Growing Remote Workforce

READ TIME: 5 MINUTES Remote work remains a growing focus of employers with employees increasingly seeking jobs that permit remote or hybrid work arrangements. Though the flexibility and benefits of remote work for employees is highly desired, it comes with some additional considerations and potential tax complications for the employer. State Income Tax Withholding Considerations […]
Read more
April 22, 2024
COBRA, Compliance Alert

Group Health Plan Guide to COBRA

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits due to job loss, reduction in hours, death, divorce, and other life events the right to choose to temporarily continue health benefits provided by their group health plan. This guide includes: Employers required to offer COBRA Plan types […]
Read more
April 8, 2024
HIPAA

Timely Responses Required for Requests under HIPAA’s Right of Access Rule

READ TIME: 4 MINUTES On December 15, 2023, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), announced a settlement under the Health Insurance Portability & Accountability Act (HIPAA) Right of Access Rule. This penalty illustrates that the Right of Access Rule remains a focus of HHS and that health […]
Read more
April 8, 2024
Compliance Alert

March 2024 Compliance Recap

READ TIME: 7 MINUTES ACA reporting is in its first year of the required electronic reporting for employers filing ten or more returns annually. Employers and employees must make changes to HSAs by the April 15 deadline. Employers of all sizes continued to prepare for the June 1 RxDC Reporting using the newly released instructions. […]
Read more