Blog

Employer groups that offer prescription drug coverage to Medicare eligible employees, dependents and/or retirees, need to provide annual creditable disclosures to both their eligible plan participants and the federal Centers for Medicare and Medicaid Services (CMS). “Creditable” plans mean that the coverage provided is as good as, if not better... read more →

Implementation of the "Cadillac Tax," the Affordable Care Act's excise tax on high-cost employer-sponsored health coverage, has been delayed until 2022. Previously, this tax—which would impose a 40% tax on plans that cost more than $10,200 (for self-only coverage) and $27,500 (for family coverage)—was set to become effective in 2020. An... read more →

Important information for prospective individual medical enrollees who did not enroll at open enrollment: Amerihealth (NJ): Coverage effective dates can only be 1st or 15th of the month. For when coverage is ending mid-month, Amerihealth will enroll 1st of that month month, if the application is received prior to the... read more →

The Internal Revenue Service (IRS) has begun enforcing the employer shared responsibility provision (aka "employer mandate" or "pay or play" provision) of the Affordable Care Act (ACA) for the 2015 tax year by sending Letter 226J to tens of thousands of applicable large employers (ALEs).  Here are ten things to keep in... read more →

Effective January 1, 2017, the New Jersey Small Employer Health Coverage Program (SEH Program) aligned its definition of a "Small Employer" for health insurance coverage purposes with the federal definition. This means that the methodology used to determine a small employer’s group size now looks to the total number of full-time... read more →

The Centers for Medicare and Medicaid Services (CMS) is providing relief to certain Medicare beneficiaries enrolled in Medicare Part A and individual coverage bought through a health insurance "exchange" to allow them to enroll in Medicare Part B without penalty through September 30, 2017. CMS is also offering assistance to individuals... read more →

On May 4, 2017, the U.S. House of Representatives passed legislation to repeal and replace the Affordable Care Act (ACA). An earlier version of the House bill, called the American Health Care Act (AHCA), had been debated in March but was not voted on due to opposition from Democrats and... read more →

The ACA created Internal Revenue Code (IRC) Sections 6055 and 6056 which require employers, insurers, and other reporting entities report health insurance information to the IRS for purposes of enforcing the Individual Responsibility (aka “Individual Mandate”) and Employer Shared Responsibility (aka “Play or Pay”) provisions of the ACA. Section 6055 requires reporting... read more →

Employers and health insurance issuers must provide the Summary of Benefits and Coverage (SBC) and Glossary to all employees who are offered and who enroll in group coverage, per the ACA. The SBC is a standard document that explains all of a health plan’s basic coverage terms and cost-sharing requirements using... read more →

On December 13, 2016 President Obama signed the 21st Century Cures Act which includes a provision allowing small businesses to offer a new type of health reimbursement arrangement for their employees’ health care expenses, including individual insurance premiums. The provision for Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs), a new type of tax-free... read more →