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Employers with less than 100 full-time equivalent employees (FTEs) but more than 50 FTEs will not subject to Employer Shared Responsibility until January 1, 2016 if they can complete a certification process to demonstrate that, during the period between February 9, 2014 and December 31, 2014, the employer did not:... read more →

On 7/22, the D.C. Circuit Court ruled that the Internal Revenue Service (IRS) lacked the authority to allow tax credits under the Affordable Care Act (ACA) to be provided in the Obamacare ‘exchanges’ (‘Marketplaces’) that are not run by states. Later that day, however, a Virginia District Court panel hearing... read more →

The Affordable Care Act (ACA) includes several reforms directed at promoting and improving the effectiveness of workplace wellness programs. The Department of Health and Human Services (HHS), Employee Benefits Security Administration (EBSA) and Internal Revenue Service (IRS) collectively published final regulations on the ACA’s nondiscrimination requirements for workplace wellness programs... read more →

The Affordable Care Act (ACA) required each state to establish an online competitive marketplace where, beginning in 2014, individuals and small businesses would be able to purchase health insurance. The Small Business Health Options Program (SHOP) is the marketplace component for small businesses. The Department of Health and Human Services... read more →

The Open Enrollment to elect individual medical coverage in 2014 in the Health Insurance Marketplaces ended on March 31, 2014. This means that for the rest of the year, the only way an individual can elect coverage is if they qualify for a Special Enrollment Period (SEP). A SEP includes, but... read more →

Starting in 2014, one of the essential health benefits (EHBs) that must be included in medical coverage sold to individuals or small businesses under the Affordable Care Act (ACA) is pediatric dental and vision. Essential pediatric dental benefits include no plan maximums for in-network services, out-of-pocket maximums that vary per... read more →

The Internal Revenue Service (IRS) Notice 2013-54 (Notice) issued in September 2013 addresses how certain reforms under the Patient Protection and Affordable Care Act (ACA) apply to health reimbursement arrangements (HRAs), cafeteria plans and other employer payment plans. The Notice is effective for plan years beginning on or after January... read more →

Effective January 1, 2014, a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period that exceeds 90 actual days. Please note the following administrative guidelines per insurer: AETNA: the waiting period will change to a maximum of 60 days at the first... read more →

President Obama made a 'game-changing' announcement yesterday to the implementation of the health care law that ALL of our small group and individual medical clients need to be aware of, when he stated that Americans MAY keep their current health plan vs. being forced into new Affordable Care Act (ACA) compliant plans in 2014. This... read more →

Before dropping their Group Health Plan and having employees instead purchase coverage via the individual 'marketplaces' created by the Affordable Care Act (also known as the individual 'exchanges'): Loss of Business Expense Deductions:Employer contributions to a group health plan are deductible business expenses. Added Salary Expenses:If employers drop coverage, employees... read more →