Blog

The Employer Play or Pay mandate, known as "Employer Shared Responsibility" under the Affordable Care Act (ACA), will only apply to employers with at least 100 fulltime equivalent employees (FTEs) in 2015, as the Administration has provided an additional year for employers with less than 100 fulltime equivalent employees to... read more →

The Affordable Care Act (ACA) requires health insurance issuers and sponsors of self-insured health plans to pay "Patient-Centered Outcomes Research Institute" (PCORI) fees. The fees are reported and paid annually using IRS Form 720. For fully-insured plans, the insurers are responsible for the fee (most build in the fee into their current... read more →

The IRS has released the final forms and instructions under sections 6055 and 6056 for applicable large employers (‘ALEs’), insurers and employers with self-insured health plans for reporting on individual and employer mandates under the Affordable Care Act (ACA). The first reporting is required in early 2016 for the 2015... read more →

2014 was the first year that small employer groups had to comply with Pediatric Dental coverage requirements under the Affordable Care Act (ACA). Although the basis of the law has not materially changed for 2015 for groups with under 51 employees, it is important to note that each state has adjusted... read more →

Starting January 1, 2015, medical plans will no longer be required to provide Certificates of Creditable Coverage (COCCs) under the Health Insurance Portability and Accountability Act (HIPAA). As a result, medical insurers will stop producing and sending COCCs as of the 1st of the year. These certificates, also sometimes referred... read more →

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 →