By Brian M. Pinheiro on Posted in Individual Coverage Mandate,LegislationThe Tax Cuts and Jobs Act, signed into law by President Donald J. Trump shortly before Christmas, is the most significant tax reform legislation in more than 30 years. While early versions of the legislation would have made sweeping changes to employee benefit plans and executive compensation arrangements, the final Act has a narrower, though [&hellip… Continue Reading »
By Jean C. Hemphill, Brian M. Pinheiro, Brenda M. Ching and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / Suppliers,LegislationThe House Ways and Means and Energy and Commerce Committees have released, in two parts, budget reconciliation legislation, the first steps of Congress’ proposal to “repeal and replace” the Affordable Care Act. Reconciliation legislation is limited to budget-related provisions and restricts legislators’ ability to address fully all of the repeal and replacement provisions that we [&hellip… Continue Reading »
By Kurt R. Anderson, Edward I. Leeds and Brian M. Pinheiro on Posted in Cadillac Tax,Taxes and FeesThe Internal Revenue Service has issued a new notice addressing issues relating to future rules governing the calculation and payment of the so-called “Cadillac tax” under the Affordable Care Act. Beginning in 2018, the ACA will impose a 40 percent nondeductible excise tax on the value of group health coverage that exceeds a baseline amount [&hellip… Continue Reading »
By Edward I. Leeds, Brian M. Pinheiro, Jean C. Hemphill and Diane A. Thompson on Posted in Employer Responsibilities,ReportingThe Internal Revenue Service has issued two lengthy sets of questions and answers on the requirement under the Affordable Care Act that employers report on their compliance with the employer mandate and employees’ qualification for exchange subsidies. The new guidance is divided into general information about the reporting rules and information about completing the actual [&hellip… Continue Reading »
By Brian M. Pinheiro, Edward I. Leeds, Brian D. Pedrow and Daniel V. Johns on Posted in Cadillac Tax,Taxes and FeesYesterday, the Internal Revenue Service issued preliminary but much-anticipated guidance on the so-called Cadillac tax imposed by the Affordable Care Act (ACA). The new notice offers very few concrete answers to employer questions about how the tax is to be calculated. Mostly, the IRS identifies issues that may be the subject of future proposed regulations, [&hellip… Continue Reading »
By Jean C. Hemphill, Diane A. Thompson, Brian M. Pinheiro, Edward I. Leeds and Alisa M. Huth on Posted in LitigationDoes the Affordable Care Act (ACA) authorize the payment of premium and copayment subsidies, or “premium assistance subsidies,” to individuals enrolled in a federally established Exchange? On July 22, 2014, two federal courts issued conflicting opinions on this subject. The U.S. Court of Appeals for the District of Columbia Circuit, in Halbig v. Burwell, concluded [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and Edward I. Leeds on Posted in LitigationThe U.S. Supreme Court has ruled in favor of three for-profit corporations that claimed that the Affordable Care Act (ACA) mandate to provide preventive care coverage for certain types of contraception violated the protections afforded to them under the federal Religious Freedom Restoration Act of 1993 (RFRA). This ruling is expected to apply primarily to [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and Edward I. Leeds on Posted in Litigation,Plan Design Requirements,Preventive ServicesThe U.S. Supreme Court has ruled in favor of three for-profit corporations that claimed that the Affordable Care Act (ACA) mandate to provide preventive care coverage for certain types of contraception violated the protections afforded to them under the federal Religious Freedom Restoration Act of 1993 (RFRA). This ruling is expected to apply primarily to [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and calpasj on Posted in Employer Mandate/Shared Responsibility (Pay or Play),Employer ResponsibilitiesVery large employers will be required to offer health care coverage to their full-time employees or pay a penalty to the federal government beginning January 1, 2015. Under the final regulations released by the U.S. Department of Treasury (Treasury Department) on February 10, 2014, however, employers with fewer than 100 full-time employees will have an extra [&hellip… Continue Reading »
By Brian M. Pinheiro and Edward I. Leeds on Posted in Employer Responsibilities,Waiting PeriodsThe U.S. Departments of Health and Human Services, Labor, and Treasury have released a joint set of proposed regulations implementing the requirement in the Patient Protection and Affordable Care Act that group health plans and health insurance issuers offering group health insurance cannot apply a waiting period that exceeds 90 days. The proposed regulations make the [&hellip… Continue Reading »
By Brian M. Pinheiro on Posted in Reinsurance,Taxes and FeesThe U.S. Department of Health and Human Services has published final regulations that will enable plan sponsors and insurers to calculate their liability under the transitional reinsurance fee provisions of the Patient Protection and Affordable Care Act. Beginning in 2014 (and continuing for 2015 and 2016), employers and other sponsors of self-funded health plans, as well [&hellip… Continue Reading »
By Brian M. Pinheiro and Edward I. Leeds on Posted in Insured Plans,Medical Loss RatioIn the next few weeks, employers with insured group health plans, or insured options (such as an insured HMO) in an otherwise self-funded plan, may receive rebate checks from their insurers. Employers receiving these checks will need to consider how to apply the amounts in a manner that complies with applicable law. An insurer’s obligation [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and Edward I. Leeds on Posted in Individual Coverage Mandate,Litigation,Medicare, Medicaid, and CHIPIn its highly anticipated decision in National Federation of Independent Business et al. v. Sebelius, the U.S. Supreme Court ruled this morning that the “individual mandate” set forth in the Patient Protection and Affordable Care Act is constitutional. As a result, almost every individual in the United States must either obtain health coverage—through an employer, [&hellip… Continue Reading »
By Brian M. Pinheiro and calpasj on Posted in Employer Responsibilities,ReportingThe Patient Protection and Affordable Care Act requires employers to report the aggregate cost of employer-sponsored health coverage on the Forms W-2 of its employees. In March 2011, the Internal Revenue Service issued interim guidance on the Form W-2 informational reporting requirement in the form of 31 Q&As. Recently, the Internal Revenue Service revised this [&hellip… Continue Reading »
By Brian M. Pinheiro on Posted in Employer Responsibilities,Summary of Benefits and CoverageContinuing with the recent proliferation of guidance on health care reform, the U.S. Departments of the Treasury, Labor, and Health and Human Services have released proposed regulations and requested comments regarding the implementation of a new, simplified benefit summary requirement created by the Patient Protection and Affordable Care Act (the 2010 health care reform legislation). [&hellip… Continue Reading »
By Brian M. Pinheiro and Edward I. Leeds on Posted in Individual Coverage Mandate,LitigationIn Thomas More Law Center v. Obama, a deeply divided panel of the U.S. Court of Appeals for the Sixth Circuit has upheld the individual mandate provision of the Patient Protection and Affordable Care Act (the new health care reform law) against a challenge that the mandate is unconstitutional on its face. Each of the [&hellip… Continue Reading »
