Health Care Reform Dashboard

Health Care Reform Dashboard

Charting developments on the
Affordable Care Act

Employer Responsibilities

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Bipartisan Budget Act Repeals ACA Auto-Enrollment Rule

The Bipartisan Budget Act of 2015 (H.R. 1314), signed into law on November 2, 2015, repeals the automatic enrollment rule added by Section 1511 of the Affordable Care Act (ACA). The auto-enrollment rule amended the Fair Labor Standards Act (FLSA) to require employers, if they employed more than 200 full-time employees and offered a health [&hellip… Continue Reading »

New Guidance on Cost-Sharing Limits and Provider Nondiscrimination Rules

The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group health plans must cap the amount that plan participants pay in deductibles, copayments, coinsurance and the like at $6,850 for self-only [&hellip… Continue Reading »

New Guidance on Affordable Care Act Reporting Requirements

The 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 »

Expatriate Plans Exempted from Many Affordable Care Act Provisions

In the Consolidated and Further Continuing Appropriations Act (the recently enacted federal budget bill often known as the “CRomnibus” legislation), Congress has exempted health plans designed to cover expatriates from most of the requirements of the Affordable Care Act. The exemption will generally apply where a group health plan provides significant health coverage and substantially [&hellip… Continue Reading »

Health Plan ID Program Suspended

Late on October 31, the Centers for Medicare and Medicaid Services (CMS) Office of E-Health Standards and Services announced that it was suspending the program that required all health plans to register for a health plan ID number to be used in certain electronic transactions. This program required larger health plans to obtain a health [&hellip… Continue Reading »

Health Plan ID Requirements and Other End-of-Year Considerations

Employers and other health plan sponsors may be focused on preparing for the commencement of the employer mandate under the Affordable Care Act on January 1, 2015, but a number of other deadlines and developments are emerging this autumn for plan sponsors to consider. Health Plan IDs. As we reported earlier, many health plans are [&hellip… Continue Reading »

IRS Issues More Guidance on Affordable Care Act Reporting Requirements

Following up on regulations and forms published earlier this year, the IRS has issued instructions and other guidance on the shared responsibility reporting requirements under the Affordable Care Act. The new rules require: Health benefit providers, including group health plan sponsors and insurers, to provide information on an individual’s compliance with the individual mandate requirements [&hellip… Continue Reading »

Government Agencies Release Further Accommodations to Organizations Opposing Mandated Contraceptive Coverage

In response to the recent U.S. Supreme Court decision in Burwell v. Hobby Lobby, Inc., the U.S. Departments of Health and Human Services (HHS) and Labor (DOL) published proposed rules on August 22, 2014, expanding the availability of the religious accommodation to the contraceptive mandate provided in their July 2013 final regulations to closely held [&hellip… Continue Reading »

IRS Issues Draft ACA Reporting Forms

The Internal Revenue Service recently released draft versions of the forms that will be used to meet the shared responsibility reporting requirements under the Affordable Care Act (ACA). These draft forms have been released for comment and may not be used for filing until they are finalized. Instructions for the forms have not yet been [&hellip… Continue Reading »

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act (ACA), and other laws will affect your plans. As we pass the midpoint of 2014, it is [&hellip… Continue Reading »

New ACA Shared Responsibility Reporting Requirements

Under the Affordable Care Act, employers are required to report information relating to both the employer mandate and the individual mandate. As a result of these new rules, employers will need to provide information to the government relevant to whether employers and individuals are meeting their responsibilities under these mandates. Employers also will have to [&hellip… Continue Reading »

Employer Mandate Addresses Small Employers and Staffing Organizations

The final regulations on the ACA’s shared responsibility rules for employers (the “employer mandate”) established basic rules for compliance, including: Rules for determining whether the employer mandate applies A look-back measurement methodology that most employers subject to the rules will use for determining who is a full-time employee Safe harbor alternatives for determining whether coverage [&hellip… Continue Reading »

New FAQs Address Effect of Affordable Care Act on COBRA and Other Matters

In a wide-ranging set of frequently asked questions (FAQs) and other guidance, the U.S. Departments of Labor, Treasury, and Health and Human Services have addressed a number of issues pertaining to the Affordable Care Act (ACA). They include issues pertaining to COBRA and the Children’s Health Insurance Program Reauthorization Act (CHIPRA), annual cost-sharing limits, preventive care, [&hellip… Continue Reading »

ACA Employer Mandate Final Regulations Released; Enforcement Delays Provided for Mid-Sized Employers

Very 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 »

IRS Issues Proposed Regulations on Employer-Provided Health Care Coverage Reporting Requirements

The Internal Revenue Service has issued proposed regulations on reporting requirements under the Affordable Care Act (ACA). The regulations, released on September 9, 2013, address two separate ACA reporting requirements: one relating to the individual mandate and the other relating to the employer mandate. Failure to comply could result in tax penalties unless the failure [&hellip… Continue Reading »

Effective Date of ACA Employer Mandate (Pay or Play) is Postponed

In a startling development, the federal government appears ready to delay by one year the effective date of one of the central provisions of the Affordable Care Act (ACA)—the shared responsibility provisions (more commonly called the “employer mandate” or “pay or play”). This will give employers additional time to engage in strategic workforce planning in [&hellip… Continue Reading »

DOL Releases Guidance on Employer Notices about Exchange Availability

The U.S. Department of Labor (DOL) has published guidance on the notice that most employers must provide to their employees by October 1, 2013, about the insurance that will be available through health care marketplaces known as “exchanges.” The guidance includes three model notices. Under the Affordable Care Act, employers offering health coverage must notify employees [&hellip… Continue Reading »

More Guidance Issued on Summaries of Benefits and Coverage

The U.S. Department of Labor has issued a set of frequently asked questions, together with a new template, for the Summary of Benefits and Coverage (SBC) that applies to group health plans and individual health insurance. The new rules and form modify the guidance that was in effect for the first SBCs that employers needed to [&hellip… Continue Reading »

Agencies Propose Regulations on the 90-Day Waiting Period Requirement

The 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 »