The IRS has announced its intent to begin enforcing the employer-shared responsibility provisions (otherwise known as the employer mandate or pay-or-play provisions) of the Affordable Care Act for the 2015 calendar year. The IRS also published a template letter that it will mail to any applicable large employer (ALE) if it determines the ALE owes [&hellip… Continue Reading »
After a brief lull in activity, recent developments are likely to involve all three branches of government in addressing issues under the Affordable Care Act. The Legislature: It is often said that Congress rarely takes action until a crisis needs to be addressed. With the demise of this summer’s repeal and replace effort, initiatives to [&hellip… Continue Reading »
The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges established under the Affordable Care Act (ACA) in 2018. The final rules, issued in expedited fashion, generally follow the proposed regulations and include changes [&hellip… Continue Reading »
The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance published under the ACA by the new administration—are singular acts or signals of guidance to come, as Congress [&hellip… Continue Reading »
Changes are imminent for the Affordable Care Act and a range of other laws and regulations affecting the health care industry. Ballard Spahr attorneys established a Health Care Reform Initiative in 2008 to monitor and analyze health care reform developments. This Health Care Reform Dashboard was a product of that initiative. We intend to continue following [&hellip… Continue Reading »
The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report issued by the White House Mental Health and Substance Use Disorder Parity Task Force. This guidance manifests the administration’s continuing [&hellip… Continue Reading »
Following up on the issuance of final regulations on various market reform provisions under the Affordable Care Act (ACA), the IRS has issued a notice with Questions and Answers that take a more detailed look at specific ACA issues. In particular, this notice addresses: Health reimbursement arrangements (HRAs). The guidance confirms that retiree-only HRAs may [&hellip… Continue Reading »
In a much-anticipated decision, the U.S. Supreme Court ruled today that individuals who enroll for coverage in a health insurance exchange may qualify for a subsidy to make that coverage more affordable, regardless of whether the exchange is established by the federal or a state government. The 6-3 decision in King v. Burwell upholds the [&hellip… Continue Reading »
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 »
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 »
The Department of Health and Human Services (HHS) recently announced that qualified health plans (QHPs) established by the Affordable Care Act (ACA)—which include federally-facilitated insurance exchanges and federal subsidies available for low-income consumers to purchase health insurance—are not “federal health care programs” under the Social Security Act. If this interpretation withstands or avoids judicial review, [&hellip… Continue Reading »
The U.S. Department of the Treasury has published proposed regulations that provide guidance on how an employer may determine whether its group health plan provides “minimum value.” This determination is important because a large employer (generally speaking, with 50 or more full-time employees) faces a $3,000 annual penalty (under Code section 4980H(b)) with respect to each [&hellip… Continue Reading »
The U.S. Department of Health and Human Services has issued final regulations and a set of frequently asked questions and answers establishing standards for the provision of essential health benefits in the individual and small group insurance markets, both inside and outside of an Exchange. In large part, the final rules adopt standards set forth in the proposed regulations [&hellip… Continue Reading »
The U.S. Department of Health and Human Services (HHS) released proposed rules designed to create a single, streamlined application process for several government health insurance programs. The application process is being developed in preparation for the Health Exchange Programs that begin on January 1, 2014, under the Affordable Care Act. The proposed rules summarize changes [&hellip… Continue Reading »
In regulations and other pronouncements issued toward the end of 2012, the government has provided further details on new taxes and fees introduced by the Affordable Care Act (ACA). Health plan sponsors will be particularly interested in the amounts that they will be assessed to fund various ACA programs. This guidance includes: Regulations, a fact [&hellip… Continue Reading »
The U.S. Department of Health and Human Services (HHS) has issued two sets of proposed regulations issued under the Affordable Care Act (ACA) that will affect the design, availability, and cost of health insurance plans, primarily in the individual and small group markets. Most significantly, HHS has published proposed regulations defining the “essential health benefits” [&hellip… Continue Reading »
In a series of three notices, the IRS has signaled the approach that it may take on certain key issues arising under the employer shared responsibility, or “pay or play,” provisions of the Affordable Care Act (ACA) and is seeking comment on these and other questions. All of the matters discussed in the notices will [&hellip… Continue Reading »
On February 17, 2012, the U.S. Department of Health and Human Services (HHS) released a set of FAQs concerning the Essential Health Benefits Bulletin it issued on December 16, 2011. The FAQs offer new guidance and raise new questions about the scope of what is considered an essential health benefit (EHB) for purposes of applying [&hellip… Continue Reading »
Although the pace of new legislation affecting health and other welfare benefits has slowed after the first two years of the Obama Administration, plan sponsors will find no shortage of developments to monitor and implement in 2012. This alert provides a very brief review of recent developments and matters to watch in the new calendar [&hellip… Continue Reading »
Following up on guidance issued last month, the Department of Health and Human Services has proposed two new sets of regulations and the Department of the Treasury has proposed one on the state-based health insurance marketplaces known as Affordable Insurance Exchanges. (To view our alert on the earlier guidance, click here.) The Patient Protection and [&hellip… Continue Reading »
The U.S. Department of Health and Human Services has proposed two sets of regulations under the Patient Protection and Affordable Care Act (the 2010 health care reform legislation) relating to changes that will take effect in 2014. Although the new rules focus principally on what states must do to meet health care reform requirements, health [&hellip… Continue Reading »
The IRS has issued a notice explaining provisions in the recently enacted health care reform legislation that establish a federal income tax credit for small employers who implement or maintain health insurance coverage for employees. The notice clarifies various aspects of the new rules, including the following: To qualify for the full tax credit, an [&hellip… Continue Reading »
