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Showing posts from May, 2013

2014 Compliance Checklist

The Affordable Care Act (ACA), which was signed into law in March 2010, put in place comprehensive health coverage reform, with effective dates spread out over a period of four years and beyond. Some of ACA’s reform initiatives are already in effect for employers and their group health plans, such as the Form W-2 reporting requirement for large employers and the requirement for non-grandfathered health plans to cover certain preventive care services without cost-sharing. Many of ACA’s key reform initiatives will become effective in 2014 . Key ACA reforms that will affect employers in 2014 include health plan design changes, increased wellness program incentives, a new reinsurance fee, the employer “pay or play” mandate, and additional reporting requirements. To prepare for this next phase of ACA reform, employers should review upcoming requirements and make sure they have a compliance strategy in place. This Legislative Brief provides a health care reform compliance checklist for 2014

DOL Issues Model Exchange Notice and Sets Compliance Deadline

Beginning January 1, 2014, individuals and employees of small businesses will have access to insurance coverage through the Affordable Care Act’s (ACA) health insurance exchanges (Exchanges). Open enrollment under the Exchanges will begin October 1, 2013.   ACA requires employers to provide all new hires and current employees with a written notice about ACA’s Exchanges.  This requirement is found in Section 18B of the Fair Labor Standards Act (FLSA). On May 8, 2013, the Department of Labor (DOL) released Technical Release 2013-02 to provide temporary guidance on the Exchange notice requirement. This temporary guidance will remain in effect until DOL issues regulations or other guidance. According to DOL, future regulations or other guidance will provide employers with adequate time to comply with any additional or modified requirements. In connection with the temporary guidance, DOL announced the availability of model Exchange notices for employers to use to satisfy the

Additional FAQs Released on Summary of Benefits and Coverage

The Affordable Care Act (ACA) requires health plans and health insurance issuers to provide a summary of benefits and coverage (SBC) to applicants and enrollees. The SBC is intended to be a short, simple explanation about the health plan’s benefits and coverage than can help consumers more easily compare plan options.  On April 23, 2013, the U.S. Department of Labor (DOL), Department of Health and Human Services (HHS), and the U.S. Treasury (the Departments) issued Frequently Asked Questions (FAQs Part XIV) on the SBC requirement for the second year of its applicability. This guidance was provided in addition to the final regulations issued on February 14, 2012 and three prior sets of FAQs related to the SBC rules (FAQs Parts VIII, IX and X). The new FAQs address issues related to providing SBCs in the second year of applicability, including: changes made to the templates for the SBC and the uniform glossary; Transition relief with respect to the minimum essential covera

Proposed Rule Released on Minimum Value and Affordability

On May 3, 2013, the Internal Revenue Service (IRS) released a proposed rule on the minimum value and affordability rules under the Affordable Care Act (ACA).  In this proposed rule, IRS provides guidance on determining whether health coverage under an employer-sponsored plan is affordable and provides minimum value for purposes of determining the employer “pay or play” penalties.  In particular, the proposed regulation: explains how to calculate minimum value (MV); outlines special rules for determining how health reimbursement arrangements (HRAs), health savings accounts (HSAs) and wellness program incentives are counted in determining MV and affordability; and provides new safe harbors for determining MV. This proposed rule would apply for tax years ending after December 31, 2013. Background Effective for 2014, ACA provides premium tax credits and cost-sharing reductions to eligible individuals who purchase qualified health plan coverage through a Health Insurance Exchange.  To qual