The question had arisen on how to treat opt out incentives. By that we mean a monetary offer by an employer to employees to waive coverage under the employer’s health plan. Informal IRS comments had indicated that such incentives would be included when determining whether an offer of coverage is affordable. There are generally two […]
ACA, Affordability, Affordable Care Act, Incentives, opt-out incentivesThis ALERT will provide a high level overview of what looks likely to be a very complicated process if the Notices are any indication. Background The Cadillac tax under the Affordable Care Act applies to taxable years beginning after December 31, 2017. It imposes a 40 per cent nondeductible excise tax on employer-sponsored health coverage […]
ACA, Cadillac, Cadillac tax, excise taxErisaALERT 2014-11 – What is the transitional reinsurance fee? The Affordable Care Act established a three-year (2014, 2015 and 2016) transitional reinsurance program to stabilize premiums in the individual market inside and outside of the Marketplaces. Who must pay the transitional reinsurance fee? A contributing entity must make reinsurance contributions on behalf of its enrollees […]
ACA, compliance, HCR, transitional reinsurance feeErisaALERT 2014-10 – What is an HPID? Note: Late on October 31, HHS announced a delay HPID requirement. A health plan identifier (HPID) is intended to increase standardization within HIPAA standard transactions. Both the Affordable Care Act and the Social Security Act require the adoption of a standard unique health plan identifier. Covered entities are […]
ACA, Affordable Care Act, HCR, Health Plan Identifier, HPIDErisaALERT 2014-09 – ACA’s shared responsibility provisions impose penalties on individuals who do not maintain minimum essential coverage (MEC) and on plan sponsors who do not offer minimum value, affordable coverage. The way the IRS will know if an individual has MEC and if an employer offers minimum value, affordable coverage is via the §6055 […]
6055, 6056, ACA, compliance, Disclosure, HCR, ReportingThe DOL, IRS and HHS have issued final regulations clarifying the maximum length of an employee orientation period in light of the 90-day waiting period limitation ErisaALERT 2012-13 under the Affordable Care Act (ACA). To guard against potential subterfuges for the passage of time, final regulations provide that one month is the maximum allowed length of […]
90 day waiting period, ACA, orientation periodIndividuals enrolled in or eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage have a new special enrollment period to sign up for qualified health plan (QHP) coverage through the marketplace. Last month, the Department of Labor (DOL) released a new model COBRA notice. The new notice makes it clear that individuals may have […]
ACA, COBRAErisaALERT 2013-05 discussed the statutory requirements and the proposed regulations regarding the new reporting and disclosure requirements imposed by the Affordable Care Act (ACA) relating to the individual mandate and shared responsibility. On March 10, 2014 final regulations were issued for §6055 Information Reporting of Minimal Essential Coverage (MEC) and §6056 Information Reporting by Applicable […]
6055, 6056, ACA, Disclosure, ReportingWe previously covered the shared responsibility requirements in ErisaALERT 2012-13, 2013-01 and 2013-02. Many of the provisions in the proposed rule carry over to the final regulations. The regulations continue to be very complex and will require careful review as it relates to your particular situation. In this ALERT we will discuss some of the […]
ACA, shared responsibilityOn November 8, 2013, the Departments of Labor, Health and Human Services, and the Treasury (the Departments) issued final rules on the Mental Health Parity Addiction Equity Act of 2008 (MHPAEA). Concurrently, the Departments posted Frequently Asked Questions related to the final rule. There is also a question relating to MHPAEA in the latest Frequently […]
ACA, Affordable Care Act, Mental health parity, MHPAEA, Wellstone(c) 2015 Erisa Diagnostics - We focus on benefits, so you can focus on business