Latest ACA Updates
This page is updated on a regular basis with the latest Affordable Care Act amendments and new legislation. These notices are pulled from sources such as the DOL, HHS, IRS, Healthcare.gov and Regulations.gov. We will not post items that came from an article or post from somebody outside of the above mentioned organizations due to the possibility of misinterpretation by the author.
July 31, 2015 - PCORI Fee Reporting is due to the IRS. For more information on this ACA Fee on Self-Insured health benefits, go to our PCORI Fee links at www.benelect.com/ppaca
June 26, 2015 - IRS Releases draft versions of Form 1094/1095 Information Returns. The forms and insturctions are complex and it is helpful to understand the purpose of the forms before embarking on learning how to complete them. Employers with 50 or more full-time employees (applicable large employers, ALE) must use Forms 1095-C and 1094-C to report information about offers of health coverage and enrollment in health plans. Form 1094-C must be used to report summary information to the IRS for each employer and to transmit Forms 1095-C to the IRS. These forms will be used in determining whether an employer owes a payment under section 4980H and in determiniing the eligibility of employees for the premium tax credit. For employers with self-funded plans, the 1095-C will provide information to IRS about individuals who have minimum essential coverage under the plan and therefore are not liable for the individual shared responsibility payment.
August 19, 2014 - HIPAA released new regulations in 2012 that require self-funded “Controlling” group health plans to obtain a unique Health Plan Identifier (HPID). Large health plans, a plan with more than $5 million in annual claims paid, must obtain their HPID by 11/5/14. Small health plans, a plan with less than $5 million in annual claims paid, have until 11/5/15 to obtain a number. For more information click here.
February 28, 2013 - Multiple Employer Welfare Arrangements (MEWAs) falls under new DOL regulations issued today. A MEWA is an employee welfare plan or other arrangement through which multiple employers come together to create a Plan for the purpose of providing health care and other benefits to their workers. In summary, the new regulation allows for close regulation to include immediate cease and desist orders which can be ordered by the Secratary of Labor when it is apparent that fraud is taking place. For more information click here.
February 20, 2013 - Today the DOL released new FAQs in relation to deductible, cost sharing limits and preventive services. One of the highlight items in this release is the language that insurers may exceed the annual deductible limit if it cannot reasonably reach a given level of coverage (metal tier) without doing so. For more information and the actual text click here.
January 24, 2013 - New guidance indicates that HRAs used to pay for individual health insurance policy premiums will not be allowed come 2014. The DOL FAQ states that PHS Act Section 2711 generally prohibits an employer-sponsored HRA cannot be integrated with individual market coverage or with an employer plan that provides coverage through individual policies. Under ACA, employers that improperly offer arrangements that violate PHS Section 2711 or other group health plans risk exposing themselves to liability for significant unanticipated health benefit claims, as well as other penalties and costs. such arrangements are prohibited as part of the ACA health care reforms.
Additionally, the Notice of State Exchange mandate for employers was delayed until late summer or early fall.
For more information click here.
November 30, 2012 - Transitional Reinsurance Fee of $63 per enrollee, per year was clarified and will apply to all carriers and self-insured group health plans. For more information click here.