Healthcare

Thursday, 26 May 2016

Is Section 6055 reporting required for HRA coverage?

Written by Thomson Reuters

Question: Our company sponsors a Health Reimbursement Arrangement (HRA) that’s integrated with our fully insured major medical plan. Only employees who enroll in our medical plan can participate in the HRA, though expenses of an employee’s spouse or tax dependent are also covered. We understand that the insurer is responsible for the information reporting required under Section 6055 of the Internal Revenue Code. But, as plan sponsor, is our company required to separately report the HRA coverage to the IRS and covered individuals?..

Published in Healthcare
Thursday, 26 May 2016

ACA update: Agencies release important guidance and materials

Written by Thomson Reuters

Earlier this year, the Department of Labor, the Department of Health and Human Services and the IRS jointly issued a set of FAQs regarding the Affordable Care Act (ACA). The guidance addresses a variety of important requirements under the law. Here are some highlights: Preventive services. The FAQs confirm that the required preparation for a preventive screening colonoscopy is an integral part of the procedure and must be covered without cost-sharing, subject to reasonable medical judgment...

Published in Healthcare
Thursday, 26 May 2016

Rising drug prices call for employer vigilance

Written by Thomson Reuters

The Affordable Care Act requires that employers’ prescription drug benefits cover at least one drug in every category and class in the U.S. Pharmacopeia (the official list of approved medicines). Yet recent research indicates that prescription drug prices are climbing more quickly than general medical costs...

Published in Healthcare
Monday, 02 May 2016

Extended: Renewals of noncompliant small employer plans

Written by Thomson Reuters

The Centers for Medicare and Medicaid Services has announced the extension of an important transitional policy. The policy in question allows states to permit insurers in the individual and small group markets to renew health insurance policies they’d otherwise have had to cancel because of noncompliance with certain insurance market reforms under the Affordable Care Act (ACA). Where permitted by a state, insurers that have continually renewed eligible nongrandfathered individual and small group policies since January 1, 2014, may now renew such coverage for a policy year beginning on or before October 1, 2017. (Previously, this deadline was October 1, 2016...

Published in Healthcare
Monday, 02 May 2016

Self-insurance remains a popular post-ACA option

Written by Thomson Reuters

The practice of self-insuring for health benefits claims has been on a steady upward climb over the past two decades. The Affordable Care Act (ACA) was predicted to trigger a spike in self-insurance — particularly among smaller employers. But, at least so far, the reality is different. The basis of the prediction was an anticipated upward cost pressure on fully insured plans attributable to, among other factors, new ACA-imposed taxes on insurance companies...

Published in Healthcare
Tuesday, 29 March 2016

Studies show achieving ACA goals demands trial, error and patience

Written by Thomson Reuters

No one really expected the Affordable Care Act (ACA) to be the silver bullet that would stop health care cost inflation dead in its tracks. Yet, perhaps understandably, many employers remain frustrated by the substantial challenge of managing these expenses. A pair of new studies, however, yield some practical insights into the fine-tuning and persistence needed to control costs and keep employees as healthy as possible. AMA analysis The first study is entitled “Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health Care: Enrollees With Skin in the Game...

Published in Healthcare
Tuesday, 29 March 2016

Mind your Form M-1, whether you’re a MEWA or not

Written by Thomson Reuters

Form M-1 is used to report compliance with group health plan mandates under Part 7 of the Employee Retirement Income Security Act, as well as under provisions of the Affordable Care Act (ACA). The form must be filed by multiple employer welfare arrangements (MEWAs) providing medical benefits other than exclusively excepted benefits — regardless of whether the MEWA is a group health plan. In addition, many entities claiming not to be MEWAs because of the exception for collectively bargained plans are still required to file Form M-1 for the first three years after the entity last “originated” or in certain other special circumstances. Annual Form M-1 filings are due March 1 of the year following the calendar year being reported...

Published in Healthcare
Tuesday, 29 March 2016

How are seasonal workers treated under the “play or pay” provision?

Written by Thomson Reuters

Question: Our company has a regular full-time workforce of approximately 40 employees. This year, we’re planning to hire about 80 more full-time retail employees in November and December for the holiday shopping season. How do we determine whether doing so will subject us to the Affordable Care Act’s (ACA’s) employer shared responsibility rules? Answer: To determine whether your company is subject to the ACA’s employer shared responsibility rules — commonly referred to as the “play or pay” provision — you must count all of your employees...

Published in Healthcare
Tuesday, 01 March 2016

Can we match our employees’ pretax HSA contributions?

Written by Thomson Reuters

Question: Under our company’s cafeteria plan, qualifying participants can make pretax salary reduction contributions to their Health Savings Accounts (HSAs). Can our company make matching contributions based on a percentage of participants’ pretax HSA contributions? Answer: Probably. Some employers’ HSA contributions are subject to strict comparability requirements that effectively prohibit matching contributions because the contributions would trigger a 35% excise tax on the employer...

Published in Healthcare
Tuesday, 01 March 2016

IRS extends due dates for 2015 Forms 1094 and 1095

Written by Thomson Reuters

At the end of last year, the IRS extended the deadlines for the Affordable Care Act’s information reporting on Forms 1094 and 1095 for 2015. Specifically, Forms 1094-B and 1095-B are to be filed by providers of health coverage (mostly insurers, but also some self-insuring employers and others). Meanwhile, Forms 1094-C and 1095-C are to be filed by applicable large employers. The forms provide information to the IRS and individuals for administration of the individual mandate, employer shared responsibility and premium tax credits...

Published in Healthcare
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