Healthcare

Tuesday, 01 March 2016

Diplomatic relations: Reconsidering spousal coverage

Written by Thomson Reuters

The Affordable Care Act (ACA) doesn’t require spousal coverage — only coverage for dependent children. For this reason, as employers continue to grapple with high plan costs, many are reconsidering whether and how to offer health care insurance to their employees’ spouses. The dollar savings are there for the taking. But many employees would likely frown on seeing spousal coverage suddenly become expensive or vanish entirely...

Published in Healthcare
Monday, 01 February 2016

Can we incentivize employees with high claims costs to opt out?

Written by Thomson Reuters

Question: Our company offers coverage under a self-insured major medical plan to full-time employees. Can we offer cash incentives to those with a history of high claims costs to opt out of our plan and buy individual policies instead? Answer: In a word, no. This idea was addressed in guidance jointly issued just last year by the IRS, the Department of Labor and the Department of Health and Human Services...

Published in Healthcare
Monday, 01 February 2016

IRS Notice 2015-87 addresses many aspects of the ACA

Written by Thomson Reuters

The IRS issued Notice 2015-87 late last year to provide guidance on how various provisions of the Affordable Care Act (ACA) apply to employer-sponsored health plans. The guidance, which includes 26 questions and answers, is generally applicable to plan years beginning on or after December 16, 2015, though it can be relied on for earlier periods. Let’s look at some highlights. Employer contributions When required employee contributions to buy employer-sponsored coverage aren’t “affordable,” as defined under the ACA, employees are potentially eligible for premium tax credits and applicable large employers (ALEs) may face liability under the “play or pay” provision...

Published in Healthcare
Monday, 01 February 2016

Tap the brakes: Cadillac tax delayed, but challenges remain

Written by Thomson Reuters

As 2015 was winding down, Congress pushed back the effective date of the “Cadillac tax” two years. The much-debated provision of the Affordable Care Act (ACA) will now take effect on January 1, 2020, instead of January 1, 2018. As originally conceived, the Cadillac tax was supposed to affect only particularly generous, or “luxury,” health care plans. But many analysts believe it will, either immediately or eventually, impact quite a few “nonluxury” plans as well...

Published in Healthcare
Monday, 04 January 2016

Does the ACA apply to executive physical programs?

Written by Thomson Reuters

Question: Our company would like to offer free comprehensive physical examinations as a perquisite for several top executives. Does the Affordable Care Act (ACA) restrict our design options for such a program? Answer: Yes, the ACA may affect the structure of an executive physical program. These programs typically provide for a comprehensive annual exam that includes more diagnostic tests than a standard well-adult visit, thus triggering compliance requirements...

Published in Healthcare
Monday, 04 January 2016

Assorted nuggets: Final regs on ACA implementation

Written by Thomson Reuters

This past November, the IRS, Department of Labor and Department of Health and Human Services jointly issued final regulations covering a variety of topics related to the implementation of the Affordable Care Act (ACA). Effective for plan years beginning on or after January 1, 2017, these assorted nuggets incorporate agency guidance into a mixture of proposed and interim final regs dating back to 2010. Here are some highlights. Grandfathered plans The final regulations maintain the rule that grandfathered status is determined separately as to each "benefit package" under a group health plan...

Published in Healthcare
Monday, 04 January 2016

EEOC’s proposed rule would restrict wellness program incentives

Written by Thomson Reuters

As more employers establish employee wellness programs, the challenges of these initiatives are coming further into focus. One notable issue is that, to pinpoint the health care objectives pertinent to employees and their dependents, programs need access to medical information. Typically, this data is gathered using a health risk assessment. But many employees aren't inclined to submit to these assessments, or even participate in wellness programs in the first place...

Published in Healthcare
Tuesday, 01 December 2015

Do our contributions count toward the Health FSA limit?

Written by Thomson Reuters

Question: Our company's cafeteria plan includes a health Flexible Spending Account (FSA) that has always been funded solely by employee salary reductions. For next year, however, we're thinking about adding an employer contribution feature ― such as a matching or seed contribution. Would these employer contributions count toward the limit that applies to health FSAs? Answer: The statutory limit ($2,550 for plan years beginning in 2015 or 2016) applies only to health FSA salary reduction contributions...

Published in Healthcare

In October, the Department of Labor, the Department of Health and Human Services and the IRS jointly issued an important round of FAQs. The agencies addressed a wide variety of preventive services required under the Affordable Care Act to be provided without cost-sharing by nongrandfathered, nonexcepted group health plans. The FAQs also impart new information regarding wellness programs and mental health parity. Let's look at some highlights...

Published in Healthcare
Tuesday, 01 December 2015

No silver bullet, but promising: ACOs and the ACA

Written by Thomson Reuters

Accountable Care Organizations (ACOs) have been around for about a decade, but their growth appears to be accelerating. By 2020, more than 70 million Americans will be covered by ACOs, according to health care intelligence gatherers Leavitt Partners. That's up from about 20 million today. As you might expect, the Affordable Care Act (ACA) is considered a key driver in their increasing popularity...

Published in Healthcare
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