IRS Issues More Guidance On Employers That Pay For Individual Health Insurance Policies for Employees – Gives Limited Relief to Small Employers

I have blogged more on the topic of how the Health Care Reform Act applies to employers that reimburse employers for individual health insurance policies than any other topic in the last year.  At one point in time, as indicated in my post of June 11, 2014, The IRS Meant What It Said in Notice 2013-54 – Employers Who Pay For Individual Health Insurance Policies for Employees On a Pre-Tax Basis Face Massive Penalties, it looked like such arrangements might be permissible if done on an after-tax basis.  However, as noted in my post of November 13, 2014, Agencies Come Down Hard on Various Employer Health Plans and Arrangements, the IRS clarified that was not the case in a series of FAQs it issued that same month. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , ,

Share this Article:

IRS Forms and Instructions Finalized for Reporting Health Coverage

On February 8, 2015, the IRS released final forms and instructions for reporting health coverage pursuant to Code Sections 6055 and 6056, which were added by the Health Care Reform Act.  Please see our SW Benefits Update, “Final IRS Forms and Instructions for Reporting Health Coverage Clarify Large Employer Requirements for 2015 and Beyond” for more information on this reporting and the noteworthy revisions to the instructions.  The forms and instructions can be found here, and in the SW Benefits Update. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , ,

Share this Article:

Health Care Reform 2015 – An Update

2015 is a significant year for health care reform because the large employer shared responsibility penalties under Internal Revenue Code Section 4980H take effect for most large employers.  See our SW Benefits Update, Health Care Reform’s Employer Shared Responsibility Penalties:  A Checklist for Employers, for a detailed explanation of the large employer penalties.

Many people are under the mistaken impression that Health Care Reform might go away because of the recent changes in Congress.  As explained below, that is not likely anytime in the near future.  Accordingly, large employers may wish to move forward now with their large employer penalty compliance efforts. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , ,

Share this Article:

EAPs That Meet Four Requirements May Avoid Application of Health Care Reform

Benefits provided through an employee assistance program (“EAP”) may be considered group health plan coverage, which would subject the EAP to the health care reform requirements mandated by HIPAA and the Health Care Reform Act, unless the EAP meets the criteria for being “excepted benefits.”

In September 2013, the IRS, HHS, and DOL collectively issued Notice 2013-54, which stated that, through 2014, benefits provided through an EAP were considered excepted benefits if the EAP did not provide “significant benefits in the nature of medical care.”  The notice did not elaborate on the terms “significant” or “medical care,” but the notice permitted employers to use a reasonable, good faith interpretation of these terms.  Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , ,

Share this Article:

HHS Extends November 17 Deadline to Submit Covered Lives Data under Reinsurance Program

The Health Care Reform Act created the transitional reinsurance program, which requires most self-insured health plans to make contributions to HHS for the 2014, 2015, and 2016 calendar years, in an attempt to stabilize premiums in the individual market.  The contribution amount is determined by the number of covered lives under each plan.  For 2014, the contribution amount is $63 per covered life.  The number of covered lives must be calculated and submitted to HHS by November 15 of each year.  The first filing was due November 17, 2014 for the 2014 calendar year (November 15, 2014 was a Saturday).

HHS has extended this November 17, 2014 deadline until December 5, 2014Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , ,

Share this Article:

Agencies Come Down Hard on Various Employer Health Plans and Arrangements

As we move into 2015, employers continue to grapple with numerous Health Care Reform concepts.  Employers should be cautious regarding arrangements promoted to avoid health care penalties because the agencies are cracking down, as shown below.

On November 4, 2014, the IRS and other agencies indicated that they have become aware that group health plans that do not provide coverage for in-patient hospitalization and physician services are being promoted to employers as providing “minimum value coverage” that would allow the employer to avoid some Health Care Reform penalties if other requirements are met.  The Departments believe that such plans do not provide minimum value coverage and are going to implement regulations to this effect in 2015.  Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , , ,

Share this Article:

Gear Up for Reporting of Health Coverage

Starting in 2016, Section 6055 of the Internal Revenue Code (the “Code”), which was added by the Health Care Reform Act, requires all entities providing “minimum essential coverage” (“MEC”) to submit information to the IRS concerning each covered individual for the 2015 calendar year.  Section 6055 also requires these entities to provide statements containing similar information to certain covered individuals.  MEC is broadly defined to include any group health plan or group health insurance that is not an excepted benefit (e.g., stand-alone dental or vision plans). As noted, all entities providing MEC must comply with Section 6055. This includes, for example, all employers sponsoring self-insured group health plans, regardless of employer size.  Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , ,

Share this Article:

HIPAA Business Associates Agreements – Reminder of September 22 Deadline

On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued a final rule under HIPAA making substantial changes to the rules for vendors that provide services to HIPAA-covered plans, such as third-party administrators, pharmacy benefit managers and certain brokers – known in the HIPAA world as “Business Associates.” Under this final rule, Business Associates are required, for the first time, to comply with the HIPAA Security Rule, many provisions of the HIPAA Privacy Rule and are subject to direct enforcement by HHS. As a brief reminder, and as we discussed in our Employee Benefits Update 2013 End of Year Plan Sponsor “To Do” List Part 2 – Health and Welfare, existing agreements with Business Associates must be amended to comply with the requirements of this final rule on or before September 22, 2014. Read More ›

Posted in Employee Benefits, Health & Welfare Plans | Tagged , , , , , , ,

Share this Article:

Subsidized Post-Termination COBRA Benefits

Nancy Campbell recently wrote a newsletter that discussed how health care reform impacts COBRA. One of the issues that Nancy addressed is subsidized COBRA and severance arrangements. The purpose of this blog is to dive deeper into the issues employers should consider when providing subsidized post-termination COBRA benefits.

• Providing Post-Termination Medical Benefits on an After-Tax Basis. Sections 105 and 106 of the Code exclude employer-provided health coverage and benefits from an employee’s gross income if certain requirements are met. One requirement that must be met for self-funded health insurance plans to qualify for this exclusion from gross income is compliance with the nondiscrimination rules of Section 105(h) of the Code. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , ,

Share this Article:

The IRS Meant What It Said in Notice 2013-54 – Employers Who Pay For Individual Health Insurance Policies for Employees On a Pre-Tax Basis Face Massive Penalties

In our 2013 End of Year Plan Sponsor “To Do” List  Part 2 – Health and Welfare I did a lengthy summary of the various changes required to employer health care arrangements on account of IRS Notice 2013-54.  On May 6, 2014, I followed that up with a blog entitled Non-integrated health reimbursement arrangements (whatever they are called) are subject to $36,500 per-participant per-year penalty.  I am compelled to follow-up with yet another blog regarding the importance of IRS Notice 2013-54.

On May 13, 2014, the IRS issued two very direct Q&As about the impact of Notice 2013-54 on employers who pay for individual health insurance policies for employees on a pre-tax basis.  Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , ,

Share this Article: