forms

IRS Publishes Form Drafts for New ACA Employer Reporting Requirement

On Thursday, July 24, 2014, the IRS published highly anticipated drafts of the forms large employers with 50 or more full-time equivalent employees will be required to use for the Code 6056 reporting requirement.  Code 6056 requires applicable large employers to file a transmittal with the IRS (Form 1094-C) and provide a new return to […]

Guide

A Brief Employer Guide to ACA Insurance Subsidy Court Decisions

Kaiser Health News recently published a great article entitled “Brief Consumer Guide to Health Law Court Decisions” outlining the highlights of yesterday’s conflicting decisions from two U.S. courts of appeal addressing whether tax subsidies implemented by the Patient Protection and Affordable Care Act (PPACA) may be provided to individuals purchasing insurance through an exchange operated […]

verdict

Four Things Employers Need to Know About the Hobby Lobby Decision

In a landmark (but not totally unanticipated) decision, the United States Supreme Court held in favor of Hobby Lobby, Conestoga Wood Specialties, and Christian bookstore Mardel, a group of family-owned, closely-held for profit corporations who challenged the Patient Protection and Affordable Care Act’s (PPACA) preventive care requirement.  Specifically, the companies opposed PPACA’s requirement that non-grandfathered group […]

dependent care

FAQ: Are Plan Eligibility Restrictions for Adult Dependent Children Still Allowed?

Last week’s Kaiser Health News Insuring Your Health column tackles a question frequently asked by individuals as well as employer group health plan sponsors: Can a plan place eligibility restrictions on dependent children with access to health insurance through their own employer?  “Not anymore” is the answer. The Patient Protection and Affordable Care Act (PPACA) requires group health […]

delayed

HHS Approves NC Delay of Employee Choice in SHOP Exchange

On May 27, 2014, the U.S. Department of Health and Human Services (HHS) issued a final rule in an effort to move toward implementing employee choice in the Small Business Health Insurance Options Program, also known as the SHOP Exchange.  This feature allows small employers purchasing group health insurance through the SHOP Exchange to choose […]

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Small Employer Reform News

HHS Approves NC Delay of Employee Choice in SHOP Exchange

On May 27, 2014, the U.S. Department of Health and Human Services (HHS) issued a final rule in an effort to move toward implementing employee choice in the Small Business Health Insurance Options Program, also known as the SHOP Exchange.  This feature allows small employers purchasing group health insurance through the SHOP Exchange to choose […]

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North Carolina News

Guide

A Brief Employer Guide to ACA Insurance Subsidy Court Decisions

Kaiser Health News recently published a great article entitled “Brief Consumer Guide to Health Law Court Decisions” outlining the highlights of yesterday’s conflicting decisions from two U.S. courts of appeal addressing whether tax subsidies implemented by the Patient Protection and Affordable Care Act (PPACA) may be provided to individuals purchasing insurance through an exchange operated […]

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Affordable Care Act News

non-compliance

IRS Highlights Stiff Penalty for Reimbursing Individual Premiums

Since the IRS and Treasury published Notice 2013-54 in September 2013, pre-tax employer reimbursement of an employee’s individual health insurance premiums has been a hot topic of conversation.  Historically, many employers have provided this type of benefit in lieu of offering a group health plan – a strategy that now needs to be reevaluated as […]

hour glass

New Special Enrollment Period for COBRA Participants – 3 Things Employers Should Know

On May 2, 2014, the U.S. Department of Health and Human Services (HHS) revealed a new special enrollment period designed to allow current COBRA participants to terminate COBRA coverage and purchase a plan through the Marketplace between May 2, 2014 and July 1, 2014.  In a bulletin published May 2, HHS cited concerns about whether […]

HHS Specifies End of PCIP Coverage as “Exceptional Circumstance” For Exchange Special Enrollment

On April 24, 2014, CMS flexed its regulatory muscle by issuing a notice allowing participants in the Pre-Existing Condition Insurance Program (PCIP) until June 30, 2014 to enroll in a qualified health plan offered through the Exchange, also known as the Health Insurance Marketplace.  Introduced as part of the Patient Protection and Affordable Care Act […]

Avoid the Trap

PPACA’s Employer Mandate: Top 6 Play or Pay Traps to Avoid

It is no secret that the Patient Protection and Affordable Care Act (PPACA) requires many employers to provide health insurance coverage to full-time employees, or pay a tax penalty.  Employers subject to “Play or Pay” let out a collective sigh of relief when the final regulations, issued in February 2014, provided some additional transition relief in […]

Man holding tiny dollar bills

MLR Rebate Checks May be a Little Smaller in the Summer 2015

Many news outlets are reporting on the break the administration plans to give to insurers. (See the Kaiser report here.) The break is expected to come in the form of an adjustment to the MLR calculations. The Affordable Care Act (ACA) requires insurance carriers to maintain a certain medical loss ratio (MLR). The MLR requires carriers […]

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