United Benefit Advisors Insight and Analysis Blog

Designing Your HRA or Flex Contributions to Meet Affordability Requirements

Posted by: Danielle Capilla    Feb 11, 2016 12:00:00 PM

An Applicable Large Employer (ALE) that offers minimum essential coverage (MEC) to substantially all of its full-time employees may still owe penalties if the coverage it offers is inadequate because it is not “affordable” or it does not provide “minimum value.” Coverage is considered affordable if it costs less than 9.5 percent of the employee's household income. Because employers rarely know an employee's household income, employers may meet the affordability requirement through one of three safe harbor options – the W-2 safe harbor, the rate of pay safe harbor, or the federal poverty level safe harbor.

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Minimum Value: HRA Contributions and Flex Credits

Posted by: Danielle Capilla    Feb 9, 2016 12:00:00 PM

The Internal Revenue Service (IRS) recently issued a final rule that clarifies various topics relating to the Patient Protection and Affordable Care Act (ACA) and premium tax credit eligibility provisions. Mirroring guidance from IRS Notice 2015-87, the final rule clarifies that health reimbursement arrangement (HRA) contributions by an employer that may be used to pay premiums for an eligible employer sponsored plan are counted toward the employee's required contribution, subsequently reducing the amount required for their contribution.

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Topics: ACA, PPACA Affordable Care Act, IRS, health reimbursement arrangements, HRA, Premium Tax Credits, Danielle Capilla

IRS Updates FAQs Related to 6055/6056 Reporting

Posted by: Danielle Capilla    Feb 4, 2016 12:00:00 PM

The long-standing IRS FAQs related to reporting under sections 6055 and 6056 on requirements provided by the Patient Protection and Affordable Care Act (ACA) have been updated to reflect new information. Final instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in September 2015, as were the final forms for 1094-B, 1095-B, 1094-C, and 1095-C. On December 28, 2015, in Notice 2016-04, the IRS extended the information reporting due dates for insurers, self-insuring employers, other health coverage providers and applicable large employers. The updated FAQs take the information from Notice 2016-04 into account.

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Topics: ACA, IRS Form 1095, IRS Form 1094, employer shared responsibility, Danielle Capilla, Affordable Care Act, ACA Section 6055, ACA Section 6056, individual shared responsibility

How Do Your Copays and Deductibles Stack Up? Benchmark Your Employees' Out-of-Pocket Costs

Posted by: Bill Olson    Feb 2, 2016 12:00:00 PM

As many analysts projected, premiums continue to rise, forcing many employers to manage this expanding price tag by shifting costs to their employees. As UBA reported in its breaking news, this cost shifting took the form of higher deductibles, out-of-pocket maximums, and copays for both singles and families.

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Topics: health care costs, out-of-pocket limits, UBA Health Plan Survey, health care deductibles

ACA Penalties and Taxes and Fees — Oh My!

Posted by: Bill Olson    Jan 28, 2016 12:00:00 PM

Employers breathed a sign of relief when the looming Cadillac tax was delayed. But are you subject to other fees and penalties under the ACA? The ACA has introduced a multitude of new fees that employers must pay, in addition to penalties for non-compliance with employer shared responsibility rules. These dollar amounts change annually, as does the percentage amount used to calculate affordability in relation to the ACA. UBA’s new ACA Advisor, “Patient Protection and Affordable Care Act Fees, Penalties” gives a quick reference summary of the key 2015 and 2016 fees and penalties associated with the ACA.

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Topics: ACA, Transitional Reinsurance Fee, Cadillac Tax, minimum essential coverage, Affordable Care Act, PCORI Fee, ACA penalties

Being Hyper Aware of Hypertension

Posted by: Bill Olson    Jan 26, 2016 12:00:00 PM

As wellness programs continue to flourish particularly among large employers, a discovery is being made about one of the most important health conditions – hypertension. Hypertension (also known as high blood pressure) is a medical issue where the pressure of the blood in a person’s cardiovascular system is constantly elevated. According to the Mayo Clinic, a person can have high blood pressure for years without any symptoms. Yet even without symptoms, damage to arteries, blood vessels, and even the heart continues until serious health issues, including a heart attack and stroke, happen.

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Topics: wellness, health care costs, health screening, hypertension, biometric screening

Should Employers Opt Out of Their Coverage Opt-Out Program?

Posted by: Danielle Capilla    Jan 21, 2016 12:00:00 PM

According to the 2015 UBA Health Plan Survey, fewer employers are offering bonuses to waive coverage, but for those that do, the bonus amount is on the rise. Only 2.9% of employers offered a bonus to employees to waive medical coverage in 2015, a 17.1% decrease from 3.5% two years ago. The average annual single bonus in 2015 was $1,680, which is a 10% increase from 2013.

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Topics: ACA, Affordability, UBA Health Plan Survey, Danielle Capilla, coverage waiver bonus, opt-out arrangement

How to Benchmark Your Health Plan

Posted by: Bill Olson    Jan 19, 2016 12:00:00 PM

Are you benchmarking your health plan correctly? If you are using data from your carrier or a small study of only large employers, chances are you are not effectively analyzing your rates. To truly benchmark your plan, you need to compare your plan to others in your state, industry, and size category.

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Topics: health insurance premiums, health plan benchmarking, Group health plans, UBA Health Plan Survey

IRS Provides Major Delay in 6055 and 6056 Reporting

Posted by: Danielle Capilla    Jan 14, 2016 12:00:00 PM

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance, while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer.

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Topics: ACA, minimum essential coverage, employer shared responsibility, Danielle Capilla, Affordable Care Act, applicable large employers, ACA reporting, IRS Form 6055 and 6056

Top 8 Free (!) UBA Healthcare Cost and Compliance Resources for Employers

Posted by: Bill Olson    Jan 12, 2016 12:00:00 PM

UBA offers a comprehensive library of ACA Advisors and white papers to help employers navigate health care cost and compliance. Every year we look at the documents most accessed by employers and remind our audience of these helpful, free resources. Here’s what was most in demand in 2015.

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Topics: compliance, ACA, health plan benchmarking, UBA Health Plan Survey, Don't Roll the Dice on Department of Labor Audits, cafeteria plan, Affordable Care Act, annual benefit limits, white paper, health care cost, account-based plans