The Patient Protection and Affordable Care Act (ACA) imposes a fee on insurers of certain fully insured plans and plan sponsors of certain self-funded plans to help fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI fee is due by July 31 of the year following the calendar year in which the plan or policy year ends.
Since the ACA was enacted eight years ago, many employers are re-examining employee benefits in an effort to manage costs, navigate changing regulations, and expand their plan options. Self-funded plans are one way that's happening.
In 2017, the UBA Health Plan survey revealed that self-funded plans have increased by 12.8% in the past year overall, and just less than two-thirds of all large employers’ plans are self-funded.
Here are six of the reasons why employers are opting for self-funded plans:
Topics: ACA, self-funding, Self-Funded, self funded health plans, small business, white paper, UBA white paper, small business health care options
The ACA requires employers to report the cost of coverage under an employer-sponsored group health plan. Reporting the cost of health care coverage on Form W-2 does not mean that the coverage is taxable.
Topics: ACA, Affordable Care Act, employer-sponsored health insurance, W-2 reporting
Recently, the Internal Revenue Service (IRS) issued the instructions for Forms 1094/1095 for the 2017 tax year, announced PCORI fees for 2017-18, and announced cost-of-living adjustments for 2018. The IRS provided additional guidance on leave-based donation programs' tax treatment and released an information letter on COBRA and Medicare. Here’s a recap of these actions for your reference.
Topics: ACA, COBRA, PCORI, Affordable Care Act, tax law, leave-based donation program
October was a busy month in the employee benefits world. President Trump announced a new Acting Secretary for the U.S. Department of Health and Human Services (HHS). Eric Hargan fills the position vacated by Tom Price, who resigned in late September 2017. The U.S. Department of Labor (DOL) issued a proposed rule to delay a disability claims procedure regulation's applicability date and HHS released its proposed rule on benefits and payment parameters for 2019. The U.S. Department of the Treasury (Treasury) issued its Priority Guidance Plan for projects it intends to complete during the first half of 2018.
Topics: ACA, Affordable Care Act, Benefit Payment and Parameters rule, Qualified Small Employer HRA, disability claims procedures
On October 12, 2017, the White House released an Executive Order, signed by President Trump, titled "Promoting Healthcare Choice and Competition Across the United States."
It is important to note that the Executive Order (EO) does not implement any new laws or regulations, but instead directs various federal agencies to explore options relating to association health plans, short term limited-duration coverage (STLDI), and health reimbursement arrangements (HRAs), within the next 60 to 120 days.
Topics: ACA, health reimbursement arrangements, Affordable Care Act, association health plans
Earlier this month, the Department of Labor (DOL) provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and the 21st Century Cures Act (Cures Act). This is the DOL's 38th FAQ on implementing the Patient Protection and Affordable Care Act (ACA) provisions and related regulations. The DOL is requesting comments on a draft model form for participants to use to request information regarding nonquantitative treatment limitations, and confirms that benefits for eating disorders must comply with the MHPAEA. Comments are due by September 13, 2017.
Topics: ACA, Affordable Care Act, Mental Health Parity and Addiction Act, mental health, 21st Century Cures Act
On June 22, 2017, the United States Senate released a "Discussion Draft" of the "Better Care Reconciliation Act of 2017" (BCRA), which would substitute the House's House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The House bill was titled the "American Health Care Act of 2017" (AHCA). Employers with group health plans should continue to monitor the progress in Washington, D.C., and should not stop adhering to any provisions of the ACA in the interim, or begin planning to comply with provisions in either the BCRA or the AHCA.
Topics: ACA, health care reform, Better Care Reconciliation Act of 2017, American Health Care Act of 2017
The Section 125 cafeteria plan regulations and the Patient Protection and Affordable Care Act (ACA) require employers to take certain actions when an employee reduces hours.
Consider this scenario: An employer has an employee who is reducing hours below 30 hours per week. The employee is performing the same job and duties. The employee was determined to be full-time during the most recent measurement period. The employee is currently in a stability period.
Topics: ACA, cafeteria plan, Affordable Care Act, Section 125 plan, reduction in hours
Workplace wellness programs have increased popularity through the years. According to the most recent UBA Health Plan Survey, 49 percent of firms with 200+ employees offering health benefits in 2016 offered wellness programs. Workplace wellness programs’ popularity also brought controversy and hefty discussions about what works to improve population health and which programs comply with the complex legal standards of multiple institutions that have not really “talked” to each other in the past. To “add wood to the fire,” the Equal Employment Opportunity Commission (EEOC) made public some legal actions that shook the core of the wellness industry, such as EEOC vs. Honeywell International, and EEOC vs. Orion Energy Systems.
Topics: wellness, ACA, employee benefits, workplace wellness, GINA
