United Benefit Advisors Insight and Analysis Blog

CMS Allows States to Extend Life of "Grandmothered" or Transitional Health Insurance Policies

Posted by: Danielle Capilla    Mar 21, 2017 9:30:00 AM

On February 23, 2017, the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets.

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Topics: ACA, health plan benchmarking, UBA Health Plan Survey, Danielle Capilla, Affordable Care Act, grandmothering, transitional relief, transitional health insurance policy

Tax Treatment of Fixed Indemnity Health Plans

Posted by: Danielle Capilla    Mar 9, 2017 9:30:00 AM

A fixed indemnity health plan pays a specific amount of cash for certain health-related events (for example, $40 per office visit or $100 per hospital day). The amount paid is neither related to the medical expense incurred, nor coordinated with other health coverage. Further, a fixed indemnity health plan is considered an "excepted benefit."

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Topics: ACA, HIPAA, excepted benefits, Danielle Capilla, Affordable Care Act, fixed indemnity health plan, fixed dollar indemnity plans, taxation of health benefits

The “Line 22” Question: Which Box(es) Do I Check?

Posted by: Danielle Capilla    Mar 1, 2017 9:30:00 AM

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.

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Topics: ACA, employer shared responsibility, Danielle Capilla, Affordable Care Act, play or pay requirements, applicable large employers, IRS Form 1094-C

Top Five Compliance Assessment Surprises

Posted by: Bob Bentley    Feb 23, 2017 9:30:00 AM

Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.

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Topics: compliance, ACA, COBRA, Affordable Care Act, Albers & Company, benefits compliance, Department of Labor audit, USERRA, life insurance, compliance assessment, Bob Bentley, benefits notices

IRS Q&A About Employer Information Reporting on Form 1094-C and Form 1095-C

Posted by: Danielle Capilla    Feb 22, 2017 9:30:00 AM

The Internal Revenue Service (IRS) recently updated its longstanding Questions and Answers about Information Reporting by Employers on Form 1094-C and Form 1095-C that provides information on:

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Topics: ACA, Danielle Capilla, Affordable Care Act, COBRA continuation coverage, Form 1094-C, IRS reporting, Form 1095-C, offer of coverage

Keeping Pace with the Protecting Affordable Coverage for Employees Act

Posted by: Vicki Randall    Feb 16, 2017 9:30:00 AM

Last fall, President Barack Obama signed the Protecting Affordable Coverage for Employees Act (PACE), which preserved the historical definition of small employer to mean an employer that employs 1 to 50 employees. Prior to this newly signed legislation, the Patient Protection and Affordable Care Act (ACA) was set to expand the definition of a small employer to include companies with 51 to 100 employees (mid-size segment) beginning January 1, 2016.

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Topics: health care costs, ACA, essential health benefits, minimum essential coverage, Affordable Care Act, PACE Act, Compliancedashboard, Vicki Randall, Protecting Affordable Coverage for Employees Act, small employer

Good Sense Guide to Minimum Essential Coverage Forms 1094-C and 1095-C

Posted by: Vicki Randall    Feb 2, 2017 9:30:00 AM

If you are an Applicable Large Employer (ALE), you may still be catching your breath from 2015 Patient Protection and Affordable Care Act (ACA) reporting. However, in a couple of weeks the process starts all over again as you prepare for the 2016 reporting cycle. As with all new requirements, the first filing cycle had some bumps as there was little guidance for some of the questions and issues that arose. In preparation for 2017, let’s take a look at the “C” forms and discuss areas of the forms that may have been confusing.

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Topics: ACA, Affordable Care Act, applicable large employers, Compliancedashboard, Vicki Randall, Form 1094-C, IRS reporting, Form 1095-C, offer of coverage

Implications of the 21st Century Cures Act

Posted by: Danielle Capilla    Feb 1, 2017 9:30:00 PM

On December 13, 2016, former President Obama signed the 21st Century Cures Act into law. The Cures Act has numerous components, but employers should be aware of the impact the Act will have on the Mental Health Parity and Addiction Equity Act, as well as provisions that will impact how small employers can use health reimbursement arrangements (HRAs). There will also be new guidance for permitted uses and disclosures of protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). We review the implications with HRAs below; for a discussion of all the implications, view UBA’s Compliance Advisor, “21st Century Cares Act”.

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Topics: ACA, premium subsidies, health reimbursement arrangements, HRA, Affordable Care Act, health care cost, 21st Century Cures Act, Qualified Small Employer HRA, insurance premium reimbursement

Making Sense of Form 1095 Minimum Essential Coverage Reporting

Posted by: Vicki Randall    Jan 12, 2017 9:30:00 AM

In a few weeks, a second season of shared responsibility reporting will begin. For some of you, last year’s inaugural year of reporting may have felt eerily similar to Lewis Carroll’s famous book. You know the one. It included a little girl falling down a dark hole, a rabbit frantically checking his watch and a lot of other crazy characters. Now that you have the benefit of one year of reporting under your belt, let’s look at the reporting forms and try to make them less confusing by breaking them down.

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Topics: ACA, IRS Form 1095, minimum essential coverage, employer shared responsibility, Affordable Care Act, individual shared responsibility, Compliancedashboard, IRS reporting, Form 1095-B, Form 1095-C

Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act

Posted by: Nancy Bourque    Jan 10, 2017 9:30:00 AM

The Occupational Safety and Health Administration (OSHA) recently released a final rule on the procedures for the handling of whistleblower complaints under Section 1558 of the Patient Protection and Affordable Care Act (ACA). The regulations protect employees (which includes former employees and applicants for employment) who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions, or for reporting potential violations of the ACA’s consumer protections.

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Topics: ACA, Affordable Care Act, OSHA, Nancy Bourque, whistleblower complaints, retaliation, consumer protection