United Benefit Advisors Insight and Analysis Blog

HRAs, HSAs, and Health FSAs – What's the Difference?

Posted by: Danielle Capilla    Feb 19, 2016 4:55:25 PM

Health reimbursement arrangements (HRAs), health savings accounts (HSAs) and health care flexible spending accounts (HFSAs) are generally referred to as account-based plans. That is because each participant has their own account, at least for bookkeeping purposes. Under the tax rules, amounts may be contributed to these accounts (with certain restrictions) and used for health care on a tax-favored basis.

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Topics: health plan benchmarking, PPACA Affordable Care Act, health savings account, health reimbursement arrangements, HRA, HSA, UBA 2014 Health Plan Survey, health care flexible spending account, health plan cost trends, HFSA

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

Cafeteria Plans: How to Handle Participant Contributions

Posted by: Danielle Capilla    Oct 20, 2015 12:00:00 PM

Cafeteria plans, or plans governed by IRS Code Section 125, allow employees to pay for expenses such as health insurance with pre-tax dollars. Employees are given a choice between a taxable benefit (cash) and specified pre-tax qualified benefits, for example, health insurance. Employees are given the opportunity to select the benefits they want, just like an individual standing in the cafeteria line at lunch.

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Topics: ACA, section 125 plans, PPACA Affordable Care Act, Danielle Capilla, cafeteria plan

IRS Notice on Minimum Essential Coverage Reporting

Posted by: Danielle Capilla    Oct 8, 2015 12:00:00 PM

Minimum essential coverage or "MEC" is the type of coverage that an individual must have under the Patient Protection and Affordable Care Act (ACA). Employers that are subject to the ACA's shared responsibility provisions (often called play or pay) must offer MEC coverage that is affordable and provides minimum value.

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Topics: ACA, PPACA Affordable Care Act, minimum essential coverage, employer shared responsibility, play or pay requirements

Perfect Attendance! How to Handle Leaves of Absence under the ACA

Posted by: Danielle Capilla    Oct 6, 2015 12:00:00 PM

The Patient Protection and Affordable Care Act (ACA) requires applicable large employers (ALEs) to offer full-time employees health coverage, or pay one of two employer shared responsibility penalties. An ALE is an employer with 50 or more full-time or full-time equivalent employees (for 2015, this threshold is 100). A full-time employee is an employee who works 30 hours or more a week.

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Topics: ACA, PPACA Affordable Care Act, leave of absence, employer shared responsibility, applicable large employers, counting employees

IRS Proposes Minimum Value Rule Change to Mesh IRS and HHS Rules

Posted by: Danielle Capilla    Sep 24, 2015 12:00:00 PM

Beginning in 2015, under the Patient Protection and Affordable Care Act (ACA), large employers must offer affordable, minimum value coverage to their full-time employees or potentially pay a penalty. Some companies have or had been marketing a plan that they state satisfies the minimum value requirement (an actuarial value of 60 percent), based upon a calculator provided by the Department of Health and Human Services (HHS), even though the plan does not cover inpatient hospital charges. New information provided by the IRS and HHS in 2014 and recently in 2015 should be considered as employers review their benefit offerings.

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Topics: ACA, PPACA Affordable Care Act, minimum essential coverage, minimum value coverage, play or pay requirements

HHS Proposes First of Anticipated Nondiscrimination Regulations

Posted by: Danielle Capilla    Sep 22, 2015 11:28:00 AM

The Department of Health and Human Services (HHS) has issued the first of the anticipated nondiscrimination rules, which sets forth proposed regulations to implement Section 1557 of the Patient Protection and Affordable Care Act (ACA). Section 1557 provides that individuals shall not be excluded from participation, denied the benefits of, or subjected to discrimination under any health program or activity which receives federal financial assistance, on the basis of race, color, national origin, sex, age, or disability. The proposed regulations also apply to any program administered by an agency of the federal government or an entity established under Title I of the ACA. These applicable entities are "covered entities" and include a broad array of providers, employers, and facilities. State-based Marketplaces are covered as Title I entities, as are Federally-Facilitated Marketplaces.

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Topics: ACA, PPACA Affordable Care Act, Danielle Capilla, covered entities, ACA Section 1557, nondiscrimination rules

IRS Releases Draft 2015 Instructions for 6055/6056 Reporting

Posted by: Danielle Capilla    Sep 10, 2015 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. Reporting will first be due early in 2016, based on coverage in 2015. All reporting will be for the calendar year, even for non-calendar year plans. Mid-size employers (those with 50 to 99 employees) will report in 2016, despite being in a period of transition relief in regard to having to offer coverage. The reporting requirements are in Sections 6055 and 6056 of the ACA. Draft instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in August 2015.

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Topics: ACA, health care reform, IRS Reporting Rules, PPACA Affordable Care Act, IRS Form 1095, IRS Form 1094, Danielle Capilla, Affordable Care Act

UBA Survey Finds Self-Funded Pharmacy Plans Have Increased Nearly 30 Percent in Five Years

Posted by: Bill Olson    Sep 8, 2015 3:51:33 PM

As a result of the Patient Protection and Affordable Care Act (ACA) triggering cost increases for fully insured employer-sponsored health insurance plans, more employers are moving to a self-funded model for pharmacy plans, particularly among large employers (1,000+ employees), according to the 2014 United Benefit Advisors (UBA) Health Plan Survey.

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Topics: ACA, health plan benchmarking, health care reform, PPACA Affordable Care Act, pharmacy benefits, UBA Health Plan Survey

Preventive Services Final Rules

Posted by: Danielle Capilla    Aug 6, 2015 12:00:00 PM

Federal agencies released final regulations on the preventive services mandate of the Patient Protection and Affordable Care Act (ACA) that requires non-grandfathered group health plans to provide coverage without cost-sharing for specific preventive services, which for women include contraceptive services.

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Topics: ACA, PPACA Affordable Care Act, contraception coverage, religious opposition to contraception, Cost-Sharing, group health insurance, preventive services, Danielle Capilla