United Benefit Advisors Insight and Analysis Blog

Post-PACE, UBA Conducts State-By-State Survey of Small Group Definitions

Posted by: Bill Olson    Feb 18, 2016 12:00:00 PM

Group of peopleThe newly enacted PACE Act offered significant relief to employers with 51 to 99 employees who, under the Patient Protection and Affordable Care Act (ACA), would otherwise have been subject to community rating.

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Topics: ACA, PPACA, community rating, Danielle Capilla, Affordable Care Act, PACE Act, small group insurance market, small group definition

Top 10 Questions about the Minimum Value Penalty

Posted by: Danielle Capilla    Feb 16, 2016 12:00:00 PM

An employer that offers minimum essential coverage 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." It also may owe penalties on the employees it does not offer coverage to who receive a premium subsidy.

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

Top 10 UBA Blogs from 2015 Reveal Hot Button Healthcare Issues for Employers

Posted by: Bill Olson    Jan 7, 2016 12:00:00 PM

  1. IRS Provides Details on Reimbursing Premiums for Individual Health Coverage or Medicare Part B, Part D, for Medigap for Active Employees. For many years, employers were permitted to reimburse premiums paid for individual coverage on a tax-favored basis, however, these "employer payment plans" frequently are unable to meet all of the PPACA requirements. Read more
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Topics: wellness, ACA, PPACA, IRS Reporting Rules, summary of benefits and coverage, Cadillac Tax, PPACA reporting, Medicare, UBA Health Plan Survey, Affordable Care Act

COBRA and the Affordable Care Act

Posted by: Danielle Capilla    Jan 5, 2016 12:00:00 PM

The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee's own cost. COBRA provisions are found in the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code (Code), and the Public Health Service Act (PHSA). Employers with 20 or more employees and group health plans are subject to COBRA provisions. Most governmental plans, church plans, and certain plans of Indian tribal governments are exempt from COBRA. Employers should always consult with counsel about state continuation laws that are similar to COBRA and apply to small employers.

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Topics: ACA, PPACA, COBRA, ERISA, change in status event, Affordable Care Act, COBRA continuation coverage

Cadillac Tax – Should employers be making changes now?

Posted by: Elizabeth Kay    Dec 10, 2015 12:00:00 PM

The Affordable Care Act (ACA) has brought about many changes in employee benefits. Plans have been eliminated, benefits added, rules changed, and rules have been delayed.

The ACA has always been a heavily debated topic between the Republicans and Democrats, and now that we are coming up to another presidential election we know that we can expect it to be talked about quite a lot.

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Topics: ACA, PPACA, Cadillac Tax, UBA Health Plan Survey, play or pay requirements, health insurance cost

IRS Issues Second Notice to Assist in Developing Cadillac Tax Regulations

Posted by: Danielle Capilla    Aug 27, 2015 12:00:00 PM

The IRS has issued its second notice regarding the upcoming implementation of the Patient Protection and Affordable Care Act’s (ACA) excise tax on high cost employer-sponsored health coverage, also known as the “Cadillac tax.” Beginning in 2018, plans that provide coverage that exceeds a threshold will owe the tax.

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Topics: ACA, PPACA, Cadillac Tax, Danielle Capilla, PPACA fees, Affordable Care Act, ACA excise tax

Employers Procrastinating?

Posted by: Peter Freska    Jun 18, 2015 12:00:00 PM

Employee Benefit News published an article titled, “Employers procrastinating on ACA recordkeeping compliance.” It is an interesting read, as it refers to a recent survey by PricewaterhouseCoopers in which “Only 10% of some 480 employers in 36 industries responding to a recent poll have implemented an in-house or outsourced solution to comply with Affordable Care Act reporting requirements.” This is an alarming number, as employers may be subject to significant penalties for non-compliance.

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Topics: PPACA, UBA Partner Firms, PPACA Affordable Care Act, PPACA reporting, employer-shared responsibility reporting, The LBL Group

Final Rule Issues Standards for Insurers and Marketplaces in 2016

Posted by: Linda Rowings    Mar 24, 2015 12:00:00 PM

Recently, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services issued a Final Rule with standards for insurers and Marketplaces in 2016, covering topics such as transparency in health insurance rate increases, formulary drug lists, drug mail order opt out provisions, determination of minimum value, and benefits discrimination. Open enrollment for the 2016 benefit year will begin on November 1, 2015, and end on January 31, 2016.

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Topics: PPACA, essential health benefits, PPACA Affordable Care Act, Transitional Reinsurance Fee, cost-sharing limit, transparency in health insurance rates, insurance Marketplace, benefits discrimination

IRS Provides Details on Reimbursing Premiums for Individual Health Coverage or Medicare Part B, Part D, or Medigap for Active Employees

Posted by: Linda Rowings    Mar 17, 2015 12:00:00 PM

On February 18, 2015, the Internal Revenue Service (IRS) issued Notice 2015-17. This Notice addresses employer payment or reimbursement of individual premiums in light of the requirements of the Patient Protection and Affordable Care Act (PPACA). For many years, employers were permitted to reimburse premiums paid for individual coverage on a tax-favored basis, and many smaller employers adopted this type of an arrangement instead of sponsoring a group health plan. However, these “employer payment plans” frequently are unable to meet all of the PPACA requirements that took effect in 2014, and in a series of Notices and frequently asked questions (FAQs) the IRS has made it clear that an employer may not either directly pay premiums for individual policies or reimburse employees for individual premiums on either an after-tax or pre-tax basis. This is the case whether payment or reimbursement is done through a health reimbursement arrangement (HRA), a Section 125 plan, a Section 105 plan, or another mechanism.

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Topics: ACA, PPACA, IRS, employer payment plans, Medicare Part B, premium reimbursement, Medigap, Medicare Part D, two-percent shareholder, TRICARE

Agencies Provide Guidance on Single Benefit Products and Excepted Benefits

Posted by: Linda Rowings    Mar 12, 2015 12:00:00 PM

On February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits. Many provisions of PPACA do not apply to excepted health benefits. Supplemental excepted benefits are those that are provided under a separate policy, certificate, or contract of insurance and are Medicare supplement insurance (Medigap), Tricare supplemental programs, or “similar” supplemental coverage.

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Topics: ACA, health care reform, PPACA, excepted benefits, supplemental health coverage