In some of my previous blogs, the foundation of the Consolidated Omnibus Reconciliation Act of 1985 (COBRA) continuation coverage was reviewed. Now that the groundwork has been laid, it is time to tread into the territories (or laws) where employers can lose their footing. The area covered in the following is that of the intersection of COBRA and the Family and Medical Leave Act of 1993 (FMLA).

Form 5500 is the annual report that group benefit plans use to report required information about the plan’s financial condition and operations. Most group and pension plans that are subject to ERISA are required to file a Form 5500. With the July 31 deadline for calendar year plans fast approaching, and higher penalties for not filing taking effect in August, this is a good time to review this important plan filing.

The Patient Protection and Affordable Care Act of 2010 (ACA) has many tax provisions written within its 906 pages. I’ll give a brief overview of the taxes, and sprinkle in some good news among some not-so-good news.

As we mentioned in the first edition of this mini-series on the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), “marketplaces” or “exchanges” created by the Patient Protection and Affordable Care Act (ACA) did not make COBRA obsolete. Rather, COBRA is still going strong. And while the general rule of COBRA is not necessarily that difficult to understand, the timeframes, notice requirements, intricacies, and the ways in which COBRA interacts with other laws presents employers with potentially extremely expensive outcomes.

In the earlier days of the Patient Protection and Affordable Care Act (ACA), a common question among employers and benefit advisors was whether there would still be a need for COBRA, the Federal Consolidated Omnibus Budget Reconciliation Act of 1985. Many people speculated that COBRA would be a thing of the past. This was a logical step for those in the insurance industry. When an employee was faced with the option of paying full cost for continued employer coverage or possibly qualifying for heavily subsidized care on the Marketplace, it seemed to be a “no brainer.” Six years after the passage of the ACA, which was signed into law on March 23, 2010, and three years after the initial launch of the Marketplace in October 2013, COBRA is still a law with which to be reckoned. In a series of articles, I will address COBRA in general and also delve into other related issues, such as mini-COBRA, COBRA and account-based plans, and the interaction of COBRA and Medicare.

The Patient Protection and Affordable Care Act (ACA) established the Transitional Reinsurance Program to help stabilize premiums in the individual private and public marketplaces. The Transitional Reinsurance Fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016, regardless of the policy or plan year. Insurers of fully insured major medical plans and sponsors of self-funded major medical plans are responsible for filing and submitting contributions for the Transitional Reinsurance Program.

The Affordable Care Act's Employer-Shared Responsibility (ESR), otherwise known as Play or Pay, is here! Not only are employers struggling to apply the once-abstract-but-now-actual complex and convoluted rules and regulations, employers are facing yet another hurdle – Affordable Care Act (ACA) Information Returns (AIR).

Health Insurance Providers Fee

Section 9010 of the Patient Protection and Affordable Care Act (PPACA) imposes a fee on each covered entity engaged in the business of providing health insurance for United States health risks. This is known as the Health Insurance Providers (HIP) fee or the Health Insurers Tax (HIT) tax. The first filings were due from covered entities by April 15, 2014, and the first fees were due September 30, 2014. Self-insured plans are not covered entities for the purpose of the HIP Fee. The HIP fee is an important revenue source for PPACA, amounting to $8 billion in 2014 and rising to $14.3 billion by 2018. While fully insured plans are not directly responsible for the HIP fee, the Congressional Budget Office was correct when it indicated that it would be “largely passed through to consumers in the form of higher premiums.” Some premiums have increased as much as 4.5%.

The Patient Protection and Affordable Care Act (PPACA) specifically encourages and promotes the expansion of wellness programs in both the individual and group markets. In the individual market, the secretaries of the departments of Health and Human Services (HHS), Treasury, and Labor are directed to establish a pilot program to test the impact of providing at-risk populations who utilize community health centers an individualized wellness plan that is designed to reduce risk factors for preventable conditions as identified by a comprehensive risk-factor assessment. Results will be compared against a controlled group.

The last few months have seen as many complaints filed by the U.S. Equal Employment Opportunity Commission (EEOC) against wellness programs. On August 20, 2014, the EEOC brought its first direct challenge of a wellness program under Title I of the Americans with Disabilities Act (ADA) against Orion Energy Systems, Inc. (The Orion Suit). On September 30, 2014, the EEOC initiated its second ADA action against Flambeau, Inc.’s wellness program (The Flambeau Suit). The latest petition was filed on October 27, 2014, against Honeywell International, Inc.’s wellness program (The Honeywell Suit), and it includes counts under both the ADA and the Genetic Information Non-Discrimination Act (GINA).