Tag Archives: Health Care Reform

Where Do We Stand with Health Care?

The American Heath Care Act was designed to provide health care reform and to replace former President Obama’s Affordable Care Act (the “ACA”). However, the House of Representatives, under President Trump’s direction, cancelled its vote in late March because of lack of overall support from Republicans to get passage of the bill in the House. … Continue Reading

Affordable Care Act Employer Penalties – Another Reason to Make Sure Workers are Properly Classified as Employees or Independent Contractors

Beginning next year, an applicable large employer that does not offer affordable minimum value group health coverage to its fulltime employees (and their children up to age 26) will be vulnerable to employer shared responsibility penalties under Internal Revenue Code §4980H.  Whether an employer is an “applicable large employer” depends on its number of fulltime … Continue Reading

Dueling Decisions in the 4th and D.C. Circuit Courts of Appeals Spell More ACA Uncertainty for Employers

Just as employers are gearing up to prepare for compliance with the Shared Responsibility rules under the ACA, a pair of decisions from two federal appeals courts has thrown a curve ball into what was already a complicated assessment of risk for employers and raised new questions. The U.S. Court of Appeals for the District … Continue Reading

“Final” Obamacare Employer Penalty Rules Released

The US Treasury released the final regulations implementing the employer shared responsibility penalty provisions of the 2010 health care reform law on February 10, 2014.  In many ways, the final regulations resemble the proposed regulations issued over a year ago but there are several – mostly welcome – changes and transition provisions for employers.  (See … Continue Reading

REMINDER! VIRTUALLY ALL EMPLOYERS MUST FURNISH “MARKETPLACE” NOTICE TO EMPLOYEES BY OCTOBER 1, 2013

The Patient Protection and Affordable Care Act requires employers to furnish employees a notice of the availability of coverage through public health insurance exchanges, i.e., the “Marketplace”. The Department of Labor requires that employers give employees the notice by October 1, 2013. As highlighted in our earlier blog post, Department of Labor Technical Release 2013-02  … Continue Reading

Employers Must Provide Notices Regarding Availability of Exchange Coverage

A provision of the 2010 health care reform law requires employers to provide notices, by March 1, 2013, to all employees regarding the availability of health coverage options through the state-based exchanges created pursuant to that law. In January, the Department of Labor had announced delayed enforcement of the exchange coverage notice provision (which added Section … Continue Reading

More Guidance on the Summary of Benefits and Coverage (But No Surprises)

The Department of Labor, Health and Human Services and the Treasury collectively published new FAQs regarding the requirement to provide a summary of benefits and coverage (SBC) under the Affordable Care Act (ACA) (http://www.dol.gov/ebsa/faqs/faq-aca14.html#footnotes). The FAQs include an updated SBC template and an updated sample completed SBC (available at cciio.cms.gov and www.dol.gov/ebsa/healthreform).  It is noteworthy … Continue Reading

Proposed Regulations on Certificates of Creditable Coverage

Proposed regulations published on March 21, 2013 addressed not only the 90-day waiting period rule discussed below but also the eventual elimination of notices of creditable coverage under HIPAA’s preexisting condition exclusions rules. The 2010 health care reform law prohibits group health plans from imposing preexisting condition exclusions, effective for plan years beginning on or … Continue Reading

Government Proposes Expanded Relief From Contraceptive Mandate

As explained in an earlier post, the 2010 health care reform law requires health plans to provide women’s preventive care and services without cost sharing. Regulations issued August 1, 2011 included all FDA-approved contraception for women in the definition of women’s preventive care and services. That includes abortion and abortifacient drugs (like the so-called “morning-after” pill). The regulations … Continue Reading

Employer Relief – Extension for Issuing Health Care Reform Exchange Coverage Notice

As expected, the government issued guidance (in the form of frequently asked questions posted on the Department of Labor’s website) postponing the due date for employers to issue notices regarding the availability of health coverage under state exchanges. Under the 2010 health care reform law, a provision added to the Fair Labor Standards Act requires … Continue Reading

Health Care Reform Resource Center

We are pleased to announce the launch of Jackson Lewis’ Health Care Reform Resource Center. Our Resource Center provides one convenient place for you to obtain key health care reform-related law, agency guidance, Jackson Lewis articles and related information. We hope you find this resource helpful.… Continue Reading

IRS Releases Proposed Regulations on Employer Penalty under Health Care Reform Law

The IRS released proposed regulations last week that amplify and modify earlier guidance issued on the 2010 health care reform law’s employer penalty provision.  Highlights of the proposed regulations include: For purposes of determining whether an employer has the threshold 50 full-time employees, an employer can use any consecutive 6-month period in 2013, instead of … Continue Reading

More Health Care Reform Fees – Redistribution of Risk

Employers wrestling with how to budget for the additional costs associated with the 2010 health care reform law have one more cost to consider: the “transitional reinsurance program” fee. Barely discussed in the public forum up to now (probably because the amount per plan was not determinable), the government has clarified how this fee could impact … Continue Reading

How Employers Can Approach Health Care Reform’s Shared Responsibility Penalty

Many employers put off making plans to deal with the employer shared responsibility penalty provision of the 2010 health care reform law until after the November elections.  With President Obama’s re-election and no real possibility of legislative repeal, procrastinating further would be ill-advised.  Employers need to understand now the way the penalty can be triggered … Continue Reading

IRS Provides Guidance Regarding New Limit on Health FSA Contributions

The Internal Revenue Service (IRS) has provided guidance regarding the new salary reduction contribution limits to health flexible spending arrangements (health FSAs) under Internal Revenue Code section 125 cafeteria plans in Notice 2012-40, issued May 30, 2012. Currently, there are no statutory limits on employee salary reduction contributions to health FSAs, but plan sponsors typically … Continue Reading

Health Care Reform Update: DOL Provides Guidance on Summary of Benefits and Coverage Requirement

The US Department of Labor (“DOL”) has released frequently asked questions (“FAQs”) regarding implementation of the federal health care reform law’s summary of benefits and coverage requirement. (This set of FAQs is Part VIII in the general series about implementation of the law.) See our earlier blog post regarding the summary of benefits and coverage regulations that were … Continue Reading

Group Health Plan Summary of Benefits and Coverage Due By Next Open Enrollment

  The agencies primarily responsible for enforcing the Patient Protection and Affordable Care Act of 2010 issued 150 pages of final regulations implementing the mandate that group health plans and insurers provide a four-page summary of benefits and coverage to individuals who enroll in health plans. Under the regulations issued February 9, 2012, plan administrators and … Continue Reading

Additional IRS Guidance on W-2 Reporting of Health Care Costs

The Internal Revenue Service (“IRS”) has  amended its guidance to employers on how to report the cost of group health coverage. Notice 2012-9 addresses, among other things, cost determinations for employee assistance programs, wellness programs, and health reimbursement arrangements.  Internal Revenue Code section 6051(a)(14), enacted as part of the Patient Protection and Affordable Care Act of … Continue Reading
LexBlog