Tag Archives: PPACA

Employers – Review Your Controlled Group to Assure ACA and Retirement Plan Compliance

Beginning in 2015, certain employers that fail to offer affordable health insurance that provides minimum value to their full-time employees and their dependents may incur substantial Employer Shared Responsibility penalties under the Affordable Care Act (“ACA”).  We previously wrote about the importance of properly classifying workers as employees or independent contractors to assure ACA compliance.  … 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

Remember ERISA Basics: SPD and Eligibility

During the past 14+ years practicing employee benefits law, I’ve seen many changes, not the least of which has been the Affordable Care Act (ACA). However, with all of the recent changes flowing from the ACA, it is important not to forget some very basic and long-standing aspects of plan compliance, design, drafting and administration, … 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

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

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

Eleventh Circuit Decides Health Care Reform Individual Mandate Is Unconstitutional

The individual mandate provision of the 2010 health care reform law is unconstitutional, the U.S. Court of Appeals for the Eleventh Circuit decided in Florida v. HHS on August 12th. The Sixth Circuit previously held in Thomas More Law Center v. Obama that the individual mandate is constitutional. Therefore, the Eleventh Circuit decision creates a circuit split, … Continue Reading

Employers Find Relief in Repeal of Certain Health Reform (PPACA) Provisions

The U.S. Supreme Court has refused to engage in expedited review of the decision of a Virginia District Court that held unconstitutional the individual mandate contained in the Patient Protection and Affordable Care Act (“PPACA”). The Supreme Court’s April 25 decision suggests there will be a long road to resolution of the constitutional attack on the … Continue Reading

Score Tied 2-2 as the Healthcare Challenge Heads to the Legal Superbowl – The Supreme Court

Federal District Court Judge, Roger Vinson, for the Northern District of Florida, Pensacola Division struck down the Patient Protection and Affordable Care Act (“PPACA”), the Federal health reform law dubbed by its critics as “Obamacare,” on Constitutional grounds yesterday. Judge Vinson agreed with the Attorneys General of 26 states that the mandates of the law … Continue Reading

HHS Updates Guidance on Obtaining Waivers from PPACA Annual Limits

The Patient Protection and Affordable Care Act (Affordable Care Act), requires the Secretary of Health and Human Services (HHS) to impose restrictions on the imposition of annual limits on the dollar value of essential health benefits in a new or existing group health plan for plan years beginning on or after September 23, 2010 and prior to January 1, 2014. Interim final regulations published on June 28, 2010, established these restricted annual limits, along with the possibility for a waiver from these restricted annual limits as granted by HHS if complying with the interim final regulations would result in a significant decrease in access to benefits or a significant increase in premiums.… Continue Reading
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