Individuals
The penalty for failing to comply with Cafeteria Plan rules identified in Internal Revenue Code Section 125 can be severe. The penalties can include the application of income taxes against participants who otherwise thought they were electing non-taxable benefits, the application of employment taxes against participants and the employer, and penalties for failing to withhold and report taxes appropriately, among other things.
Grandmothered plans are the name commonly used for health insurance plans in the individual and small group markets that were issued after the Affordable Care Act (ACA) was signed into law (March 23, 2010) and before the so-called full implementation date of the law (January 1, 2014).
Many types of telemedicine coverage eliminate the ability for a person enrolled in a qualified high deductible health plan (HDHP) to make contributions to a Health Savings Account (HSA).
President Jospeh Biden has issued an executive order instructing the Department of Treasury (DOT) to review regulations that pertain to subsidy eligibility on the Health Insurance Marketplace (Marketplace). The primary purpose of the executive order is to determine if regulatory changes can be made to fix the so-called “family glitch.”
Non-grandfathered health plans (i.e., health plans issued on or after March 23, 2010) are required to cover innetwork preventive services at 100% with no cost-sharing to a member. This is a requirement that was imposed by the Affordable Care Act (ACA). The preventive services that must be covered are specified by the Health Resources and Services Administration (HRSA), the United States Preventive Services Task Force (USPSTF), and the Centers for Disease Control and Prevention (CDC).
The COVID-19 national emergency was set to expire on March 1, 2022; however, President Joseph Biden issued an extension of the national emergency on February 18, 2022. It is unknown at this time when the national emergency will be declared over.
Health Savings Accounts (HSAs) have become a popular way to pay for out-of-pocket medical expenses and/or save for future medical expenses. HSAs are considered by many to be the “unicorn” of financial accounts. The primary reason for this claim to fame are the triple tax advantage features of HSAs.
The Employee Retirement Income Security Act of 1974 (ERISA) requires employers to provide a Summary Plan Description (SPD) to employees if they offer health, dental, vision, life, disability, or other benefits.
The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) jointly issued guidance on a new requirement that individual and group health plans must cover over-the-counter (OTC) COVID-19 diagnostic tests.
The Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices. PCORI is funded in part by fees which are charged to health plans. The following information is designed to help employers understand their upcoming payment obligations.