ACA

Posted July 13th, 2021 in Producers, Individuals

On June 28, 2021, the Department of Health and Human Services (HHS) proposed new rules that would primarily impact individual health plans that are sold through Health Insurance Marketplaces. The proposed rules aim to lengthen the annual enrollment period, expand Navigator duties, and minimize any burden or confusion for consumers. A summary of some of the key provisions has been outlined below:

Posted June 17th, 2021 in Employers, Producers, Individuals

Earlier this morning, the U.S. Supreme Court dismissed a case challenging the constitutionality of the Affordable Care Act (ACA), often referred to as Obamacare. The entire ACA continues to remain as the law of the land.

Posted June 2nd, 2021 in Employers, Producers

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.

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Posted April 20th, 2021 in Producers, Individuals

The Affordable Care Act (ACA) created premium tax credits in the individual health insurance market which first became available as of January 1, 2014. The amount of the premium tax credit available to a person is largely based on their household income. Most eligible individuals receive the premium tax credit in advance by estimating their household income for the year.

Posted January 29th, 2021 in Producers, Individuals

President Joseph Biden signed an executive order on Thursday which instructs the Department of Health and Human Services (HHS) to authorize a new special enrollment period in the individual health insurance market. The special enrollment period will be available because of the exceptional circumstances that have been created by the COVID-19 pandemic.

Posted January 13th, 2021 in Employers, Producers

Individual Coverage Health Reimbursement Arrangements (ICHRAs) first became available in 2020. ICHRAs allow employers to reimburse employees for individual health insurance coverage (or Medicare coverage) that employees obtain on their own. ICHRAs provide employers with an alternative to offering traditional group health insurance coverage to employees.

Posted December 22nd, 2020 in Employers, Producers

As we approach the new year, it is important that employers and benefit advisors not forgot some of the reporting obligations that come along with offering group health plans and other employee benefit programs.

Here are four reporting reminders:

Posted November 18th, 2020 in Employers, Producers

The Affordable Care Act (ACA) created two reporting requirements which are spelled out in Internal Revenue Code Sections 6055 and 6056.

Section 6055 requires every provider of minimum essential coverage to report information of those employees and dependents who enroll in coverage. Reporting this information to the Internal Revenue Service (IRS) is still required even though the Individual Shared Responsibility penalty (i.e. Individual Mandate) is $0.

Posted November 10th, 2020 in Employers, Producers, Individuals

The Supreme Court of the United States (SCOTUS) is scheduled to hear oral arguments about the constitutionality of the Affordable Care Act (ACA) today. The underlying issue to be heard is whether the elimination of the Individual Mandate penalty now invalidates some, all, or none of the law. One of the following outcomes is likely to occur:

Posted October 27th, 2020 in Employers, Producers

The Employer Mandate guidelines state that coverage is affordable when an employee has to pay no more than 9.5% of their household income (inflation-adjusted to 9.83% for the 2021 plan year) for self-only coverage which is offered, but which employers know the household income of an employee? As a result, there are three alternative methods that an employer can rely upon when determining if the coverage they offer is affordable. These methods are explained below and some general examples of how to apply each method have also been provided.

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