Employer Mandate

Posted December 6th, 2023 in Employers, Employees

The reporting requirements of the Affordable Care Act (ACA) are quickly approaching. Employers subject to the Employer Mandate should prepare to submit Forms 1094-C/1095-C to the Internal Revenue Service (IRS) by April 1, 2024. Employers not subject to the Employer Mandate but who offer a self-funded plan, including level funded plans and Individual Coverage Health Reimbursement Arrangements (ICHRAs) should be prepared to submit Forms 1094-B/1095-B to the IRS by this same date.

Posted September 20th, 2023 in Employers, Producers

The Employer Mandate guidelines state that coverage is affordable when an employee must pay no more than 9.5% of their household income (inflation-adjusted to 8.39% for the 2024 plan year) for self-only coverage which is offered, but which employers know the household income of an employee?

Posted August 30th, 2023 in Employers, Producers

The Internal Revenue Service (IRS) recently issued Rev. Proc. 2023-29 which includes information about the changes to the affordability percentage as it relates to the Employer Mandate for 2024.

Posted March 1st, 2023 in Employers

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees to offer continuation coverage under a group health plan for periods of 18, 29 or 36 months depending on the qualifying event. Qualifying events generally include a loss of coverage due to 1) termination of employment, 2) a reduction in hours, 3) an employee’s entitlement to Medicare, 4) death of the employee, 5) divorce or legal separation from the employee, and 6) a dependent child reaching the maximum age limit to be covered under the plan.

Posted August 8th, 2022 in Employers, Producers
The Internal Revenue Service (IRS) recently issued Revenue Procedure 2022-34 which includes important details as it relates to Advanced Premium Tax Credits (APTCs) on Health Insurance Marketplaces and “affordable coverage” as it relates to the Employer Mandate for plan years starting in 2023.
 

Advanced Premium Tax Credits (APTCs)

 
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.

Posted October 7th, 2020 in Employers, Producers

The Internal Revenue Service (IRS) has issued draft reporting forms for the purpose of filing information necessary to enforce the Employer Mandate. The 2020 draft version of the applicable forms can be found below (with finalized versions expected to be released later this year):

Draft version of Form 1095-C

Posted August 4th, 2020 in Employers, Producers

The Internal Revenue Service (IRS) recently issued Rev. Proc. 2020-36 which includes details on the minimum required contribution percentage in determining whether employer-sponsored health coverage is affordable. In 2021, employer-sponsored health coverage will be considered affordable if an employee has to pay no more than 9.83% (an increase of 0.05% from 2020) of their income for such coverage.

Posted June 4th, 2020 in Employers, Producers

The Employer Mandate requires employers with 50 or more employees to offer “minimum essential coverage” to at least 95% of its full-time employees. Failure to do so can result in a penalty of $2,570 for each full-time with a break on the first 30 employees. Most employers assume minimum essential coverage must come in the form of a traditional group health insurance plan, but that is not the case.

Posted June 2nd, 2020 in Employers, Producers

Many employee benefit laws only apply to employers who have a certain number of employees. The challenging part is that each law has its own definition and rules on how to count the number of employees when determining if a law applies to an employer. Here are some key examples:

Benefits Buzz

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