healthcare reform

Posted December 23rd, 2015 in Producers, Employers, Individuals
You may have heard that President Obama recently signed into law the Consolidated Appropriations Act of 2016, a $1.1 trillion spending bill, avoiding a shutdown and funding the federal government through September 30, 2016. The President also signed the Protecting Americans from Tax Hikes (PATH) Act of 2015 which provides nearly $700 billion in tax breaks. Here’s what it means to the Affordable Care Act (ACA) and transit reimbursement plans.   
 
Cadillac Tax
  • The Cadillac Tax has been delayed by two years until 2020.
Posted December 18th, 2015 in Producers, Employers, Individuals

On December 11, 2015, the Department of Health and Human Services (HHS) posted guidance for states interested in seeking a State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA).

Posted December 10th, 2015 in Producers, Employers, Individuals
Below is a list of some key Affordable Care Act (ACA) changes and facts that will be effective in 2016:
 
  1. The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater. 
  2. The Employer Mandate expands to include all employers who have 50 or more employees. 
  3. The Employer Mandate offer rate increases from 70% to 95%. 
  4. Employer reporting related to the offer of coverage is due for the first time during Q1 2016. 
Posted December 4th, 2015 in Producers, Employers, Individuals
The Senate needed 51 votes to pass the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (HR 3762), a budget reconciliation bill which would repeal several key parts of the Affordable Care Act (ACA).  They got 52 when they voted on December 3rd.  The bill, which was previously passed by the House of Representatives (House), was approved by the Senate with some amendments.  That means the bill will have to go back to the House for another vote, where most expect it will be passed.
Posted November 25th, 2015 in Producers, Employers

You may have thought the penalty for applicable large employers who fail to offer minimum essential coverage was $2,000 per employee. You may have also thought that if you offered coverage, but it was unaffordable and/or didn’t provide minimum value, then the penalty was $3,000 per employee who waived coverage and received a subsidy in the Exchange.

Posted November 13th, 2015 in Producers, Employers

The new reporting requirements that some employers will be subject to starting next year, as required by the Affordable Care Act (ACA), will be used to help the Internal Revenue Service (IRS) enforce the Individual and Employer Mandates, and it will also help the IRS administer subsidy eligibility in the Exchanges.
 

The following reporting forms will be the responsibility of the employer to complete:

Posted October 30th, 2015 in Producers, Employers

PCORI Fees

The Internal Revenue Service (IRS) released Notice 2015-60 on October 9, 2015.  The notice includes information on the payable amounts that are due for the Patient-Centered Outcomes Research Institute fees (PCORI fees). The fee will increase from $2.08 to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. The next round of PCORI fees will be due by July 31, 2016 for plan years ending in 2015. The payment schedule will be as follows:
Posted October 23rd, 2015 in Producers, Employers

The Protecting Affordable Coverage for Employees (PACE) Act, signed into law by President Obama on October 7, 2015 gives states the ability to continue to determine the size of their small group market rather than conforming to a national standard.

Most states currently define their small group market as employers with up to 50 employees, but the Affordable Care Act (ACA) was set to expand that definition in 2016 to include employers with up to 100 employees. The PACE Act allows each state to independently decide what small group market definition makes the most sense.

Posted October 8th, 2015 in Employers, Producers, Individuals

The open enrollment period (OEP) in the individual market will begin on November 1, 2015 and end on January 31, 2016.

During this time period, just about anyone can enroll or make plan changes to coverage in the individual market.

Here are some helpful reminders as the OEP approaches:

Who is eligible for a subsidy?

There are a number of factors that affect eligibility or can disqualify an individual for a subsidy, such as:

Posted August 31st, 2015 in Producers, Employers
The statutory limit for Health Care Flexible Spending Account (FSA) elections is expected to remain unchanged in 2016. The salary reduction limit was capped at $2,500 in 2013 as a result of the Affordable Care Act (ACA) and is subject to inflationary adjustments. In 2015, the limit was increased to $2,550. However, due to a recent government report issued by the U.S.

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