individual mandate
The IRS has released Notice 2015-17 with some new information about Employer Payment Plans, which are plans that are used to reimburse employees with pre-tax dollars for individual market coverage (e.g. HRA). Previous guidance had essentially eliminated Employer Payment Plans as an option for actively employed workers because they would not be able to comply with all of the Affordable Care Act (ACA) market reforms. Notice 2015-17 elaborates on the IRS’ position of Employer Payment Plans.
The IRS has released the maximum penalties that are payable by individuals who are without minimum essential coverage in 2015 and who do not qualify for an exemption from the Individual Mandate.
The maximum penalties for this year are the greater of:
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$325 per uninsured adult or $162.50 per uninsured child under age 18. The maximum penalty using this method is capped at $975.
On June 26, 2014, the Department of Health and Human Services (HHS) issued proposed regulations on the renewal process for individuals that have purchased health coverage through the Exchange. The regulations aim to streamline the renewal process by auto-enrolling the vast majority of existing members into a health plan for the 2015 plan year.
Minimum Essential Coverage and Minimum Value are two terms that are mistakenly considered the same by many people, but in fact, these terms have different definitions.
Minimum Essential Coverage is the type of coverage needed to satisfy the Individual Mandate requirements. The most common forms include the following health plans:
The Department of Health and Human Services (HHS) issued some new guidance on May 2, 2014 as it relates to Special Enrollment Periods and Hardship Exemptions in the individual marketplace. The new guidance has been summarized below:
Can people apply for individual health coverage after Mar. 31, 2014?
Only those individuals that experience a qualifying event can sign up for a qualified health plan mid-year after March 31st. Most qualifying events will create a special enrollment period that lasts for 60 days.
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