A recent report from the nation’s top actuaries takes a sobering look at the challenges policy makers face in creating a viable individual (i.e., non-group) health insurance market—a critical component of any plan to replace...more
We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more
8/27/2016
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Health Insurance ,
Hospitals ,
Indemnity ,
Minimum Essential Coverage ,
NAIC ,
Supplemental Insurance
Recently, we reported on Gobeille v. Liberty Mutual, in which the Supreme Court invalidated the Vermont all-payer claims data base law. Applying what appeared to us as a straight-forward application of existing ERISA...more
The Employee Retirement Income Security Act of 1974 (ERISA) made the regulation of employee benefit plans principally a matter of Federal concern. ERISA broadly and generally preempts—or renders inoperative—state laws that...more
For the last half of 2015, we spent a good deal of time explaining the Affordable Care Act reporting requirements that applied to carriers and large employers. This post examines the how of ACA reporting. In particular, it...more
As we noted in a previous post, the recently issued final 2015 Instructions for Forms 1094-C and 1095-C changed certain of the rules relating to the reporting for offers of COBRA coverage where the COBRA qualifying event...more
10/29/2015
/ Affordable Care Act ,
American Bar Association (ABA) ,
COBRA ,
Employer Group Health Plans ,
Employer Liability Issues ,
Final Rules ,
Form 1094 ,
Form 1095 ,
Full-Time Employees ,
Health Insurance ,
IRS ,
Part-Time Employees ,
Reporting Requirements ,
Safe Harbors ,
Self-Funded Health Plans ,
Shared Responsibility Rule ,
Termination ,
U.S. Treasury
When reporting offers of coverage to full-time employees under the Affordable Care Act’s (ACA) employer shared responsibility rules, much of the detail appears in Part II of IRS Form 1095-C, Lines 14, 15 and 16. For the most...more
10/23/2015
/ Affordable Care Act ,
Employer Mandates ,
Full-Time Employees ,
Health Insurance ,
Hiring & Firing ,
IRS ,
Minimum Value Plans ,
New Hires ,
Part-Time Employees ,
Penalties ,
Reporting Requirements ,
Shared Responsibility Rule
Compliance with the Affordable Care Act’s (ACA) employer shared responsibility rules requires that applicable large employers identify their full-time employees. A “full-time employee” for this purpose is an employee who...more
10/14/2015
/ Affordable Care Act ,
Disability Leave ,
Employer Mandates ,
Excise Tax ,
Full-Time Employees ,
Health Insurance ,
IRS ,
Large Employer ,
Penalties ,
Reporting Requirements ,
Safe Harbors ,
U.S. Treasury
This series is devoted principally to the reporting requirements imposed by Internal Revenue Code §§ 6055 and 6056 as added by §§ 1502 and 1514 of the Affordable Care Act (ACA), respectively. The former reports offers of...more
In Notice 2014-69, the Treasury Department and the IRS clarified that a group health plan that fails to provide substantial coverage for in-patient hospitalization and physician services will not be treated as providing...more
9/30/2015
/ Affordable Care Act ,
Amended Regulation ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Hospitals ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Physicians ,
Proposed Regulation ,
Tax Credits ,
U.S. Treasury
The IRS recently issued final instructions for Forms 1094-B and 1095-B and Forms 1094-C and 1095-C . The 2015 Instructions for Forms 1094-B and 1095-B implement a suggestion we made in a previous post relating to the...more
9/22/2015
/ Affordable Care Act ,
COBRA ,
Employer Group Health Plans ,
Employer Liability Issues ,
Expatriates ,
Final Guidance ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HRA ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Multiemployer Plan ,
Proposed Regulation ,
Reporting Requirements ,
Self-Funded Health Plans ,
U.S. Treasury
The Affordable Care Act’s (ACA) employer shared responsibility rules provide applicable large employers (i.e., those with 50 or more full-time and full-time equivalent employees on business days during the preceding calendar...more
9/10/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Excise Tax ,
Health Insurance ,
IRS ,
MEWAs ,
Multiemployer Plan ,
Professional Employer Organization ,
Reporting Requirements ,
Shared Responsibility Rule ,
Staffing Agencies ,
Taft-Hartley Act ,
Tax Credits
When it comes to mergers and acquisitions involving at least one applicable large employer (ALE), the substantive rules governing employer shared responsibility (under Internal Revenue Code § 4980H) and the corresponding...more
9/1/2015
/ Affordable Care Act ,
Asset Purchaser ,
COBRA ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance ,
IRS ,
Large Employer ,
Reporting Requirements ,
Shared Responsibility Rule ,
Social Security Taxes ,
Stock Deals ,
Successors ,
U.S. Treasury ,
Wages
Under a common strategy for controlling group health care plan costs, employers sometimes adopt arrangements under which an employee is offered cash as an incentive to waive coverage. These arrangements are colloquially...more
8/25/2015
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Final Rules ,
Flexible Spending Accounts ,
Form 1095 ,
Health Insurance ,
Health Insurance Exchanges ,
Incentives ,
Individual Mandate ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Opt-Outs ,
Penalties ,
Reporting Requirements ,
Safe Harbors ,
Shared Responsibility Rule ,
Subsidies ,
Waivers
Alden Bianchi, Chair of Mintz Levin’s Employee Benefits & Executive Compensation Practice, will provide a weekly installment on the complex reporting obligations outlined by the Affordable Care Act for health insurance...more
The Affordable Care Act (ACA) imposes information reporting rules on providers of minimum essential coverage, e.g., insurance carriers and self-funded plans, and on applicable large employers, i.e., those employers that are...more
7/27/2015
/ Affordable Care Act ,
Employer Group Health Plans ,
Employer Liability Issues ,
Employer Mandates ,
Good Faith ,
Health Insurance ,
Healthcare ,
IRS ,
Minimum Essential Coverage ,
New Legislation ,
Penalties ,
Reporting Requirements ,
Section 6722 ,
Self-Funded Health Plans ,
Trade Preferences Extension Act (TPEA)
Alden Bianchi, Chair of the our Employee Benefits & Executive Compensation Practice, will provide a weekly installment on the complex reporting obligations outlined by the Affordable Care Act for health insurance carriers and...more
7/20/2015
/ Affordable Care Act ,
Compliance ,
Corporate Counsel ,
Employer Group Health Plans ,
Employer Liability Issues ,
Employer Mandates ,
Exceptions ,
Good Faith ,
Health Insurance ,
Individual Mandate ,
IRS ,
Minimum Essential Coverage ,
Penalties ,
Popular ,
Reporting Requirements ,
Self-Funded Health Plans
Reports in the popular media portrayed King v. Burwell as a case involving premium tax subsidies used to purchase health insurance from public exchanges or marketplaces under the Affordable Care Act (ACA). According to an...more
7/7/2015
/ Affordable Care Act ,
Employer Mandates ,
Health Insurance ,
Health Insurance Exchanges ,
IRS ,
King v Burwell ,
SCOTUS ,
Shared Responsibility Rule ,
State Health Insurance Exchanges ,
Subsidies ,
Tax Credits
In this volume, we have collected the 52 weekly blog posts that comprise the series entitled, The Affordable Care Act—Countdown to Compliance for Employers. The series appeared in the Mintz Levin Employment Matters Blog...more
2/25/2015
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Cafeteria Plans ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Mandates ,
Equal Employment Opportunity Commission (EEOC) ,
Full-Time Employees ,
Health Insurance ,
Honeywell International ,
HSA ,
Minimum Value Plans ,
Pay or Play ,
Self-Insured Health Plans ,
Shared Responsibility Rule ,
Wellness Programs
The Affordable Care Act requires applicable large employers to make broad-based offers of group health insurance coverage to substantially all their full-time employees or face potential tax penalties. (The term “applicable...more
Many applicable large employers—i.e., employers that are subject to the Affordable Care Act’s (ACA) employer shared responsibility rules—have a pretty good sense of what these rules are, how they work, and what they plan to...more
Over the last couple of months, we have followed and reported on a particular ACA compliance strategy under which an employer subject to the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules...more
Last year, the Department of Labor and the Treasury Department/IRS (Departments) issued guidance on the application of certain of the Affordable Care Act’s insurance market reforms to health reimbursement arrangements (HRAs),...more
In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects...more
Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more