…and what you can do about it.
…and what you can do about it.
Delays, shifting deadlines, and even the elimination of certain provisions of the Affordable Care Act (ACA) are providing employers and group health plans additional time to comply with certain key requirements that have not yet taken effect. For 2016, the following eliminations, delays, and extensions apply.
Please Note: This information is for general reference purposes only and is not all-inclusive. Requirements and compliance deadlines are subject to change. Additionally, your company or group health plan may be exempt from certain requirements described below. Employers with questions are advised to contact a knowledgeable employment law attorney or benefits advisor to obtain specific guidance.
Provisions of the ACA which generally would have required an employer with more than 200 full-time employees to automatically enroll new full-time employees in one of the employer’s health plans, and to continue the enrollment of current employees, were repealed on November 2, 2015.
The ACA’s annual limitation on deductibles for non-grandfathered plans in the small group market has been eliminated, effective retroactively to 2010. However, the annual limitation on out-of- pocket expenses for non-grandfathered group plans was not eliminated and remains in effect.
Implementation of the so-called “Cadillac tax,” an excise tax on high-cost employer-sponsored health coverage, has been delayed until taxable years beginning after December 31, 2019.
Nondiscrimination Rules for Fully-Insured Plans
Non-grandfathered fully-insured group health plans are not required to comply with certain rules prohibiting discrimination in favor of highly compensated individuals that are currently applicable to self-insured plans, until after regulations or other administrative guidance is issued. However, health benefits offered as part of a cafeteria plan (a plan which meets specific requirements to allow employees to receive certain benefits on a pre-tax basis) generally remain subject to the nondiscrimination requirements of Internal Revenue Code section 125.
Form W-2 Reporting for Small Employers
The IRS has granted employers filing fewer than 250 Forms W-2 for the preceding calendar year transition relief from reporting the cost of coverage under an employer-sponsored group health plan on each employee’s Form W-2 until the agency publishes additional guidance.
The IRS extended the ACA information reporting due dates for calendar year 2015 returns and statements (that are filed and furnished in 2016) as follows:
These extensions have no effect on the deadlines for future years. As a reminder, the deadlines apply to all applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—as well as to small self-insured employers that are not considered ALEs.
As a result of the information reporting deadline extensions, the deadlines for employers to correct errors and receive reduced penalties for incorrect or incomplete information reported on 2015 returns or statements have also been extended, as follows:
Note: In general, the IRS will not impose penalties for 2015 returns and statements filed and furnished in 2016 on reporting entities that can show that they have made good faith efforts to comply.
A previously extended transitional policy which allows health insurance issuers, at their option, to continue small business group coverage that would otherwise be terminated or cancelled has been extended further—to policy years beginning on or before October 1, 2017, provided that all policies end by December 31, 2017. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year.
Policies subject to the transitional relief will not be considered to be out of compliance with some of the ACA’s key provisions, including:
Under previously granted transition relief, compliance with the “pay or play” requirements was delayed until 2015 for applicable large employers (ALEs) with 50 to 99 full-time employees (including full-time equivalents) that certified that they met certain eligibility criteria. For ALEs with non-calendar year health plans, this transition relief (as well as the transition relief regarding offers of coverage to dependents) extends to any calendar month during the 2015 plan year that falls in 2016.
Medical identity theft occurs when another person uses your identity or insurance information to obtain medical services. Since the U.S. Department of Health and Human Services started keeping records in 2009, between 27.8 and 67.7 million Americans have had their medical records breached. Continue reading “Avoiding Medical Identity Theft”
Critical illness insurance provides coverage over and beyond what your health insurance policy covers. Do you need it?
Critical illnesses can strike anyone, at any time. Critical illness insurance helps you deal with the unexpected costs of these health problems. According to estimates by the American Heart Association, this year alone 600,000 Americans will experience their first stroke, 785,000 Americans will have a heart attack for the first time and about 1.4 million will be diagnosed with cancer. Continue reading “Your Guide to Critical Illness Insurance”
It’s open enrollment: time to select your health insurance plan for the coming year.
If you were thinking about skipping it this time around, get ready to pay regardless. Fines for not having coverage are increasing. For 2016, they will be $695 for each adult and $347.50 for each child, up to $2,085 for a family. Or it could be 2.5 percent above the filing threshold, says the IRS (individuals $10,150, couples filing jointly $20,300), whichever is higher. Continue reading “The Costs of Not Having Health Insurance”
Clinical depression affects about one-fifth of women and one sixth of men in the United States at some point in their lifetimes. Why should employers be aware of this problem? Continue reading “Depression in the Workplace”
As of mid-July, the IRS had processed approximately 135 million of the approximately 150 million individual tax returns it expects for tax year 2014. In 2014, the Affordable Care Act’s “individual responsibility” provisions went into effect, requiring most Americans to have health insurance or pay a penalty. Continue reading “7.5 Million Americans Paid a Penalty for Lacking Health Coverage”