The Affordable Care Act (ACA) created federal reporting requirements for employers and health plans. These reporting requirements provide the government with information to administer ACA mandates, like the large employer shared responsibility penalty and the individual mandate. The ACA’s individual mandate, updated January 1, 2019, requires individuals to have minimum …
Transition Policy for Non-ACA Compliant Plans Extended Indefinitely
The Department of Health and Human Services (HHS) extended an existing transition policy indefinitely for health plans that do not comply with the Affordable Care Act (ACA). This extension applies to policy years beginning after October 1, 2022. Until the HHS announces that the coverage must come into compliance with …
Compliance Checklist: Affordable Care Act
Since the Affordable Care Act (ACA) was enacted in 2010, many changes have been made. In 2022, there are changes for employers sponsoring group health plans. Plan Design Changes Grandfathered plan status A grandfathered plan is one that existed before the ACA was enacted on March 23, 2010. The Departments …
FAQ Released on Contraceptive Coverage Under ACA
On August 16, 2021, the U.S. Departments of Health and Human Services (HHS), Labor and the Treasury (collectively, the Departments) issued a frequently asked question (FAQ) regarding enforcement of the contraceptive coverage mandate under the Affordable Care Act (ACA). Contraceptive Mandate The ACA requires non-grandfathered health plans to cover certain …
Proposed Rule Would Update 2022 Benefit & Payment Parameters
The Department of Health and Human Services (HHS) recently published a proposed rule that would revise several benefit and payment parameters under the Affordable Care Act (ACA) for the 2022 benefit year. While the proposed changes primarily impact insurers and Exchanges, it’s important to consider that some provisions could also …
PCORI Fees Deadline Approaching
The Affordable Care Act (ACA) imposes a fee on health insurance issuers and plan sponsors of self-insured health plans to help fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI fee is calculated based on the average number of lives covered under a policy or plan and is paid annually …
Supreme Court Upholds Affordable Care Act
The Affordable Care Act (ACA) as it exists today, will remain in place. On June 17, 2021, the U.S. Supreme Court upheld the Affordable Care Act (ACA) in a 7-2 ruling after several arguments challenging the constitutionality of the ACA were brought forth to the court. The Supreme Court determined …
Pennsylvania Employers Required to Provide Leave to Organ Donors
Effective June 26, 2021, employers subject to the federal Family and Medical Leave Act (FMLA) must provide leave to Pennsylvania employees to help them prepare for and recover from surgery related to an organ or tissue donation. Earlier this year, the Pennsylvania Living Donor Protection Act was signed into law, …
Draft Forms for 2021 ACA Reporting Released
Over the years, the Affordable Care Act (ACA) has created reporting requirements under Code Sections 6055 and 6056. These rules require certain employers to provide information to the Internal Revenue Service (IRS) about the health plan coverage they either offer, do not offer, or provide to their employees. 2021 Draft …
HSA & HDHP Limits Increase for 2022
On May 10, 2021, the Internal Revenue Service (IRS) released Revenue Procedure 2021-25, which provides the inflation-adjusted amounts for health savings accounts (HSAs) and high deductible health plans (HDHPs) for the 2022 plan year. As cost of living expenses continue to rise, the IRS annually adjusts the following amounts and …
Remaining 2022 Notice of Benefit & Payment Parameters Finalized
The Department of Health and Human Services (HHS) recently finalized the second Notice of Benefit and Payment Parameters (NBPP) for 2022. The final notice — which follows the first final 2022 NBPP published on January, 19, 2021 — sets forth payment parameters and provisions related to the risk adjustment program …
DOL & IRS ARPA FAQs Released
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARPA) into law. It provides a 100% subsidy of applicable COBRA premiums for eligible beneficiaries and their dependents, for the time period beginning April 1, 2021 and ending no later than September 30, 2021. COBRA …
ACA Special Enrollment Period Extended to August
On March 23, 2021, President Joe Biden and his administration reported that the Centers for Medicare & Medicaid Services (CMS) announced that it is extending the Special Enrollment Period (SEP) — which was originally available through May 15, 2021 —for an additional three months, allowing eligible individuals to enroll in …
IRS Extends HSA 2020 Contribution Deadline
On March 29, 2021, the Internal Revenue Service (IRS) issued Notice 2021-21, which extends tax deadlines to May 17, 2021 for individuals filing Form 1040 series returns and making 2020 IRA and HSA contributions. This decision follows a previous announcement from the IRS declaring that the federal income tax filing …
FAQs Clarifying COVID-19 Testing & Vaccine Coverage
The constant influx of information and everchanging compliance updates surrounding the coronavirus pandemic can be overwhelming, making it strenuous to comprehend how up-to-date guidance and coverage affects one’s organization and employees. In response, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury have issued Frequently Asked …