On September 24, 2020, President Trump issued an executive order that outlines a new plan for affordable, high-quality healthcare. The America First Healthcare Plan is aimed at protecting individuals with preexisting conditions and giving them access to care they can afford. The order directs the Departments of Health and Human …
What a New Court Justice Could Mean for the ACA
On September 18, 2020, U.S. Supreme Court Justice Ruth Bader Ginsburg passed away at the age of 87. The loss of Justice Ginsburg has shaken the country and has led to a flood of questions regarding what comes next for the Court and the Affordable Care Act (ACA). Whether the …
Pay or Play Penalties Will Increase for 2021
The Internal Revenue Service (IRS) has recently updated its frequently asked questions (FAQs) to include increased pay or play penalty amounts for the 2021 calendar year. Since 2014, the applicable per-employee dollar amounts of $2,000 and $3,000 have been increased based on the premium adjustment percentage for the year. For …
U.S. Supreme Court to Hear ACA Challenge After Election Day
The Supreme Court will hear arguments challenging the constitutionality of the Affordable Care Act (ACA) one week after Election Day – on November 10, 2020. This will be the third time the Supreme Court has reviewed the ACA’s constitutionality since the law’s tenth anniversary of enactment in 2010. Background Back …
Federal Court Blocks Rule on LGBTQ+ Healthcare Discrimination
On August 17, 2020, a federal district court blocked a Department of Health and Human Services (HHS) regulation which was intended to allow healthcare and insurance discrimination based on sex stereotyping, gender identity and pregnancy-related conditions. The U.S. District Court Judge found that the planned regulation, which was announced in …
Draft Forms for 2020 ACA Reporting Disclosed
On July 13, 2020, the IRS released 2020 draft Forms 1094-C and 1095-C. The drafts will be used by applicable large employers (ALEs) to report under Section 6056, as well as combined sections 6055 and 6056 for ALEs who sponsor self-insured plans. Draft instructions for Forms 1094-C and 1095-C have …
Greater Flexibility for Grandfathered Plans
On July 10, 2020, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury Departments issued a proposed rule intended to provide greater flexibility for grandfathered group health plans — which would include changes to certain cost-sharing requirements without losing grandfather status. The proposed rule would amend …
Employers Able to Opt Out of Contraceptive Coverage
On July 8, 2020, the U.S. Supreme Court upheld two regulations expanding exemptions from the contraceptive coverage mandate under the Affordable Care Act (ACA). Under the regulations, plan sponsors that object to providing contraceptive coverage based on sincerely held religious beliefs or moral convictions will not be penalized for failing …
FAQ’s: Families First Coronavirus Response Act
The Families First Coronavirus Response Act (FFCRA) enacted two laws that provide workers with paid leave for reasons related to the coronavirus (COVID-19) pandemic. This enables employers to keep their workers on payroll, while simultaneously ensuring that they are not forced to choose between their paychecks and the public health …
Look Back Method and COVID-19
The Affordable Care Act (ACA) requires applicable large employers (ALEs) to offer affordable, minimum value health coverage to their full-time employees or possibly pay a penalty. The evolving coronavirus crisis has raised questions on how employers should determine what a full-time employee is during periods of layoff, furlough, and COVID-19 …
Nine States Open Special Enrollment Period for Uninsured
In efforts to ease consumers’ concerns about healthcare costs in light of the COVID-19 crisis, at least nine states have reopened their health insurance exchanges for uninsured residents to enroll in coverage. The response stems from the necessity for uninsured patients to be able to receive the medical care they …
Health Insurance Carriers Address the Coronavirus
Health insurance companies are taking action to ensure members have coverage for and access to needed testing as the new coronavirus strain, COVID-19, continues to spread across the United States. Carriers such as Aetna, Independence Blue Cross, Highmark, and Cigna are actively monitoring the spread of the virus; and diligently …
Supreme Court to Challenge ACA Again in New Term
On March 2, 2020, the Supreme Court agreed to hear a third major challenge to the Affordable Care Act (ACA) after rulings in two other major cases confronted core previsions of the healthcare law. The court agreed to hear the case in its new term which begins in October 2020. …
No Statute of Limitations Applies for ACA Pay or Play Penalties
On February 21, 2020, the Internal Revenue Service (IRS) Office of Chief Counsel released a memorandum clarifying that there is no applicable statute of limitations on pay or play penalty assessments under the Affordable Care Act (ACA). Meaning, there is no time limit for the IRS to assess penalties for …
HHS Extends Transition Policy for Non-ACA Compliant Plans
Since 2014, the Department of Health and Human Services (HHS) has continuously extended a transition policy for certain health plans that do not comply with the Affordable Care Act (ACA). This policy has been extended another year. Health insurance issuers have the option of renewing current polices for current enrollees …