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 …
HHS Issues Proposed Notice of Benefit & Payment Parameters for 2021
On January 31, 2020, the Department of Health and Human Services (HHS) published its proposed Notice of Benefit and Payment Parameters for 2021. The proposed rule explains the benefit and payment parameters under the Affordable Care Act (ACA). If finalized, the provisions included in the proposed rule would apply for …
SOTU and the Employee Benefits Market
On February 4, 2020, President Donald Trump delivered the 2020 State of the Union Address (SOTU) to a joint session of Congress. A series of topics were presented including private healthcare, federal paid family leave and prescription drug cost reform. These items have already made significant impacts on the employee’ …
U.S. Supreme Court Denies Motion to Expedite ACA Case
On January 21, 2020, the United States Supreme Court denied motions to expedite consideration of Texas v. Azar, the lawsuit which challenged the constitutionality of the Affordable Care Act’s (ACA) individual mandate. The decision to deny expediting the case follows a United States Court of Appeals for the Fifth Circuit …
ACA Reporting Deadlines Are Approaching
Affordable Care Act (ACA) reporting deadlines are approaching soon under Section 6055 and Section 6056 for the 2019 calendar year. Reporting entities must: File returns with the Internal Revenue System (IRS) by February 28, 2020 if filing on paper (or March 31, 2020 if filing electronically); and Furnish 2019 Forms …
PCORI Fees Extended for Another 10 Years
Not only did the Further Consolidated Appropriations Act, signed into law on December 20th, repeal three taxes under the Affordable Care Act; the law also extends payment of PCORI fees for the next ten years (2020 through 2029). The ACA created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, …
Three ACA Taxes Repealed & Federal Appeals Court Ruling
On Friday, December 20th, President Trump signed H.R. 1865 into law, the Further Consolidated Appropriations Act of 2020, which included a full repeal of three taxes originally imposed by the Affordable Care Act (ACA): Repeal of the Cadillac Tax beginning in 2020, which would have imposed a 40% excise tax …