By the end of 2017 the IRS plans to send notification to applicable large employers (ALE) of potential liability for failure to comply with the “pay or play” mandate of the Affordable Care Act (ACA). These notifications (Letter 226J) will be sent to ALE employers that the IRS determines had one or more employee, in at least one month in 2015, that received a subsidy toward health care premiums purchased through the marketplace because the employer failed to provide health coverage that is compliant with the ACA requirements (affordable and providing minimum essential coverage). The IRS will make this determination based on information provided by employers on Forms 1094-C and 1095-C (required ACA reporting forms) as well as information provided to the IRS on individuals’ tax returns. Continue reading
Based on the regulations of the Affordable Care Act (ACA), Health Care Insurance Marketplaces (also referred to as Exchanges) will begin to send out notifications to certain employers when one or more of their employees enrolls in coverage through the Marketplace and is eligible for a subsidy, or Advanced Premium Tax Credit, for one or more months. In 2016 the notices will only be sent when employees provide a complete address for the employer. This means that in 2016 employers may not get notices from the Exchange for all employees who are receiving subsidies. A sample notice can be found here.
The following are some common questions many employers have about these notices. Continue reading
One of our full-time employees has asked to take Family and Medical Leave Act (FMLA) leave on an intermittent or reduced leave schedule. What does this mean, and how does it affect our employee’s health coverage?
A lot has happened over the past few years. The Affordable Care Act, or ACA, has transformed the way millions of people obtain health insurance coverage for themselves and their families. But it’s a complicated law, with a lot of moving parts. Many consumers, workers and human resources professionals/employers are confused about whe
re their role in covering workers ends and the ACA begins. This is particularly true in instances where a worker has left the job and is no longer eligible for coverage under the employee group plan. Here are answers to some of the most frequently asked questions:
At some companies, there may not be a well established system in place for handling the tasks necessary to comply with COBRA. Here’s a brief overview of COBRA as well as a question from a concerned employer about the implications of not complying, along with a detailed answer.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives eligible workers and their families who lose their health benefits the right to choose to continue group health benefits for limited periods of time under certain circumstances. The life events that enable an individual to become eligible for COBRA include voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death and divorce. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. — The U.S. Department of Labor
Question: Our company sponsors a group health plan for its employees. What are the consequences if we fail to comply with COBRA?
If your organization employs seasonal workers or part-timers for the holidays, take note: The IRS has issued a Health Care Tax Tip on how these individuals affect whether your business is subject to the shared responsibility provisions of the Affordable Care Act (ACA).
A major component of the Affordable Care Act is guaranteed preventive care services at no cost to any person with healthcare insurance. At first glance it would appear that free preventive care would include annual wellness exams from the subscriber’s primary care physician along with other yearly checkups at no cost to the subscriber. However further review of this mandate makes it clear that it has a much broader intention.