Employers: Watch for Notices Coming from Health Care Exchanges

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

Intermittent FMLA Leave and Employee Health Coverage

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?

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Does COBRA Still Matter Post ACA?

A lot has happened over the past few years. The Affordable Care COBRAAct, 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:

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What Happens If There is a Breakdown of COBRA Compliance?

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.

COBRA Basics
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?

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Seasonal Workers and the ACA Shared Responsibility Penalty

If your organization employs seasonal workers o1428638_61478545r 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).
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Preventive Care and Prescriptions Under The Affordable Care Act

addiction-71574_1280A 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.

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Small Employers Get Reprieve on Health Premium Reimbursement Plans

business-world-541431_1280Historically, employers that wanted their employees to be protected with health coverage, but didn’t want the hassle of having a company health plan, could simply give them an amount of money sufficient to reimburse them for the cost of buying that coverage or some portion of it.  As long as the individuals provided evidence that they used those funds for that purpose, the dollars were excludable from taxable income for the employees.

Alternatively, employers could just pay the premiums directly to the insurance carrier.

Back in November 2014, however, the Department of Labor (DOL) declared that companies reimbursing employees for medical care instead of offering a health care plan is equivalent to a health plan and is subject to the Affordable Care Act (ACA).  And since those reimbursement arrangements failed to meet ACA requirements in two ways — that is, the condition that group health plans have no annual limits on benefits, and also that no co-pay for certain preventive health services must be paid — they were ruled to be noncompliant with the law.

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