ACA Times

SEPTEMBER 15, 2022

ACA open enrollment for the 2023 plan year is just over a month away, and this time, individuals may have more options and a better experience than years prior. We…. The post Upcoming ACA Open Enrollment Shaping Up To Be Strongest Yet first appeared on The ACA Times.

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ACA Times

AUGUST 11, 2022

Trends to eliminate discrimination in all facets of the workplace continue to take hold across the country. Health and Human Services (HHS) is the latest government agency to make this…. The post HHS Proposes Rule to Bolster ACA’s Section 1557 first appeared on The ACA Times.

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ACA Times

JULY 19, 2022

Now that we’ve cleared the 2022 halfway mark, it appears the IRS is on track to hit its goal of clearing the historic backlog by the end of the year.…. The post IRS Now Issuing Letter 5699 For 2020 Tax Year first appeared on The ACA Times.

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ACA Times

FEBRUARY 22, 2022

This coming Monday, February 28, is the deadline for paper filing ACA Forms 1094-C and 1095-C to the IRS for the 2021 tax year. As a reminder, Applicable Large Employers (ALEs) with fewer than 250 1095-C forms can opt for the paper filing option for satisfying their ACA reporting requirements. If you’re paper filing your ACA information for the 2021 tax year and looking to make the deadline next week, then your filings should be in the mail already.

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ACA Times

FEBRUARY 9, 2022

The IRS is experiencing a massive mail backlog of unprocessed documents first caused by COVID-19. Included in that backlog of notices are ACA penalty assessments. To help the situation, the agency said it would be reassigning 1,200 employees to assist with the 2021 tax season distribution, which at the onset only compounded the backlog, making a bad situation worse. .

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ACA Times

DECEMBER 20, 2021

On December 9, 2021, the IRS published the final ACA reporting instructions for the 2021 tax year , including the final 1094-C and 1095-C forms. As expected, the forms and instructions are nearly identical to the draft forms released in July. Below we’ve covered what you need to know about the final ACA reporting instructions for the 2021 tax year. Two new codes for Line 14 of the 1095-C.

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ACA Times

DECEMBER 9, 2021

Employers preparing for a smooth 2021 filing season should keep in mind the important ACA deadlines to avoid IRS penalties. Every year, Applicable Large Employers (ALES) must file and furnish their ACA information to the IRS as required by the ACA’s Employer Mandate. Under the ACA’s Employer Mandate , ALEs, or employers with 50 or more full-time employees and full-time equivalent employees must: Offer Minimum Essential Coverage (MEC) to at least 95% of their full-time employees (and their depend

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ACA Times

SEPTEMBER 7, 2021

The Department of Health and Human Services (HHS) recently made available an FAQ specifying the cost-sharing reduction limits (CSR) for the 2022 tax year. In the FAQ , the HHS makes clear that the maximum out-of-pocket limit for plans beginning on or after January 1, 2022, will be $8,700 for self-only coverage and $17,400 for coverage beyond self-only. .

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ACA Times

AUGUST 17, 2021

The IRS recently issued a notice that further clarifies the usage of Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage as amended via the American Rescue Plan (ARP). IRS Notice 2021-46 expands on 2021-31 and identifies several parameters around COBRA continuation coverage in a question and answers format. Before diving into the specifics, it’s important to note how the ARP created changes to COBRA coverage for select individuals.

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ACA Times

JULY 28, 2021

Earlier this year the IRS released final regulations regarding the relationship between Employer Shared Responsibility Provisions (ESRP) and individual coverage Health Reimbursement Arrangements (HRAs). And then they were withdrawn by the Biden administration for review. In this piece, we will dive into what the regulations clarify and how employers should proceed.

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ACA Times

MAY 21, 2015

The IRS has issued an explanation of how companies can determine if they are an ”applicable large employer” or ALE, and how that affects their obligations under the Affordable Care Act. Some provisions of the ACA apply only to ALEs, which are generally those with 50 or more full-time or full-time equivalent employees. These employers are subject to the employer shared responsibility provisions and to the annual employer information return provisions.

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ACA Times

MAY 26, 2015

Almost one out of four American adults, or 31 million people, were underinsured in 2014, a study found. High deductibles or out–pocket costs made medical coverage unaffordable for many, and left others burdened by debt. Data drawn from the Commonwealth Fund Biennial Survey found that half (51%) of underinsured adults reported problems with medical bills, and more than two five (44%) reported they avoided getting needed medical care because of cost.

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ACA Times

MAY 27, 2015

Although some insurance companies had expected the Affordable Care Act to create operational problems, an industry study found that the financial and administrative performance of payers actually improved for plans offered on the federal and state exchanges and in Medicaid expansion states. However, doctors and hospitals continue to have relatively low levels of trust in insurers, the study found.

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ACA Times

MAY 28, 2015

The Department of and Human Services announced awards of $112 million regional cooperatives about 5,000 primary physicians in 12 states, aimed at improving the heart health of their nearly 8 million patients and preventing heart attacks and stroke. Heart disease is the leading cause of death for men and women in the United States. The program, called EvidenceNOW : Advancing Heart in Primary Care, will help primary care practices in urban and rural communities.

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ACA Times

JUNE 2, 2015

Companies seem to have enjoyed excellent financial during the Act’s first year implementation, despite being forbidden by the law to turn down individuals with pre-existing medical conditions or charge them higher premiums. According to a study by the Kaiser Family Foundation , a key company profitability known as the “medical loss ratio” will range from 81% to 87% for policies for 2014 when all the figures (which are reported to state regulators) are available.

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ACA Times

JUNE 3, 2015

Click image to enlarge. The CVS Health pharmacy chain will carry information about healthcare and preventative services, by the U.S. Department and Human Services (HHS), the company’s MinuteClinic.com and CVS.com websites. CVS is using technology developed by HHS to support the Act’s efforts to shift the focus healthcare from treatment to prevention.

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ACA Times

JUNE 3, 2015

Officials from at least 16 states met in early May for a confidential, unannounced meeting to discuss options available to their states if the Supreme Court rules against the Obama administration in the King v. Burwell case. The Wall Street Journal disclosed the meeting. According to reporters Louise Radnofsky and Stephanie Armour, the officials concluded they would have no practical way to respond to a ruling that would strike down subsidies in the 34 states that do not operate their own health

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ACA Times

JUNE 5, 2015

The House Ways and Means Committee approved H.R. 160, which would repeal the 2.3% excise tax on medical device manufacturers imposed under the Affordable Care Act and intended to help cover some of the costs of the law. The bill is expected to be considered soon by the full House. “It’s an iron law of economics that when you tax something, you tax something, you get less of it, so we’ve really got our wires crossed here,” Committee Chair Rep.

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ACA Times

JUNE 8, 2015

Unpaid bills, better known as “bad debt,” declined at non-profit hospitals in states that expanded during 2014, according to a study by Moody’s Investors. Hospitals in the 29 states and Washington, D.C. that expanded experienced an average reduction in bad debt 13%. The reduction was over 40% in some cases. Hospitals in expansion states also benefited from having to provide less charity , when voluntarily waive charges for medical services.

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ACA Times

JUNE 9, 2015

The decision by 22 states not to expand Medicaid under the will ACA will result in 5,200 avoidable deaths each year, according to a White House Report, along with hundreds of thousands of Americans not receiving needed medical care and health screenings such as cholesterol tests, mammograms and pap smears. The 44-page report “Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid,” details the medical and economic benefits that would result if the 22 state followed the

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ACA Times

JUNE 9, 2015

A Republican Congressman has introduced to help individuals who would lose their insurance subsidies if the Supreme Court rules in favour of the plaintiffs in the “King v. Burwell” case. A verdict in the case, which challenges the administration’s ability to provide Affordable Care Act subsidies in states that do not operate their own healthcare exchanges or online marketplaces, is expected to be announced at the end of June.

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ACA Times

JUNE 12, 2015

By a margin of 55% to 38%, Americans believe the Supreme Court should not block federal subsidies in the states that do not operate their own health insurance exchange, an ABC-Washington Post poll found. The The Affordable Care Act subsidies to low-income consumers are the subject of the King v. Burwell case now before the high court. A decision is expected by the end of June.

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ACA Times

JUNE 15, 2015

Nearly three-quarters of the public (73%) think prescription drugs costs are unreasonable, and place the blame on pharmaceutical companies rather than health insurance companies, a Kaiser Foundation poll found. Asked for their views about why drugs are expensive, 77% of the public cited drug company profits, while 64% said the cause was the cost of medical research, 54% said the cost of advertising and marketing, and 49% said it was the result of lawsuits against pharmaceutical companies.

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ACA Times

JUNE 17, 2015

The Internal Revenue Service issued revised regulations regarding the Summary of Benefits and Coverage (SBC) that must be provided to those covered by health insurance plans. The SBC is intended to help individuals better understand their health coverage and to compare their plan with other coverage options. For group insurance plans, such as employer-sponsored health insurance, the insurer provides the SBC to the employer for distribution to employees.

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ACA Times

JUNE 18, 2015

The federal agencies that regulate the Act issued a set Frequently Asked Questions (FAQ) to clarify the limits on cost-sharing under the ACA. For plan years beginning in 2016, the maximum annual limit on cost-sharing for all individuals is $6,850, regardless whether the is covered under a self-only plan or a plan that also covers others, such as a family plan or a plus-one plan.

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ACA Times

JUNE 24, 2015

A repeal of the Affordable Care Act would increase the federal deficit by $353 billion over the next 10 years, according to a report by the Congressional Budget Office and the staff of the Joint Committee on Taxation. Repealing the ACA would also increase the number of people without health insurance by about 19 million in 2016, rising to about 24 million in 2020 and afterward, according to the CBO.

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ACA Times

JUNE 25, 2015

In a 6-3 decision, the Supreme Court ruled on June 25 th that it is legal for government subsidies under the Affordable Care Act to be available to all Americans, as the Obama administration had argued. [ The full text of the ‘King’ ruling, and the dissent, is available here. ]. Plaintiffs in the landmark King v. Burwell case had argued that the subsidies should only be given to residents of states that had “established” their own exchanges or online markets for health insurance, as

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ACA Times

JUNE 25, 2015

The changes to America’s health care delivery system introduced by the Affordable Care Act are causing some of the nation’s largest health insurance companies to explore merger talks with competitors. The ACA is likely to lead to “consolidation on a huge scale,” according to Andrew Ross Sorkin of the New York Times. Anthem, Inc. has made a merger bid for Cigna Corp., Aetna, Inc. is in discussions with Humana Inc., and UnitedHealth Group Inc. has “made overtures” to Cigna, writes Sorkin, a highly

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ACA Times

JUNE 29, 2015

Now that the Supreme Court has ruled in favor of the administration’s position in the ‘King v. Burwell’ case, supporting the legality of Affordable Care Act subsidies in all states, residents and legislators in states that have declined to expand Medicaid coverage are pondering what that ruling means to them. Drafters of the ACA assumed all states would take advantage of the law’s offer to cover most or all of the cost of expanding Medicaid coverage to include all Americans whose income was belo

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ACA Times

JULY 2, 2015

Information is now available online for 11.4 million financial transactions paid by drug and medical device suppliers to 600,000 physicians and 1,100 teaching hospitals. The payments total $6.49 billion. The data, gathered in 2014, was published by The Centers for Medicare & Medicaid Services (CMS) as part of its Open Payments program, and can be downloaded or searched online.

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ACA Times

JULY 2, 2015

The Affordable Care Act’s requirement that insurers offer coverage to everyone, including those with serious pre-existing medical expenses, has not resulted in a surge of hight-cost claims. The federal agency that reinsurers commercial insurers against claims between $45,000 and $250,000 said that the number of such claims was lower than expected. As a result, it will cover 100% of the claims, rather than the 80% it could have paid if expenses had exceeded projections.

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ACA Times

JULY 3, 2015

The US Court of Appeals has denied a religious college’s request to bar the government from enforcing the Affordable Care Act’s requirement that insurance plans cover the cost of all legal forms of contraception. Wheaton College, a nondenominational evangelical Christian college in Illinois, had sought an injunction that would have the effect of blocking coverage for interuterine devices (IUDs) and medications that prevent a fertilized ovum from implanting in the uterine wall.

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ACA Times

JULY 7, 2015

Penalties in sections of the Internal Revenue Code relating to the failure to timely file correct and complete information in a return as well as the failure to timely distribute correct and complete statements were substantially increased – by up to 150% – with the passage on June 29 of the Trade Preferences Extension Act of 2015 (“TPE Act”). The penalties are related to IRC Sections 6721 and 6722.

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ACA Times

JULY 9, 2015

Despite the Affordable Care Act’s success in getting 16 million more Americans enrolled in health insurance programs, major hurdles still keep consumers from understanding their coverage, finding a doctor and accessing care, according to a study by RAND Corp. Many of the newly insured don’t understand the coverage and benefits offered by their plans or such unfamiliar terms as “copays,” “coinsurance,” and “network,” the study found.

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ACA Times

JULY 9, 2015

Time’s Up on Premium Reimbursement. The IRS has taken a hard position on employer payment plans under the ACA, and now the time is up for small employers to comply. Pre-tax employer plan arrangements do not satisfy the ACA reform mandates, and employers that continue to offer an employment payment plan staff stiff penalties, says attorney Christopher Allessee.

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ACA Times

JULY 13, 2015

Impac t of ‘King’ on Applicable Large Employers. The Supreme Court’s decision in ‘King v. Burwell’ had ramifications for “applicable large employers” that went beyond approving payment of insurance subsidies in all states. For companies with 50 or more full-time workers, says attorney Alden Bianchi. The decision “puts an end to any hope for a reprieve from assessable payments under the ACA’s employer shared responsibility rules for employers whose

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ACA Times

JULY 14, 2015

The Obama administration has unveiled new rules aiming to address religious objections by to providing birth control to female employees as required by the Act. The change allows some to opt out providing birth control as preventive at no to workers. The employees would still receive the services directly from the ’s company. Neither the employees nor the company will be charged.

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