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IRS Issues FAQs relating to PPACA Informational Reporting under Sections 6055 and 6056

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Category: Health Reimbursement Arrangements, PPACA,

On Sept. 22, 2014, the IRS released two sets of FAQs discussing the informational reporting requirements under Internal Revenue Code Sections 6055 and 6056. Section 6055 requires employers that sponsor self-insured plans to report specific information to the IRS and to plan participants which will assist the IRS in administering and enforcing the individual mandate. 

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Premium Tax Credits at Risk After Circuit Split

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Category: ACA, IRS, PPACA,

Two federal appeals courts issued conflicting rulings on a key provision of the Patient Protection and Affordable Care Act (PPACA) relating to the availability of premium tax credits and cost-sharing subsidies on the federally facilitated exchanges. First, the U.S. Court of Appeals for the D.C. Circuit, in Halbig v. Burwell, overturned this provision, stating that PPACA does not authorize the Internal Revenue Service (IRS) to provide premium tax credits and cost-sharing subsidies for insurance purchased on the federally facilitated exchanges (as the law does for insurance purchased on state-established exchanges). Shortly thereafter, the U.S. Court of Appeals for the Fourth Circuit, in King v. Burwell, upheld the same PPACA provision, stating that PPACA does authorize the IRS to provide premium tax credits and cost-sharing subsidies on federally facilitated exchanges. Parties in both cases plan to appeal the rulings, and the cases appear to be headed to the U.S. Supreme Court, particularly with the circuit split.

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Patient Centered Outcomes Research Institute (PCOR)

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Category: Health Reimbursement Arrangements, HRA, PCOR, PPACA,

Under health care reform (PPACA), a new nonprofit corporation was established, the Patient Centered Outcomes Research Institute (PCOR).  This corporation will be funded in part by PCOR/CER (comparative effectiveness research) fees paid by certain health insurance issuers or plan sponsors of applicable self-insured health plans.  Please note that Health reimbursement Arrangements (HRA) are categorized as a self-insured health plans unless, in rare occasions, it is determined to be an excepted benefit (i.e. for vision and dental expenses only) and are therefore subject to this fee.

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DOL Releases Proposed Guidance Affecting COBRA Model Notices

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Category: COBRA, DOL, PPACA,

On May 2, 2014, EBSA released an advanced copy of proposed rulemaking, which will be published in the May 7, 2014, Federal Register. The guidance amends notice requirements for COBRA so as to better align PPACA and COBRA notice requirements and to add information relating to special enrollment rights in the state health insurance exchanges.

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Important Affordable Care Act Deadline: Employee Notices of the Health Insurance Marketplace (Exchange) Due by October 1, 2013 (copy)

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Category: CDHC, COBRA, Compliance and Regulatory, DOL, Health Care Reform, IRS, PPACA, Taxes,

On May 8, 2013, the Employee Benefits Security Administration of the U.S. Department of Labor (“DOL”) issued Technical Release No. 2013-02 (“Release”) providing important guidance under the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (“Affordable Care Act”), with regard to the requirement that employers provide notices to their employees of the existence of the Health Insurance Marketplace (“Marketplace”), previously referred to as the “Exchange.”

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What To Do Now? Re-forming What We Know About Health Care Reform

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Category: CDHC, Compliance and Regulatory, DOL, Health Care Reform, PPACA,

By Justyn Harkin, Communications Specialist, The Jellyvision Lab

Wow, did someone get the license number from that truck? My head is spinning. I mean, one moment I was just minding my own business, peacefully thinking about clever ways to explain coverage options to employees, and the next—major changes to key provisions of the ACA!

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ACA Employer Mandate is Delayed Until 2015

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Category: CDHC, Compliance and Regulatory, DOL, ERISA, Health Care Reform, HHS, PPACA, Taxes,

The Affordable Care Act (ACA) employer mandate provision has been delayed until 2015. This news was announced July 2, 2013 by the ​US Department of the Treasury on behalf of the Administration.

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Important Affordable Care Act Deadline: Employee Notices of the Health Insurance Marketplace (Exchange) Due by October 1, 2013

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Category: CDHC, COBRA, Compliance and Regulatory, DOL, Health Care Reform, IRS, PPACA, Taxes,

On May 8, 2013, the Employee Benefits Security Administration of the U.S. Department of Labor (“DOL”) issued Technical Release No. 2013-02 (“Release”) providing important guidance under the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (“Affordable Care Act”), with regard to the requirement that employers provide notices to their employees of the existence of the Health Insurance Marketplace (“Marketplace”), previously referred to as the “Exchange.”

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DOL Releases Model Notice and Guidance on PPACA’s Exchange Notice Requirement

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Category: Compliance and Regulatory, DOL, Health Care Reform, PPACA,

On May 8, 2013, the DOL issued Technical Release No. 2013-02, which includes temporary guidance and a model notice relating to the notice to employees of coverage option (known as the “Exchange Notice”) requirement under PPACA. As background, PPACA requires employers subject to the FLSA to provide each employee with a written notice that describes information about the state health insurance exchanges (also referred to as “marketplaces”), including the availability of premium tax credits and the implications relating to purchasing coverage through the exchanges.

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The ACA – What you need to do NOW

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Category: CDHC, Compliance and Regulatory, DOL, ERISA, Health Care Reform, IRS, PPACA, Taxes,

By Robert J. Lowe

The Patient Protection and Affordable Care Act includes many requirements applicable to employer group health plans. Some of these requirements are already effective but some of the most significant requirements will become effective in 2014. Employers should now be considering what they need to do to comply with ACA requirements that will become effective in 2014.

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Clarification by Treasury and IRS Relaxes Election Change Rules

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Category: Cafeteria Plans, CDHC, Compliance and Regulatory, Health Care Reform, HHS, IRS, PPACA, Section 125 Plans,

So employers and employees can take advantage of the health insurance Exchanges starting January 1, 2014, regulators issued some exceptions to the permitted election changes rule for cafeteria plans.

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ObamaCare signals big role for Health Savings Accounts


Category: CDHC, Compliance and Regulatory, Health Care Reform, Health Savings, Health Savings, HSA, IRS, PPACA, Taxes,

contributed by: Dan Perrin, Executive Director of the HSA Coalition

Despite getting clobbered in the fiscal cliff negotiations, Republicans have something to celebrate this year - the survival of health savings accounts, or HSAs. They had feared

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Consumer Engagement Is The New Healthcare Reality


Category: Cafeteria Plans, CDHC, Flexible Spending, FSA, Health Care Reform, Health Reimbursement, Health Savings, HRA, HSA, PPACA, Section 125 Plans,

Every so often it seems another round of surveys is released demonstrating the strong, continual growth of the consumer-directed health care (CDHC) market and the accompanying behavioral shift in how Americans approach buying health care. This month has

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Who is Eligible for New Health Insurance Premium Tax Credits?


Category: Compliance and Regulatory, Health Care Reform, IRS, Medicare, PPACA, Taxes,

What premium tax credits and cost-sharing subsidies are available to individuals in 2014 and who is eligible for them?

To assist individuals and families who do not qualify for Medicare or Medicaid and are not offered affordable health coverage by their employers, a refundable tax credit (the “premium tax credit”) and a cost sharing subsidy will be available beginning in 2014 to help pay for insurance purchased through an Exchange.

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