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IRS Issues Notice Setting Adjusted Applicable Dollar Amount for PCOR Fee at $2.08

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Category: Compliance and Regulatory, Health Reimbursement Arrangements, HRA,

On Sept. 18, 2014, the IRS published Notice 2014-56, setting the applicable dollar amount for plan years that end on or after Oct. 1, 2014, and before Oct. 1, 2015. As a reminder, the PCOR fee is calculated using the average number of lives covered under the plan and the applicable dollar amount for that plan year. The applicable dollar amount is $2 for plan years ending after Oct. 1, 2013, and before Oct. 1, 2014. Notice 2014-56 announces that the applicable dollar amount for plan years that end on or after Oct. 1, 2014, and before Oct. 1, 2015, is $2.08. For plan years ending on or after Oct. 1, 2015, the adjusted applicable dollar amount will be published in future Internal Revenue Bulletin guidance.

With respect to payment responsibility, if a plan is fully insured, then the insurance carrier is responsible for paying the fee. If a plan is self-insured, the plan sponsor is responsible for the fee. For this purpose, “plan sponsor” is defined as the employer for a single employer plan.

IRS Notice 2014-56

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New Optional Section 125 Midyear Qualifying Events Released by IRS

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Category: Compliance and Regulatory, Flexible Spending, Section 125 Plans,

On Sept. 18, 2014, the IRS published Notice 2014-55, which creates two new Section 125 midyear qualifying events. The two new events apply in very specific situations and – like all Section 125 events – are optional. Employers who wish to include these new Section 125 qualifying events as options in their plan design need to amend the plan document accordingly.

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ABG Nominated for The IHC Superstar Awards

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Category: CDHC,

The Institute for HealthCare Consumerism (IHC) Superstar Category

  • Most Effective Solution Provider Award – American Benefits Group

Nominee's Company

  • American Benefits Group (Bob Cummings, Managing Principal)

Nominee's email address

Why should this person be a Superstar? 

American Benefits Group is a top national TPA  that began its life as a pioneer of FSAs in the 1980s. Today the firm provides administrative services for all account based pre-tax plans including HSAs, commuter benefits, FSAs and HRAs for over 650 employers nationwide, including a large number of leading Wall Street financial firms, Main Street America and a few well known public companies.

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Compliance Update

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Category: Compliance and Regulatory, HCSO,

The San Francisco Board of Supervisors passed an amendment to the Health Care Security Ordinance on June 17,
2014. The amendment phases in (over 3 years) a requirement that all heath care expenditures be made irrevocably and makes other changes to the HCSO. For more information, see the HCSO amendment as passed.

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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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One-Time Special Enrollment for COBRA participants

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Category: COBRA, Compliance and Regulatory,

On May 2, 2014, the Centers for Medicare and Medicaid Services (part of HHS) issued a bulletin to deal with Special Enrollment Periods (SEPs).

HHS is concerned that former Model COBRA Continuation Coverage Election Notices (Model Election Notices) published by the Department of Labor and other documents provided by employers did not address, or did not sufficiently address, Marketplace options for persons eligible for COBRA.

The concern? Persons eligible for COBRA and their qualified beneficiaries may have had insufficient information to understand that they cannot voluntarily drop COBRA and enroll in the Marketplace outside of Marketplace open enrollment.

As a result, in accordance with 45 CFR 155.420(d)(9), HHS is providing an additional special enrollment period based on exceptional circumstances so that persons eligible for COBRA and COBRA beneficiaries are able to select Qualified Health Plans (QHPs) in the Federally Facilitated Marketplace (www.healthcare.gov).

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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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CMS Issues Guidance Related to COBRA Coverage and Exchange Eligibility

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Category: COBRA, Compliance and Regulatory,

On April 21, 2014, CMS issued guidance, in the form of a frequently asked question (FAQ), clarifying how COBRA coverage impacts an individual's eligibility to enroll in the exchange and to receive a premium tax credit. As background, the open enrollment period for almost all exchanges ended March 31, 2014. Individuals may only enroll in the exchange midyear if they qualify for a special enrollment period due to a qualifying event. The FAQ clarifies that during the open enrollment period for the exchange, an individual who has voluntarily terminated his/her COBRA coverage (i.e., COBRA coverage has not been exhausted) will be eligible to enroll in a qualified health plan through the exchange.

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SB1339 Bay Area Commuter Benefits is Official

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Category: Transit, Transit and Parking Section 132,

San Francisco recently took a major step in helping both its hard-working citizens and the environment. On March 26, 2014, the SB 1339 Bay Area Commuter Benefits Program became official. Now the Bay Area Air District and the Metropolitan Transportation Commission (MTC) will be working together with their regional Bay Area commuter policy, which mandates that all employers with 50 or more full-time employees, offer commuter benefits to both full-time workers and those that work at least 20 hours a week. Employers have until September 30, 2014, to comply with the SB 1339 Bay Area Commuter Benefits Program.

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San Francisco Bay Area Passes Regional Commuter Benefit Legislation

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Category: Transit and Parking Section 132,

Achieving lower commuting costs and climate protection without raising taxes.

March 26, 2014 - (Boston, MA) Today, the Metropolitan Transportation Commission approved Regulation 14 Rule 1 of the Bay Area Air Quality Management District, which requires a commuter benefit program to be in place for all employers that have 50 or more full-time employees in the nine-county Bay Area. This regulation is a result of SB 1339, which was signed into law by Governor Brown, requiring a pilot project to be in effect until January 2017. According to the text of the bill, SB 1339, the state believes that by requiring large employers to offer commuter benefit programs, it will encourage greater use of mass transit and vanpools. For those employees who already commute to work using mass transit, it will offer them significant tax savings. Participating employers will also reduce their tax burden. Employers will have until September 30, 2014, to comply with this regulation.

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Treasury Department Delays ACA Employer Mandate for Certain Employers

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Category: Compliance and Regulatory,

Treasury Department Delays Affordable Care Act (ACA) Employer Mandate Until 2016 for Employers with 50-99 Employees that Do Not Yet Provide Affordable Insurance to Full Time Workers

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Defined Contribution: Finding Certainty in Employer Benefits

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Category: Health Savings, HSA,

How employers can stay competitive… and retain talent

“Uncertainty” is not likely to warm the hearts of many CFOs and Finance VPs, and perhaps no aspect of corporate administration has a higher level of uncertainty than healthcare and benefits. As with pension plans, the administration of defined benefit health plans is best suited to those with a defiantly optimistic view of business trends or to companies certain that they will experience year-over-year gains to fund defined benefits indefinitely.

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Important Information About Your Commuter Benefits

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Category: Commuter, Parking, Section 125 Plans, Transit,

Qualified Transportation Fringe Benefits. For 2014, the monthly limit on the amount that may be excluded from an employee’s income for qualified parking benefits is $250 (a $5 increase from the 2013 limit of $245). The combined monthly limit for transit passes and vanpooling expenses for 2014 is $130 (a $115 decrease from the 2013 limit). [EBIA Comment: The substantial decrease is due to expiration of the temporary “rule of parity” that made the combined limit for transit and vanpooling the same as the parking limit for 2012 and 2013. Whether Congress will eventually extend the rule of parity to 2014 is uncertain.]

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An Important Announcement Regarding FSA Policy

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Category: Flexible Spending, FSA, IRS,

Moments ago, the Department of Treasury issued a press release and informational fact sheet announcing a major policy change relating to flexible spending accounts (FSAs) that has many positive implications for all FSA constituents – including administrators, employers and participants.  The Department of Treasury has modified its FSA “use-it-or-lose-it” provision to allow a limited rollover of FSA funds.

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