Posts Currently viewing the tag: "Individual Shared Responsibility"

On Friday, March 24, 2017, the U.S. House of Representatives pulled the American Health Care Act (“AHCA”) from consideration after not receiving enough Republican support to pass the bill. The AHCA was President Trump’s first attempt to repeal and replace the Affordable Care Act (the “ACA”). The AHCA, among other things, would have…(Read More)

Stand-Alone HRAs for Small Employers are Back! The 21st Century Cures Act, signed by President Obama on December 13, 2016, gave small employers a means of providing employees help with their individual insurance premiums and other out-of-pocket qualified medical expenses without violating the provisions of the Affordable Care Act (ACA). Small employers…(Read More)

Update on the Status of the ACA With the impending inauguration, recent actions by the Senate and some confusing media reports, we wanted to provide a short Q&A to help you understand current events and what to expect as we head down the health care reform road in 2017… What’s the latest…(Read More)

New Law Exempts Certain Small Employer HRAs From ACA Market Reforms Gaddiel Gonzalez-Brown & Brown Consulting President Obama has signed into law the 21st Century Cures Act, which, among other things, allows small employers to offer new “qualified small employer health reimbursement arrangements” to reimburse employees for qualified medical expenses, including individual health insurance…(Read More)

    On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To…(Read More)

With the outcome of the 2016 elections now official, the Republicans will hold the majority in both chambers of Congress and control of the White House beginning in 2017. Since President-elect Trump ran on a platform of “Replace and Repeal” of the Affordable Care Act (ACA), we anticipate that acting on this campaign promise…(Read More)

Healtcare Reform Law

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year…(Read More)

Good news: You’ve got health insurance (at least, all Americans are required to or pay a penalty). Bad news: It doesn’t cover everything. Especially if something really bad happens, like a heart attack or stroke. Yes, a decent major medical plan will cover many of the health-related expenses related to a serious…(Read More)

Changes to SEP On-Exchange Verification Process Starting June 17th, 2016 individuals enrolling in coverage through a Special Enrollment Period (SEP) on the Marketplace will need to provide specific documents to verify eligibility for certain SEPs, including: Loss of minimum essential coverage Change in primary place of living Birth Marriage Adoption, placement for adoption, placement…(Read More)

The Affordable Care Act (“ACA”) requires each Health Insurance Marketplace (“Marketplace”) to notify any employer whose employee was determined to be eligible for Advance Premium Tax Credits (“APTC”) and Cost Sharing Reductions (“CSR”) because the employee attested that he or she was not: • enrolled in employer sponsored coverage, or • eligible for employer coverage…(Read More)

  You can request an appeal of any Marketplace decision, including decisions about Your eligibility to buy coverage in the Marketplace Your eligibility for, or the amount of, premium tax credits or cost sharing reductions Your eligibility for an exemption from the penalty for not having health insurance Untimely (late) notice from the Marketplace about…(Read More)

Total Benefit Solutions has partnered with Empower Me Benefits to provide our clients with best in industry benefits technology that’s customizable for even the smallest employer. The EmpowerMe Benefits Exchange allows you to remain complaint with the Affordable Care Act (ACA), easily manage benefits, and control health care costs with a single solution. The…(Read More)

The attached resource file is a compilation of all of our compliance bulletins for 2015 provided by our business partners at Emerson Reid and your benefits support team. Click the link below to download the entire 2015 compilation: 2015 Compliance Compilation   &nbsp…(Read More)

Health Care Reform: Taxes and Fees-PCORI Fee, Transitional Reinsurance Fee, Insurer Fee and Excise Tax   From United Healthcare: Taxes and fees under the health reform law impact both fully insured and self-funded plans. But, they impact funding types differently. Employers with self-funded health plans submit applicable health reform fees directly to…(Read More)

Fraud, Waste & Abuse: did you know? As a nation, we spend over $2.7 trillion on healthcare every year, and it is estimated that tens of billions are lost each year to FWA.  One recent study estimated that fraud and abuse added as much as $98 billion to annual spending on Medicare and Medicaid…(Read More)

Group Health Plan Notices 2015 CALENDAR From our partners at HR360: This calendar/checklist is designed to help companies review the key reporting and notice requirements that may apply to their employer-sponsored group health plans under ERISA , the Affordable cxare Act, Medicare and more. Please note that this list is for general reference purposes…(Read More)

The Affordable Care Act’s Employer Shared Responsibility (ESR) provision — often called “the Employer Mandate” or “Play or Pay” — requires large employers to offer health coverage to their full-time workers or face a potential penalty. Small employers with fewer than 50 full-time and full-time-equivalent employees are exempt. Play or Pay takes…(Read More)

IRS Penalties for Small Employers Reimbursing Individual Health Insurance Premiums Will Not Apply Until July 2015 IRS Notice 2015-17 provides limited transition relief from the assessment of excise taxes for small employers who reimburse, or directly pay, the premium for an employee’s individual health insurance policy. Prohibited Plans An “employer payment plan” is…(Read More)

CMS Announces Special Enrollment Period for Tax Season Contact:    press@cms.hhs.gov   CMS Announces Special Enrollment Period for Tax Season Eligible consumers have from March 15 through April 30 to enroll in coverage The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who…(Read More)

Download our 2014 Compliance Bulletin Compilation, featuring all of our released compliance bulletins for the entire year!  Topics include, Health Savings Accounts, The Individual Mandate, Employer “pay or play” mandate, exemptions, FSA carryovers and much, much more. All of the bulletins are in an easy to search format for your convenience. 2014 Compliance Compilation – Download…(Read More)

On February 24, 2014, the United States Departments of Health and Human Services issued a final rule that addressed the requirement to provide HIPAA Certificates of Creditable Coverage (HIPAA Certificates) under the Affordable Care Act (ACA). As the ACA prohibits pre-existing condition exclusions, the new rule eliminates the requirement to provide HIPAA Certificates beginning…(Read More)

  Previously, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (collectively, the “Departments”) explained that  HRAs and employer payment plans cannot reimburse individual policies. On November 6, the Departments issued their twenty-second set of FAQs which make clear that: An employer cannot offer employees cash to reimburse the purchase…(Read More)

What do you get with Total Benefit Solutions as your Marketplace Navigator? A broker who is Unbiased and objective  Trained Local Certified Licensed Insured Up to date Representing you Part of a team of dedicated professionals Click here for more information and to see our “Marketplace Navigator” brochure: Individual Enrollment Navigator Brochure &nbsp…(Read More)

Two New Election Changes Allowed Existing cafeteria plan rules make it difficult (if not impossible) for participants to revoke pre-tax salary reduction elections mid-year and enroll in qualified health plan coverage through the Health Insurance Marketplace (the “Marketplace,” sometimes referred to as the “Exchange”).  To provide additional flexibility, the IRS issued Notice 2014…(Read More)

Agent and Broker Handling of Federal Tax Information Federal Tax Information (FTI) is classified as confidential and may not be used or disclosed except as expressly authorized by the Internal Revenue Code, which may require written consent of a taxpayer in certain situations. As an agent or broker operating in an Individual Marketplace, it is…(Read More)

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