U.S. Supreme Court Contraceptive Ruling

In a 5-4 decision that was described by one of the dissenting Justices as a “decision of startling breadth”, the Supreme Court has ruled in Burwell v. Hobby Lobby Stores, Inc. that closely held for-profit corporations are not compelled to provide contraceptive coverage under the Affordable Care Act’s preventive care mandate if they object to that coverage on religious grounds. The decision is a “win” for Hobby Lobby who had challenged the contraceptive mandate saying it forced them to either violate their faith or pay fines.   Click here to download the bulletin

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What is Critical Illness Insurance?

Why Critical Illness as a “wrap” plan Because: They’re more affordable than you might think. They’re available for employer  groups, individuals and seniors. They make selecting a health plan easier. They provide peace of mind against a catastrophic event and large out of pocket expenses. They’re person and portable, it doesn’t matter where you get your health insurance from, having your own critical illness plan makes it better. Many clients have asked how they can supplement their employees coverage when they get enrolled through the affordable care act healthcare.gov marketplace. Employers are permitted to offer wrap plans that consist of “excepted benefits”, meaning they are not regulated by the affordable… Read More

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New Guidance on Cost Sharing Limits under Health Care Reform

The three agencies responsible for the implementation of health care reform (Treasury, Health and Human Services, and Labor) released a joint set of Frequently Asked Questions on cost sharing limits. Health care reform places a limit on the dollar amount of out-of-pocket expenses that a participant may be charged in a year. In 2014, that limit is $6,350 for self-only coverage and $12,700 for other coverage. In 2015, the limit increases to $6,600 for self-only coverage and $13,200 for other coverage. The guidance clarifies that if an out-of-network provider charges an amount greater than the amount allowed by the plan (i.e., balance bills the amount above the usual and customary… Read More

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IRS Highlights Stiff Penalty for Reimbursing Individual Premiums

From Health Care Reform Digest: Since the IRS and Treasury published Notice 2013-54 in September 2013, pre-tax employer reimbursement of an employee’s individual health insurance premiums has been a hot topic of conversation.  Historically, many employers have provided this type of benefit in lieu of offering a group health plan – a strategy that now needs to be reevaluated as a result of regulations implementing the Patient Protection and Affordable Care Act (PPACA).   Q1.  What are the consequences to the employer if the employer does not establish a health insurance plan for its own employees, but reimburses those employees for premiums they pay for health insurance (either through a qualified health… Read More

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SAME SEX MARRIAGE PA COURT DECISION

Prepared by Vince Phillips, PAHU Lobbyist May 22, 2014 On May 20, 2014, Federal Judge John Jones III issued a landmark ruling in Whitewood et al vs. Michael Wolf (Commonwealth of PA) that struck down Pennsylvania’s 1996 Marriage Law specifying that a marriage is defined as being between a man and a woman. The ruling also forced PA to recognize same-sex marriages conducted in other states. On May 21, Governor Corbett said that although as a Catholic, he disagreed with the ruling, he would not appeal it. The ruling is effective immediately but an unanswered question is effective date for employer-offered health plans. Is it now? Is it a month… Read More

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Comparative Effectiveness Fee Reminder

The Comparative Effectiveness Research Fee is now known as the Patient-Centered Outcomes Research Institute (PCORI) Fee. The Patient Protection and Affordable Care Act (the Act) imposes a new Patient-Centered Outcomes Research Institute (PCORI) fee, formerly the comparative effectiveness research fee, on plan sponsors and issuers of individual and group policies. The first year of the fee is $1 per covered life per year, the second year the fee adjusts to $2 per covered life and then it’s indexed to national health expenditures thereafter until it ends in 2019. Click here to download this bulleting regarding the timely payment of the fees.   Purpose of the Fee The assessed fees are to… Read More

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19th Set of FAQ’s Released on Affordable Care Act

Frequently asked questions (“FAQs”), prepared jointly by the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and the Treasury (collectively, the “Departments”),were issued with respect to various Affordable Care Act (“ACA”) requirements, including their effect on COBRA and CHIPRA notices…Topics Include:   Updated COBRA And CHIPRA Notices Out-Of-Pocket Maximum Requirements Generic Drugs Balance Billing Reference-Based Pricing Coverage Of Preventive Services Health FSA Carryover And Excepted Benefits Effect of Carryover on Excepted Benefits Determination Summary Of Benefits And Coverage   Click here to download the bulletin from our partners at Emerson Reid.  

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Nuts and Bolts of the Small Employer Tax Credit

This presentation is intended to convey general information about the employer health care tax credit under the affordable care act and is not an exhaustive analysis. Information contained in this presentation may change as guidance develops. Total Benefit Solutions inc and  Emerson Reid do not provide legal or tax advice. For advice specific to your situation, please consult an attorney or other professional.   Click here to download “nuts and bolts” Download Small Business Health Care Tax Credit FAQ’sFAQs

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Informal Guidance Clarifies Rules HSA Eligibility and Health FSA Carryovers

Near the end of 2013, the IRS issued Notice 2013-47 that permits a cafeteria plan to provide for the use of up to $500 of any unused amount remaining in the health FSA in the immediately following plan year (the “carryover” provision). This provision is optional, requires a plan amendment, and cannot be offered if the cafeteria plan allows a grace period. One of the outstanding questions around the carryover provision is the effect it has on HSA eligibility. Recently, the Office of Chief Counsel for the Internal Revenue Service issued a memorandum that informally addresses the interaction of the carryover on HSA eligibility and provides some solutions that may allow an individual retain… Read More

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IRS: HSA Contributions and limits for 2015 Released

The IRS has released the 2015 cost-of-living adjustments affecting HSAs and HDHPs. The 2015 IRS HSA limits are increasing for 2015. Click to download the bulletin

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