Posts Currently viewing the tag: "Individual Mandate"

    On December 20, 2017, the House and Senate sent President Trump the Tax Cuts and Jobs Act for signature. The House of Representatives passed their version of the bill on November 16, 2017 while the Senate passed their version on December 2, 2017. Because the versions were not identical, a Tax-Bill Conference…(Read More)

  Under the Affordable Care Act, a health reimbursement arrangement (HRA) must be integrated with a group health plan (as it could not meet the market reform provisions on its own) and was not able to reimburse employees for individual premiums. However, on December 13, 2016, President Obama signed into law the “21st Century Cures…(Read More)

The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for calendar year 2018. All limits increased from 2017 amounts. Click to download the bulletin below and as always contact your Total Benefit Solutions account manager at (215)355-2121  if you have any questions…(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)

On December 13, 2016, President Obama signed into law the “21st Century Cures Act” which allows small employers without group medical plans to reimburse individual premiums and other medical expenses of employees under health reimbursement arrangements (“HRAs”), effective with the 2017 plan year, and provides relief from penalties to all small employers reimbursing individual premiums…(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)

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)

The first complaint was filed challenging the permissibility of reducing hours below 30 per week in order to avoid the Employer Penalty. The complaint was filed in a New York district federal court on behalf of 10,000 workers at Dave and Buster’s. The plaintiffs allege that their hours were cut so that Dave…(Read More)

Gov. Wolf this week formally proposed setting up a state-based insurance marketplace, potentially protecting hundreds of thousands of Pennsylvania residents from the consequences of a Supreme Court decision that could gut Obamacare later this month. Read more at Remember that your Total Benefit Solutions professionals are trained, licensed, insured and available to…(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)

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)

Medicaid, CHIP, and the Affordable Care Act The Affordable Care Act significantly streamlines the eligibility standards and enrollment processes for Medicaid. It also offers a new opportunity for states to expand Medicaid to all adults ages 19 – 64 with household MAGI at or below 138% of the FPL. States have the option to expand…(Read More)

Guaranteed Issue and Guaranteed Renewability The Affordable Care Act requires health insurance issuers to offer all of their individual market and group market plans to any applicant in the state. It also requires health insurance issuers to accept any individual who applies for those policies, as long as the applicant agrees to the terms and…(Read More)

Health Reform: Network Adequacy Standards For QHP certification, a plan must have an adequate provider network available to its enrollees. A QHP must: Offer a network with a sufficient number of providers, including mental health and substance abuse providers, to ensure access to all services without unreasonable delay Include a sufficient number and geographic distribution…(Read More)

Special Enrollment Periods Under certain circumstances, individuals may enroll in a QHP or change QHPs outside of the annual open enrollment period. These SEPs are based on certain triggering events or special circumstances. Events that permit an SEP include: Gaining or becoming a dependent through marriage, birth, adoption, placement for adoption, or placement in foster…(Read More)

Individual Shared Responsibility Payment Amounts for 2014 and 2015 Tax Years The amount of the individual shared responsibility payment increases between 2014 and 2015. 2014: The annual individual shared responsibility payment is the greater of 1% of the taxpayer’s household income that is above the tax return filing threshold for the taxpayer’s filing…(Read More)

FMLA Proposed Rules To Recognize Same Sex Regardless of Residency  The DOL is proposing to amend the regulatory definition of  “spouse” under the Family and Medical Leave Act (“FMLA”) so that “spouse” for purposes of FMLA rights would include a same-sex spouse, regardless of where the employee  and spouse live. This means the “place…(Read More)

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…(Read More)

    Updated Model COBRA Election Notice Includes Information Regarding Health Insurance Exchanges Revised Notice Informs Individuals of New Coverage Alternatives A revised Model COBRA Election Notice  is now available for group health plans to inform eligible employees and dependents of the right to continuation of coverage under federal law and how to make an…(Read More)

Please be advised that Independence Blue Cross (IBC) is offering a new portfolio of Dental and Vision Care plans for adults (aged 19 and older) featuring low out-of-pocket costs and access to a large network of providers. These plans will be available for sale online, by phone, and by mail beginning on April…(Read More)

The Affordable Care Act calls for individuals to have qualifying health insurance coverage for each month of the year, have an exemption, or make a shared responsibility payment when filing his or her federal income tax return.   You may be exempt from the requirement to maintain qualifying health insurance coverage, called minimum essential coverage…(Read More)

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