Under the Affordable Care Act, insurance carriers are required to spend a minimum percentage of premium dollars on medical care and health care quality improvement.
A new year brings new employment laws and regulations for employers, and 2018 is no exception for California. A variety of measures were passed on both the State and local levels that will take effect on January 1.
On November 2, the Internal Revenue Service (IRS) issued revised FAQs on the employer shared responsibility provisions under the Affordable Care Act (ACA). Question sets 55-58 now detail the procedure the IRS will use to begin issuing proposed penalty assessments to employers that failed to comply with these provisions in 2015. Though the IRS was previously silent on the details of penalty assessments, this new information serves as a reminder to employers that compliance enforcement is a priority for the IRS.
The Patient Protection and Affordable Care Act (ACA) remains intact after several failed attempts by Congressional Republicans to repeal and replace the law. However, executive action taken throughout the month of October will result in substantive changes to various components of the ACA.
The PCORI Fee Applies to Health Insurance Issuers and Self-funded Health Plans
Under the Affordable Care Act, health insurance issuers and self-funded health plans are required to pay an annual Patient-Centered Outcomes Research Institute fee (PCORI), set to expire in 2019. Because health insurance issuers are subject to this fee, the sponsor of a fully-insured health plan does not need to take any action. However, sponsors of self-funded health plans are obligated to comply. Payment of the PCORI fee must be submitted to the IRS no later than Monday, August 1, 2016.
Employers are dedicating much time and energy ensuring compliance with the multitude of new requirements imposed by the Affordable Care Act (ACA) - understandably so. ACA compliance is uncharted territory, and miscalculations carry the potential for stiff financial penalties. However, employers should take care to remain focused on overall plan compliance, specifically ERISA regulation, as the attention on employer-sponsored group health plans from various federal agencies will only increase.