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IRS Releases Final ACA Reporting Forms for 2016

Oct 20, 2016 10:41:21 AM / by Deborah Hyde posted in ACA, ACA Reporting, hr compliance, IRS, Front Page Post, 2016, Affordable Care Act, Deborah Hyde

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After previously releasing draft versions of the forms in July, the Internal Revenue Service (IRS) released the final versions of the 2016 ACA reporting forms in early October – less than four months out from the first of the two reporting deadlines. Fortunately, the final forms do not differ significantly from the forms used for 2015 reporting. There are, however, some key differences for employers to keep in mind.

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You Received an Exchange Subsidy Notice - Now What?

Sep 13, 2016 10:29:30 AM / by Deborah Hyde posted in ACA, exchange, hr compliance, Front Page Post, Affordable Care Act, appeal, Deborah Hyde, penalties

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In Spring 2016, Exchanges began issuing notices to employers when an employee is determined by the Exchange to be eligible for a health insurance subsidy. This subsidy notice (Notice) is particularly important to Applicable Large Employers (ALEs), but all employers should be prepared to receive a Notice and respond appropriately.

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New IRS Regulations May Minimize the Advantages of Opt-out Arrangements

Aug 22, 2016 11:43:44 AM / by Deborah Hyde posted in ACA, hr compliance, Front Page Post, opt-out, affordability, Affordable Care Act, Deborah Hyde

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On July 8, 2016, the Internal Revenue Service (IRS) released proposed regulations regarding the Affordable Care Act’s (ACA) individual mandate. The proposed regulations also discuss the concept of employer-provided affordable coverage, and highlight the interaction between affordable coverage and an opt-out arrangement. While not final, the regulations provide reliable guidelines for employers who utilize opt-out provisions, as well as employers who are interested in incorporating such an arrangement into their group health plan.

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Making a Good Faith Effort: ACA Reporting in 2015

Nov 6, 2015 7:32:04 AM / by Deborah Hyde posted in ACA, 2015 ACA, ACA Reporting, Front Page Post, 2015 Affordable Care Act, Affordable Care Act, Deborah Hyde

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As employers begin the final countdown to the 2015 Affordable Care Act (ACA) reporting deadlines, an important consideration to keep in mind is the IRS’s assurance that employers who make a good faith effort to comply with the requirements will not be met with filing penalties this first year.  This penalty relief should provide some comfort, but employers may be left wondering exactly what a “good faith effort” entails.  Generally, a good faith effort is one made with honest, sincere intention.  In the context of ACA reporting, how will an employer be able to demonstrate an honest, sincere intention to comply?

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MLR Rebates Require Careful Consideration

Oct 9, 2015 8:46:44 AM / by Deborah Hyde posted in ACA, 2015 ACA, MLR, Front Page Post, Affordable Care Act, Deborah Hyde, ERISA, medical loss ratio, MLR Rebates

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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. This minimum percentage is referred to as “medical loss ratio” (MLR) and is set at 85% for large group market issuers, 80% for issuers in the small group and individual markets. Any issuer that does not meet the MLR standard for a year must provide a rebate to its policyholders. MLR rebates for 2014 were due to policyholders by September 30, 2015.

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ACA Information Center: A Resource For Applicable Large Employers

Sep 28, 2015 9:01:44 AM / by Deborah Hyde posted in ACA, IRS, Front Page Post, ACA Information Center, Affordable Care Act, applicable large employers, Deborah Hyde, large employers

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In an effort to help employers understand the complexities of the Affordable Care Act, the IRS recently rolled out the ACA Information Center for Applicable Large Employers on IRS.gov.

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What the Fund? All about Fully, Partially and Self-Funded Health Plans

Aug 26, 2015 4:11:24 AM / by Kelley Jensen posted in ACA, fully funded plans, Kelley Jensen, partial self-funding, self-funded health plans, Affordable Care Act, benefits CONSULTING, fully-funded health plans, partially funded health plans, self-funded plans, self-insured plans

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What is the difference between fully funded, self-funded and partially funded?

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Autism And Employee Benefits: The Self Insured Gap

Aug 25, 2015 9:02:13 PM / by Kelley Jensen posted in ACA, fully insured plan, Kelley Jensen, self-insured plan, ABA, Affordable Care Act, applied behavior analysis, Autism, autism spectrum disorders, benefits CONSULTING, Employee Retirement Income Security Act, ERISA

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Employers provide health insurance benefits to their employees and families because they want to be competitive with other employers, retain their workforce; and maybe, as a result of the employer mandate portion of the Affordable Care Act, are required to offer health insurance to avoid penalties.

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Calculation to Determine California Small Group Market Eligibility

Jul 7, 2015 11:14:15 PM / by Deborah Hyde posted in ACA, SB125, Affordable Care Act, benefits CONSULTING, California small group market, California Small Group Market Eligibility, Deborah Hyde, small group market, small group plan

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The expansion of the definition of a small group plan from 50 employees to 100 employees is a transition that we’ve all been tackling. Most impacted are employers in the 50-99 employee range who currently participate in the large group market but face a potential squeeze into the small group market – and small group rates – come 2016. Fortunately, we now have a bit more clarity on how employer size will be determined in California for purposes of small group market eligibility.

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