Paying Premiums for Individual Health Insurance Policies

Under PPACA, how are premiums paid to employees for purchase of individual health insurance policies treated?  That is a question many employers are now facing.

Based on guidance from the IRS, money paid to employees for purchase of an individual health plan must now be on an after-tax basis.  Group coverage may still continue to be on a pre-tax basis.

The brief below also has information on HRAs and Cafeteria Plans.

Paying Premiums for Individual Health Insurance Policies

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Pay or Play Penalty—Dependent Coverage Requirement

On May 13, 2014, the Internal Revenue Service released FAQs addressing the consequences under the employer shared responsibility rules for applicable large employers that offer health insurance coverage to all full-time employees, but do not offer dependent coverage.

An ALE will not be subject to an employer shared responsibility penalty solely because one, some or all of the dependents of its full-time employees receive health insurance coverage through an Exchange and receive a subsidy. Whether or not one or more of its full-time employees’ dependents enrolls through an Exchange and receives a subsidy does not affect an employer’s liability.

This is especially important as some companies discuss the eligibility rules of their health plans.

More information can be found below.

Pay or Play Penalty – Dependent Coverage Requirement

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Supreme Court Rejects Contraceptive Mandate for Some Companies

On June 30, 2014, the U.S. Supreme Court issued its ruling in two related cases challenging the Affordable Care Act’s (ACA) contraceptive coverage mandate. In these cases, three closely held for-profit corporations—Hobby Lobby Stores, Mardel and Conestoga Wood Specialties—argued that they should not be required to comply with the contraceptive mandate because covering certain types of contraceptives under their health plans violates their sincere religious beliefs.

The ruling was in favor of these companies.  For more information, please read the document below.

Supreme Court Rejects Contraceptive Mandate for Some Companies

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2015 Health Care Reform Compliance Checklist

As we all continue planning for the 2015 plan year, it is important to know what you need to do to stay in compliance with the Affordable Care Act.  This health care reform compliance checklist can help you do just that.

Included in the document below is information on:

  • Grandfathered plan status
  • 2015 cost-sharing limits
  • Flexible Spending Account contributions
  • Reinsurance fees
  • HIPAA certification
  • Employer penalty rules
  • What establishes a company as a large employer
  • Determining your large employer status
  • What allowances are given to medium-sized employers
  • Transition relief for non-calendar year plans
  • Monthly measurement period guidelines
  • Look-back measurement period guidelines
  • Affordability of coverage (the 9.5% rule)
  • Minimum value plans
  • Reporting of coverage

As you can tell, there is a lot to get ready for.  You do not want to be on the outside looking in on these things, so make sure you are in compliance.  While there are a lot of rules to consider, they all can be managed.

If you would like to discuss further, feel free to contact us.

Health Care Reform 2015 Compliance Checklist

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When to Begin Tracking Employee Hours for Affordable Care Act Purposes

One of the most common questions we get is related to tracking employee hours for health insurance eligibility under the Affordable Care Act.  When to begin tracking the hours and how long to track them are important things to consider when determining whether your employees are considered full-time.

Back in February, the IRS published final regulations on the employer shared responsibility rules (another post in this subject can be found here).  The brief linked below details more information, such as:

  • Which companies must track employee hours (do small employers have to track hours?)
  • How to identify full-time employees
  • What is the Monthly Measurement Method
  • What is the Look-back Measurement Method
  • When to begin tracking employee hours for both calendar year plans, and non-calendar year plans

Getting the measurement period correct is crucial to making sure you are offering benefits to the right people, which will keep you out of trouble.

Contact us if you would like to discuss further.

Pay or Play Penalty – When to Begin Tracking Employee Hours

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