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New Rule Eases Formation of Association Health Plans
The U.S. Department of Labor (DOL) has issued a new rule that allows employers to join together as a single group to offer group health insurance coverage to employees, working owners (including those without other employees), and their spouses and dependents as part of an "association health plan." The rule allows association health plans to be formed on the basis of industry or geography, such as by state, city, county, or multi-state metropolitan area.

POSTED JUNE 19, 2018 7:07 AM
'Pay or Play' Estimator Available from IRS
The Taxpayer Advocate Service—an independent organization within the Internal Revenue Service (IRS)—has developed a Employer Shared Responsibility Provision Estimator tool to assist employers in understanding how the Affordable Care Act's employer shared responsibility ("pay or play") provisions work and how the provisions may apply to them.

POSTED JUNE 15, 2018 5:05 AM
Understanding IRS 'Pay or Play' Penalty Letters
The Internal Revenue Service (IRS) is currently issuing Letter 226-J to certain applicable large employers (ALE)—generally those with at least 50 full-time employees, including full-time equivalent employees, on average during the prior year—that it believes owe a penalty for failure to comply with the Affordable Care Act's employer shared responsibility provisions ("pay or play" provisions). In conjunction with Letter 226-J, employers will receive Form 14764, which they can use to respond to Letter 226-J.

POSTED JUNE 01, 2018 2:02 AM
2019 'Pay or Play' Affordability Percentage Set at 9.86%
For plan years beginning in 2019, the Internal Revenue Service has announced that coverage will generally be considered affordable if the employee's required contribution for the lowest cost self-only health plan offered is 9.86% or less of his or her household income for the taxable year.

POSTED MAY 21, 2018 7:07 AM
How Summer Hires May Impact ALE Status
Employers looking to hire seasonal workers this summer are reminded that there is an exception when measuring workforce size to determine whether they are an applicable large employer (ALE) subject to the Affordable Care Act's employer shared responsibility ("pay or play") provisions.

POSTED MAY 17, 2018 5:05 AM
Employers: Don't Forget to Pay PCORI Fees
Employers that sponsor certain self-insured health plans—including some health reimbursement arrangements (HRAs) and health flexible spending arrangements (health FSAs)—are reminded that they are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Fees for self-insured plans with plan years that ended in 2017 are dueJuly 31, 2018, and are required to be paid viaIRS Form 720.

POSTED MAY 11, 2018 2:02 AM
How to Correct Form 1094-C and 1095-C Errors
Although the deadlines for employers to file and furnish their 2017 Forms 1094-C & 1095 have passed, employers should confirm the accuracy of these forms and correct any errors on them soon to avoid noncompliance penalties.

POSTED APRIL 26, 2018 4:04 AM
Small Businesses May Be Able to Keep Existing Health Coverage Through 2019
A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been further extended to policy years beginning on or before October 1, 2019, provided that all policies end by December 31, 2019.

POSTED APRIL 19, 2018 8:08 AM
2019 Cost-Sharing Limits for Most Group Health Plans Released
A new rule from the U.S. Department of Health and Human Services (HHS) addresses, among other things, the requirement under the Affordable Care Act that non-grandfathered group health plans limit annual out-of-pocket cost-sharing for coverage of essential health benefits under the plan. Under the rule, these out-of-pocket expenses may not exceed $7,900 for self-only coverage or $15,800 for family coverage in 2019.

POSTED APRIL 10, 2018 5:05 AM
New Rule Allows Brokers to Further Aid SHOP Enrollment
The U.S. Department of Health and Human Services (HHS) has issued a new rule that allows employers to directly enroll in SHOP coverage through a SHOP-registered agent or broker.

POSTED APRIL 10, 2018 5:05 AM

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