Health Care Reform Updates & Human Resource News Alerts

Health Care Reform News

HR360::Health Care Reform
  • Administration Eliminates Cost-Sharing Reduction Payments

    Posted on October 13, 2017
    Print

    Cuts to Take Effect Immediately

    The Trump administration announced yesterday that it will no longer make cost-sharing reduction (CSR) payments to insurance companies under the Affordable Care Act (ACA). According to a statement issued by the U.S. Department of Health and Human Services (HHS), the agency's decision to discontinue these payments immediately follows a legal review by HHS, the Department of Treasury, the Office of Management and Budget, and an opinion from the U.S. Attorney General. 

    Background
    The ACA requires insurers to offer plans with reduced deductibles, copayments, and other means of cost sharing to eligible individuals who purchase plans through the Health Insurance Marketplace. In turn, insurers receive CSR payments arranged by the Secretary of HHS to cover the costs they incur because of this requirement. Whether CSR payments were properly appropriated by Congress has been the subject of litigation since 2014.

    To read the HHS statement, click here

    © 2017 HR 360, Inc.
  • New Executive Order Calls for Expanding Health Care Options in 3 Major Areas

    Posted on October 12, 2017
    Print

    ACA Requirements Remain In Effect Pending Further Guidance or Legislation

    President Trump has signed an executive order calling upon federal agencies to consider expanding health care options in 3 major areas to potentially increase competition and lower costs. Until further guidance is issued or legislation is signed, however, all current ACA requirements remain in effect, including penalties for noncompliance.

    The following are key highlights of the order:

    • Association Health Plans (AHPs): The executive order directs the U.S. Department of Labor to consider expanding access to AHPs, which could potentially allow employers to form groups across state lines.
    • Short-Term, Limited Duration Insurance (STLDI): The executive order directs federal agencies to consider ways of expanding coverage through low-cost STLDI, which is not subject to certain ACA rules.
    • Health Reimbursement Arrangements (HRAs): HRAs are tax-advantaged, employer-established arrangements that allow eligible employees to be reimbursed for qualified medical expenses. The executive order directs federal agencies to consider changes to the rules regulating HRAs to increase their usability, expand employers' ability to offer them to employees, and allow them to be used in conjunction with nongroup coverage.

    For more information on this executive order, click here.

    Note: In general, executive orders must be implemented in a manner consistent with applicable law, including the Administrative Procedure Act, which requires extended review of and public comment on any federal rules which may be proposed as a result of an executive order. Going forward, we will promptly report changes made to any ACA requirements.

    © 2017 HR 360, Inc.
  • Federal Agencies Relax Contraceptive Coverage Mandate

    Posted on October 09, 2017
    Print

    New Rules Expand Exemptions Based on Religious and Moral Objections

    Effective as of October 6, 2017, two companion interim final rules issued by the U.S. Departments of Health and Human Services, Treasury, and Labor expand exemptions related to the Affordable Care Act requirement that non-grandfathered group health plans provide coverage without cost-sharing for contraceptive services (referred to as the "contraceptive mandate"). Previously, the contraceptive mandate was subject to exemptions for religious employers and accommodations for certain other non-profit religious organizations and closely held for-profit entities with sincerely held religious beliefs against certain contraceptives. 

    Expanded Exemptions
    The new rules exempt entities that object to establishing, maintaining, providing, offering, or arranging (as applicable) coverage, payments, or a plan that provides coverage or payments for some or all contraceptive services based on their sincerely held religious beliefs or moral convictions. For this purpose, the term "contraceptive services" includes contraceptive or sterilization items, procedures, or services, or related patient education or counseling.

    • Religious Exemption. This exemption applies to non-governmental plan sponsorsincluding non-profit organizations and for-profit entities (whether or not they are closely held or publicly traded)—that object based on sincerely held religious beliefs.
    • Moral Exemption. This exemption includes the plans of plan sponsors that are non-profit entities, as well as for-profit entities that have no publicly traded ownership interests (as defined under the law).

    Disclosure Requirements
    Exempt entities will not be required to comply with a self-certification process. However, where an exemption applies and all or a subset of contraceptive services are omitted from a plan's coverage, otherwise applicable ERISA disclosures must reflect the omission of coverage in ERISA plans.

    For more information on the interim final rules, please click here.

    © 2017 HR 360, Inc.
  • PCORI Fees Hiked for 2018 Filing Period

    Posted on October 09, 2017
    Print

    Fee Applies to Certain Self-Insured Plans

    The Internal Revenue Service (IRS) recently announced an increase in the applicable dollar amount used to determine the Patient-Centered Outcomes Research Institute (PCORI) fee for plan years that end on or after October 1, 2017 and before October 1, 2018. As a reminder, employers sponsoring certain self-insured plans are responsible for the PCORI fee.

    Fee Increase
    For plan years ending on or after October 1, 2017 and before October 1, 2018, the fee for an employer sponsoring an applicable self-insured plan is $2.39 multiplied by the average number of lives covered under the plan. PCORI fees for plan years that end between October 1, 2017 and December 31, 2017 will be due to the IRS in July 2018

    Click here to read the IRS notice announcing the increase. Details on how to determine the average number of lives covered under a plan are included in these regulations.

    © 2017 HR 360, Inc.
  • Final 2017 Instructions for Forms 1094 and 1095 Now Available

    Posted on October 05, 2017
    Print

    Used for Reporting in Early 2018

    The IRS has released the final 2017 Instructions for Forms 1094-B, 1095-B, 1094-C, and 1095-C to help employers prepare for calendar year 2017 Affordable Care Act (ACA) information reporting. Employers will use the final versions of the forms and instructions in early 2018 to report on health coverage offered (or not offered) in the 2017 calendar year.

    Key Changes for 2017 Reporting
    The 2017 instructions differ from the 2016 instructions as follows:

    • Instructions to Forms 1094-C and 1095-C: The final instructions have been revised to remove discussion of section 4980H transition relief, as none is available for 2017.
    • Instructions to Forms 1094-B and 1095-B: While no significant form revisions are listed in the instructions, the "Additional Information" section refers reporting entities to regulations relating to the requirement to solicit the taxpayer identification number (TIN) of each covered individual (including available penalty relief for failure to report a TIN if certain regulatory requirements are satisfied).

    2017 Forms
    The following forms are now available for calendar year 2017 reporting:

    Information Reporting Deadlines
    The upcoming deadlines for submitting Forms 1094 and 1095 are as follows:

    • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must file Forms 1094-C and 1095-C with the IRS no later than February 28, 2018 (or April 2, 2018, if filing electronically). ALEs must also furnish a Form 1095-C to all full-time employees by January 31, 2018.
    • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential coverage, must file Forms 1094-B and 1095-B with the IRS no later than February 28, 2018 (or April 2, 2018, if filing electronically). A Form 1095-B must also be furnished to "responsible individuals" (may be the primary insured, employee, former employee, or other related person named on the application) by January 31, 2018.
    © 2017 HR 360, Inc.
  • Marketplace Special Enrollment Periods Announced for Hurricane-Impacted Individuals

    Posted on October 03, 2017
    Print

    Special Enrollment Periods Available for 2017 Marketplace Coverage

    As a result of Hurricanes Harvey, Irma, and Maria, the Centers for Medicare & Medicaid Services (CMS) will make available special enrollment periods for certain individuals seeking health plans offered through the Federal Health Insurance Marketplace (Exchange). In general, these special enrollment periods are available to residents of Florida, Georgia, Louisiana, South Carolina, and Texas.

    Special Enrollment Period Details
    The special enrollment periods created by CMS will allow individuals impacted by the storms to select a new 2017 Marketplace plan or make changes to their existing 2017 plan at any time through December 31, 2017. Specifically, there will be special enrollment periods for individuals who:

    • Experienced a special enrollment period qualifying event between 60 days prior to the start date of the incident designated by the Federal Emergency Management Agency (FEMA) and December 31, 2017, but were unable to complete the application, plan selection, and enrollment process due to a hurricane-related weather event in 2017; or
    • Reside in or move from areas affected by a hurricane in 2017.

    These special enrollment opportunities are in addition to the annual open enrollment period this fall and any other enrollment period for which the individual may be eligible.

    Additional details on these special enrollment periods can be found here.

    © 2017 HR 360, Inc.

    HR News and Alerts

    HR360::Health Care Reform
    • Administration Eliminates Cost-Sharing Reduction Payments

      Posted on October 13, 2017
      Print

      Cuts to Take Effect Immediately

      The Trump administration announced yesterday that it will no longer make cost-sharing reduction (CSR) payments to insurance companies under the Affordable Care Act (ACA). According to a statement issued by the U.S. Department of Health and Human Services (HHS), the agency's decision to discontinue these payments immediately follows a legal review by HHS, the Department of Treasury, the Office of Management and Budget, and an opinion from the U.S. Attorney General. 

      Background
      The ACA requires insurers to offer plans with reduced deductibles, copayments, and other means of cost sharing to eligible individuals who purchase plans through the Health Insurance Marketplace. In turn, insurers receive CSR payments arranged by the Secretary of HHS to cover the costs they incur because of this requirement. Whether CSR payments were properly appropriated by Congress has been the subject of litigation since 2014.

      To read the HHS statement, click here

      © 2017 HR 360, Inc.
    • New Executive Order Calls for Expanding Health Care Options in 3 Major Areas

      Posted on October 12, 2017
      Print

      ACA Requirements Remain In Effect Pending Further Guidance or Legislation

      President Trump has signed an executive order calling upon federal agencies to consider expanding health care options in 3 major areas to potentially increase competition and lower costs. Until further guidance is issued or legislation is signed, however, all current ACA requirements remain in effect, including penalties for noncompliance.

      The following are key highlights of the order:

      • Association Health Plans (AHPs): The executive order directs the U.S. Department of Labor to consider expanding access to AHPs, which could potentially allow employers to form groups across state lines.
      • Short-Term, Limited Duration Insurance (STLDI): The executive order directs federal agencies to consider ways of expanding coverage through low-cost STLDI, which is not subject to certain ACA rules.
      • Health Reimbursement Arrangements (HRAs): HRAs are tax-advantaged, employer-established arrangements that allow eligible employees to be reimbursed for qualified medical expenses. The executive order directs federal agencies to consider changes to the rules regulating HRAs to increase their usability, expand employers' ability to offer them to employees, and allow them to be used in conjunction with nongroup coverage.

      For more information on this executive order, click here.

      Note: In general, executive orders must be implemented in a manner consistent with applicable law, including the Administrative Procedure Act, which requires extended review of and public comment on any federal rules which may be proposed as a result of an executive order. Going forward, we will promptly report changes made to any ACA requirements.

      © 2017 HR 360, Inc.
    • Federal Agencies Relax Contraceptive Coverage Mandate

      Posted on October 09, 2017
      Print

      New Rules Expand Exemptions Based on Religious and Moral Objections

      Effective as of October 6, 2017, two companion interim final rules issued by the U.S. Departments of Health and Human Services, Treasury, and Labor expand exemptions related to the Affordable Care Act requirement that non-grandfathered group health plans provide coverage without cost-sharing for contraceptive services (referred to as the "contraceptive mandate"). Previously, the contraceptive mandate was subject to exemptions for religious employers and accommodations for certain other non-profit religious organizations and closely held for-profit entities with sincerely held religious beliefs against certain contraceptives. 

      Expanded Exemptions
      The new rules exempt entities that object to establishing, maintaining, providing, offering, or arranging (as applicable) coverage, payments, or a plan that provides coverage or payments for some or all contraceptive services based on their sincerely held religious beliefs or moral convictions. For this purpose, the term "contraceptive services" includes contraceptive or sterilization items, procedures, or services, or related patient education or counseling.

      • Religious Exemption. This exemption applies to non-governmental plan sponsorsincluding non-profit organizations and for-profit entities (whether or not they are closely held or publicly traded)—that object based on sincerely held religious beliefs.
      • Moral Exemption. This exemption includes the plans of plan sponsors that are non-profit entities, as well as for-profit entities that have no publicly traded ownership interests (as defined under the law).

      Disclosure Requirements
      Exempt entities will not be required to comply with a self-certification process. However, where an exemption applies and all or a subset of contraceptive services are omitted from a plan's coverage, otherwise applicable ERISA disclosures must reflect the omission of coverage in ERISA plans.

      For more information on the interim final rules, please click here.

      © 2017 HR 360, Inc.
    • PCORI Fees Hiked for 2018 Filing Period

      Posted on October 09, 2017
      Print

      Fee Applies to Certain Self-Insured Plans

      The Internal Revenue Service (IRS) recently announced an increase in the applicable dollar amount used to determine the Patient-Centered Outcomes Research Institute (PCORI) fee for plan years that end on or after October 1, 2017 and before October 1, 2018. As a reminder, employers sponsoring certain self-insured plans are responsible for the PCORI fee.

      Fee Increase
      For plan years ending on or after October 1, 2017 and before October 1, 2018, the fee for an employer sponsoring an applicable self-insured plan is $2.39 multiplied by the average number of lives covered under the plan. PCORI fees for plan years that end between October 1, 2017 and December 31, 2017 will be due to the IRS in July 2018

      Click here to read the IRS notice announcing the increase. Details on how to determine the average number of lives covered under a plan are included in these regulations.

      © 2017 HR 360, Inc.
    • Final 2017 Instructions for Forms 1094 and 1095 Now Available

      Posted on October 05, 2017
      Print

      Used for Reporting in Early 2018

      The IRS has released the final 2017 Instructions for Forms 1094-B, 1095-B, 1094-C, and 1095-C to help employers prepare for calendar year 2017 Affordable Care Act (ACA) information reporting. Employers will use the final versions of the forms and instructions in early 2018 to report on health coverage offered (or not offered) in the 2017 calendar year.

      Key Changes for 2017 Reporting
      The 2017 instructions differ from the 2016 instructions as follows:

      • Instructions to Forms 1094-C and 1095-C: The final instructions have been revised to remove discussion of section 4980H transition relief, as none is available for 2017.
      • Instructions to Forms 1094-B and 1095-B: While no significant form revisions are listed in the instructions, the "Additional Information" section refers reporting entities to regulations relating to the requirement to solicit the taxpayer identification number (TIN) of each covered individual (including available penalty relief for failure to report a TIN if certain regulatory requirements are satisfied).

      2017 Forms
      The following forms are now available for calendar year 2017 reporting:

      Information Reporting Deadlines
      The upcoming deadlines for submitting Forms 1094 and 1095 are as follows:

      • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must file Forms 1094-C and 1095-C with the IRS no later than February 28, 2018 (or April 2, 2018, if filing electronically). ALEs must also furnish a Form 1095-C to all full-time employees by January 31, 2018.
      • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential coverage, must file Forms 1094-B and 1095-B with the IRS no later than February 28, 2018 (or April 2, 2018, if filing electronically). A Form 1095-B must also be furnished to "responsible individuals" (may be the primary insured, employee, former employee, or other related person named on the application) by January 31, 2018.
      © 2017 HR 360, Inc.
    • Marketplace Special Enrollment Periods Announced for Hurricane-Impacted Individuals

      Posted on October 03, 2017
      Print

      Special Enrollment Periods Available for 2017 Marketplace Coverage

      As a result of Hurricanes Harvey, Irma, and Maria, the Centers for Medicare & Medicaid Services (CMS) will make available special enrollment periods for certain individuals seeking health plans offered through the Federal Health Insurance Marketplace (Exchange). In general, these special enrollment periods are available to residents of Florida, Georgia, Louisiana, South Carolina, and Texas.

      Special Enrollment Period Details
      The special enrollment periods created by CMS will allow individuals impacted by the storms to select a new 2017 Marketplace plan or make changes to their existing 2017 plan at any time through December 31, 2017. Specifically, there will be special enrollment periods for individuals who:

      • Experienced a special enrollment period qualifying event between 60 days prior to the start date of the incident designated by the Federal Emergency Management Agency (FEMA) and December 31, 2017, but were unable to complete the application, plan selection, and enrollment process due to a hurricane-related weather event in 2017; or
      • Reside in or move from areas affected by a hurricane in 2017.

      These special enrollment opportunities are in addition to the annual open enrollment period this fall and any other enrollment period for which the individual may be eligible.

      Additional details on these special enrollment periods can be found here.

      © 2017 HR 360, Inc.