Health Care Reform Updates & Human Resource News Alerts

Health Care Reform News

HR360::Health Care Reform
  • Employers Can Request Filing Extension for Forms 1094-C and 1095-C

    Posted on February 24, 2017
    Print

    Paper Filers Must Submit Request by February 28, 2017

    With the Affordable Care Act information reporting deadlines for the 2016 calendar year quickly approaching, employers are reminded that they can request a 30-day extension to file Forms 1094-C and 1095-C with the Internal Revenue Service (IRS). Unless an extension is granted, employers must file these forms with the IRS no later than February 28, 2017 (or March 31, 2017 if filing electronically).

    How to Request a Filing Extension
    Employers seeking a 30-day extension must submit Form 8809 by February 28, 2017 (or March 31, 2017 if filing Forms 1094-C and 1095-C electronically) as follows:

    • Online: Complete a fill-in Form 8809 through the IRS’ FIRE system.
    • Fax:  Complete a paper Form 8809 and fax it to: 1-877-477-0572.
    • Mail: Complete a paper Form 8809 and mail it to: Internal Revenue Service, Attn: Extension of Time Coordinator, 240 Murall Drive, Mail Stop 4360, Kearneysville, WV 25430. 

    For further assistance requesting an extension, contact the IRS at 1-866-455-7438.

    © 2012 - 2013 HR 360, Inc.
  • How to Correct ACA Information Reporting Errors (Forms 1094 and 1095)

    Posted on February 21, 2017
    Print

    Employers Should Correct Errors As Soon As Possible

    With the Affordable Care Act information reporting deadlines for the 2016 calendar year approaching, employers should confirm the accuracy of all information returns and correct any errors as soon as possible with both the IRS and their employees.

    Errors on Forms 1094-C and 1095-C
    As a reminder, Forms 1094-C and 1095-C are used by applicable large employers to satisfy their reporting obligations. To correct information on the paper version of the original Authoritative Transmittal Form 1094-C, employers should take the following steps:

    • Prepare a new authoritative Form 1094-C including the correct information
    • Enter an "X" in the CORRECTED checkbox at the top of the form
    • File the standalone corrected authoritative Form 1094-C with the IRS

    If correcting information on the paper version of a Form 1095-C that was previously filed with the IRS, employers should:

    • Prepare a new Form 1095-C
    • Enter an "X" in the CORRECTED checkbox at the top of the form
    • File the corrected Form 1095-C, along with a non-authoritative Form 1094-C (DO NOT mark the CORRECTED checkbox on the Form 1094-C), with the IRS
    • Furnish the employee a copy of the corrected Form 1095-C (note that different rules apply for an employer that is eligible to use the Qualifying Offer Method)

    For more information on correcting errors, see the 2016 Instructions for Forms 1094-C and 1095-C. Section 7.1 of Publication 5165 provides instructions for making a correction to a Form 1094-C or 1095-C filed electronically.

    Errors on Forms 1094-B and 1095-B
    Forms 1094-B and 1095-B are used by self-insuring employers that are not considered applicable large employers and other parties that provide minimum essential health coverage. If a Form 1095-B filed with the IRS on paper contains an error, the employer should file a corrected return as follows:

    • Fully complete a new Form 1095-B
    • Enter an "X" in the CORRECTED checkbox at the top of the form
    • File the corrected Form 1095-B, along with a transmittal Form 1094-B, with the IRS
    • Furnish a copy of the corrected Form 1095-B to the person identified as the responsible individual

    For more information on correcting errors, see the 2016 Instructions for Forms 1094-B and 1095-B. Section 7.1 of Publication 5165 provides instructions for making a correction to a Form 1095-B filed electronically.

    © 2012 - 2013 HR 360, Inc.
  • HHS Proposes Changes to Individual Insurance Market

    Posted on February 17, 2017
    Print

    Includes Revisions to Marketplace’s Open and Special Enrollment Periods

    The U.S Department of Health and Human Services has issued a proposed rule that would amend the timing of the annual Health Insurance Marketplace (“Marketplace”) open enrollment period for the 2018 plan year and increase pre-enrollment eligibility verification for special enrollment periods, among other things.

    New Proposed Marketplace Open Enrollment Period
    The proposed rule would change the dates for open enrollment in the Marketplace for the 2018 plan year to November 1, 2017 to December 15, 2017, which is consistent with the open enrollment period established for the 2019 plan year and beyond.  Under current regulations, the 2018 plan year Marketplace open enrollment period is scheduled to run from November 1, 2017 to January 31, 2018.

    Proposed Changes to Special Enrollment Periods
    Among other things, the proposed rule calls for the following changes to special enrollment period rules:

    • Starting in June 2017, HHS would conduct pre-enrollment verification of eligibility for Marketplace coverage for all categories of special enrollment periods for all new consumers in all states served by the Healthcare.gov platform, which includes federally facilitated Marketplaces and state-based Marketplaces on the federal platform.
    • Limiting the ability of existing Marketplace enrollees to change plan metal levels during the coverage year, including in the individual market outside of the Marketplace.
    • Permitting issuers to deny Marketplace special enrollment due to loss of minimum essential coverage where the issuer has a record of termination due to non-payment of premiums, unless obligations for premiums due for previous coverage are fulfilled.

    Click here to read the proposed rule in its entirety.

    © 2012 - 2013 HR 360, Inc.
  • 3 Most Common ACA Tax Questions

    Posted on February 14, 2017
    Print

    Premium Tax Credit, Individual Mandate, and More

    The IRS offers news on trending topics and answers to questions it is hearing from taxpayers. The following reflects the most commonly asked questions that the IRS has been receiving regarding the Affordable Care Act (ACA):

    1.    What happens if an individual does not file or fails to reconcile advance payments of the premium tax credit when filing his or her return?
    Failing to file a tax return or filing a return without reconciling advance payments will delay an individual's refund and may affect future advance payments. The IRS will send a letter with instructions about what the taxpayer needs to do to resolve this issue, which may include submitting Forms 1095-A and 8962.  

    2.    Does everyone need to have health insurance coverage?
    The ACA requires individuals to have basic health coverage (called minimum essential coverage), qualify for an exemption from the requirement to have coverage, or make an individual shared responsibility payment when filing a federal income tax return. If an individual is not required to file a tax return, one does not need to be filed solely to report coverage or to claim an exemption.

    3.    How can individuals receive help with filing a return and reconciling?
    According to the IRS, filing electronically is the easiest way to file a complete and accurate tax return. Electronic filing options include free Volunteer Assistance, IRS Free File, commercial software, and professional assistance.

    For the latest IRS ACA updates, click here.

    © 2012 - 2013 HR 360, Inc.
  • Reminder: New Versions of SBC Template and Related Documents for Use On or After April 1, 2017

    Posted on February 08, 2017
    Print

    Templates and Regulatory Guidance Available on Department of Labor Website

    New versions of the Summary of Benefits and Coverage (SBC) template, instructions, uniform glossary, and related documents are required for use on or after April 1, 2017. Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times during the enrollment process and upon request.

    Changes to SBC Template
    The new SBC template includes an additional coverage example as well as language and terms to improve individuals' understanding of their health coverage. Specifically, the new template includes more information about cost sharing, such as enhanced language to explain deductibles, and requires plans to address individual and overall out-of-pocket limits. Changes have also been made to the SBC to improve readability.

    Implementation Date for Using New Template and Related Documents
    The implementation date for using the new SBC template and associated materials will be as follows:

    • Health plans and issuers that maintain an annual open enrollment period will be required to use the new editions beginning on the first day of the first open enrollment period that begins on or after April 1, 2017 with respect to coverage for plan years beginning on or after that date.
    • Health plans and issuers that do not use an annual open enrollment period will be required to use the new editions beginning on the first day of the first plan year that begins on or after April 1, 2017.

    Click here to access the new SBC templates and related materials from the U.S. Department of Labor.

    © 2012 - 2013 HR 360, Inc.
  • 5 Tips on Individual Shared Responsibility Payments

    Posted on February 07, 2017
    Print

    Exemptions, Making the Payment, & More

    The Affordable Care Act's individual shared responsibility provision (also called the individual mandate) requires every individual to have minimum essential coverage (MEC) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.

    Here are five things the IRS wants individuals to know about this payment:  

    1. Individuals are not required to make a payment if they had MEC or qualified for an exemption for each month of the year.
    2. Individuals that did not have coverage, and whose income was below the tax filing threshold for their filing status, qualify for a coverage exemption and should not make a payment.
    3. Individuals that are not U.S. citizens or nationals, and are not lawfully present in the United States, are exempt and do not need to make a payment.
    4. If an individual is responsible for the payment, he or she should pay it with his or her tax return or in response to a letter from the IRS requesting payment. Taxpayers should not direct payment to any individual or return preparer.
    5. The payment amount due is reported on Form 1040 in the "Other Taxes" section, and in the corresponding sections of Forms 1040A and 1040EZ. Individuals are only required to make a payment for the months they (or their dependents) did not have MEC or qualify for a coverage exemption.

    In most cases, the payment reduces an individual's refund. If an individual is not claiming a refund, the payment will increase the amount owed on his or her tax return.

    To learn more, visit the IRS Reporting and Calculating the Payment webpage, or use the IRS' interactive tax assistant tool.

    © 2012 - 2013 HR 360, Inc.

    HR News and Alerts

    HR360::Health Care Reform
    • Employers Can Request Filing Extension for Forms 1094-C and 1095-C

      Posted on February 24, 2017
      Print

      Paper Filers Must Submit Request by February 28, 2017

      With the Affordable Care Act information reporting deadlines for the 2016 calendar year quickly approaching, employers are reminded that they can request a 30-day extension to file Forms 1094-C and 1095-C with the Internal Revenue Service (IRS). Unless an extension is granted, employers must file these forms with the IRS no later than February 28, 2017 (or March 31, 2017 if filing electronically).

      How to Request a Filing Extension
      Employers seeking a 30-day extension must submit Form 8809 by February 28, 2017 (or March 31, 2017 if filing Forms 1094-C and 1095-C electronically) as follows:

      • Online: Complete a fill-in Form 8809 through the IRS’ FIRE system.
      • Fax:  Complete a paper Form 8809 and fax it to: 1-877-477-0572.
      • Mail: Complete a paper Form 8809 and mail it to: Internal Revenue Service, Attn: Extension of Time Coordinator, 240 Murall Drive, Mail Stop 4360, Kearneysville, WV 25430. 

      For further assistance requesting an extension, contact the IRS at 1-866-455-7438.

      © 2012 - 2013 HR 360, Inc.
    • How to Correct ACA Information Reporting Errors (Forms 1094 and 1095)

      Posted on February 21, 2017
      Print

      Employers Should Correct Errors As Soon As Possible

      With the Affordable Care Act information reporting deadlines for the 2016 calendar year approaching, employers should confirm the accuracy of all information returns and correct any errors as soon as possible with both the IRS and their employees.

      Errors on Forms 1094-C and 1095-C
      As a reminder, Forms 1094-C and 1095-C are used by applicable large employers to satisfy their reporting obligations. To correct information on the paper version of the original Authoritative Transmittal Form 1094-C, employers should take the following steps:

      • Prepare a new authoritative Form 1094-C including the correct information
      • Enter an "X" in the CORRECTED checkbox at the top of the form
      • File the standalone corrected authoritative Form 1094-C with the IRS

      If correcting information on the paper version of a Form 1095-C that was previously filed with the IRS, employers should:

      • Prepare a new Form 1095-C
      • Enter an "X" in the CORRECTED checkbox at the top of the form
      • File the corrected Form 1095-C, along with a non-authoritative Form 1094-C (DO NOT mark the CORRECTED checkbox on the Form 1094-C), with the IRS
      • Furnish the employee a copy of the corrected Form 1095-C (note that different rules apply for an employer that is eligible to use the Qualifying Offer Method)

      For more information on correcting errors, see the 2016 Instructions for Forms 1094-C and 1095-C. Section 7.1 of Publication 5165 provides instructions for making a correction to a Form 1094-C or 1095-C filed electronically.

      Errors on Forms 1094-B and 1095-B
      Forms 1094-B and 1095-B are used by self-insuring employers that are not considered applicable large employers and other parties that provide minimum essential health coverage. If a Form 1095-B filed with the IRS on paper contains an error, the employer should file a corrected return as follows:

      • Fully complete a new Form 1095-B
      • Enter an "X" in the CORRECTED checkbox at the top of the form
      • File the corrected Form 1095-B, along with a transmittal Form 1094-B, with the IRS
      • Furnish a copy of the corrected Form 1095-B to the person identified as the responsible individual

      For more information on correcting errors, see the 2016 Instructions for Forms 1094-B and 1095-B. Section 7.1 of Publication 5165 provides instructions for making a correction to a Form 1095-B filed electronically.

      © 2012 - 2013 HR 360, Inc.
    • HHS Proposes Changes to Individual Insurance Market

      Posted on February 17, 2017
      Print

      Includes Revisions to Marketplace’s Open and Special Enrollment Periods

      The U.S Department of Health and Human Services has issued a proposed rule that would amend the timing of the annual Health Insurance Marketplace (“Marketplace”) open enrollment period for the 2018 plan year and increase pre-enrollment eligibility verification for special enrollment periods, among other things.

      New Proposed Marketplace Open Enrollment Period
      The proposed rule would change the dates for open enrollment in the Marketplace for the 2018 plan year to November 1, 2017 to December 15, 2017, which is consistent with the open enrollment period established for the 2019 plan year and beyond.  Under current regulations, the 2018 plan year Marketplace open enrollment period is scheduled to run from November 1, 2017 to January 31, 2018.

      Proposed Changes to Special Enrollment Periods
      Among other things, the proposed rule calls for the following changes to special enrollment period rules:

      • Starting in June 2017, HHS would conduct pre-enrollment verification of eligibility for Marketplace coverage for all categories of special enrollment periods for all new consumers in all states served by the Healthcare.gov platform, which includes federally facilitated Marketplaces and state-based Marketplaces on the federal platform.
      • Limiting the ability of existing Marketplace enrollees to change plan metal levels during the coverage year, including in the individual market outside of the Marketplace.
      • Permitting issuers to deny Marketplace special enrollment due to loss of minimum essential coverage where the issuer has a record of termination due to non-payment of premiums, unless obligations for premiums due for previous coverage are fulfilled.

      Click here to read the proposed rule in its entirety.

      © 2012 - 2013 HR 360, Inc.
    • 3 Most Common ACA Tax Questions

      Posted on February 14, 2017
      Print

      Premium Tax Credit, Individual Mandate, and More

      The IRS offers news on trending topics and answers to questions it is hearing from taxpayers. The following reflects the most commonly asked questions that the IRS has been receiving regarding the Affordable Care Act (ACA):

      1.    What happens if an individual does not file or fails to reconcile advance payments of the premium tax credit when filing his or her return?
      Failing to file a tax return or filing a return without reconciling advance payments will delay an individual's refund and may affect future advance payments. The IRS will send a letter with instructions about what the taxpayer needs to do to resolve this issue, which may include submitting Forms 1095-A and 8962.  

      2.    Does everyone need to have health insurance coverage?
      The ACA requires individuals to have basic health coverage (called minimum essential coverage), qualify for an exemption from the requirement to have coverage, or make an individual shared responsibility payment when filing a federal income tax return. If an individual is not required to file a tax return, one does not need to be filed solely to report coverage or to claim an exemption.

      3.    How can individuals receive help with filing a return and reconciling?
      According to the IRS, filing electronically is the easiest way to file a complete and accurate tax return. Electronic filing options include free Volunteer Assistance, IRS Free File, commercial software, and professional assistance.

      For the latest IRS ACA updates, click here.

      © 2012 - 2013 HR 360, Inc.
    • Reminder: New Versions of SBC Template and Related Documents for Use On or After April 1, 2017

      Posted on February 08, 2017
      Print

      Templates and Regulatory Guidance Available on Department of Labor Website

      New versions of the Summary of Benefits and Coverage (SBC) template, instructions, uniform glossary, and related documents are required for use on or after April 1, 2017. Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times during the enrollment process and upon request.

      Changes to SBC Template
      The new SBC template includes an additional coverage example as well as language and terms to improve individuals' understanding of their health coverage. Specifically, the new template includes more information about cost sharing, such as enhanced language to explain deductibles, and requires plans to address individual and overall out-of-pocket limits. Changes have also been made to the SBC to improve readability.

      Implementation Date for Using New Template and Related Documents
      The implementation date for using the new SBC template and associated materials will be as follows:

      • Health plans and issuers that maintain an annual open enrollment period will be required to use the new editions beginning on the first day of the first open enrollment period that begins on or after April 1, 2017 with respect to coverage for plan years beginning on or after that date.
      • Health plans and issuers that do not use an annual open enrollment period will be required to use the new editions beginning on the first day of the first plan year that begins on or after April 1, 2017.

      Click here to access the new SBC templates and related materials from the U.S. Department of Labor.

      © 2012 - 2013 HR 360, Inc.
    • 5 Tips on Individual Shared Responsibility Payments

      Posted on February 07, 2017
      Print

      Exemptions, Making the Payment, & More

      The Affordable Care Act's individual shared responsibility provision (also called the individual mandate) requires every individual to have minimum essential coverage (MEC) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.

      Here are five things the IRS wants individuals to know about this payment:  

      1. Individuals are not required to make a payment if they had MEC or qualified for an exemption for each month of the year.
      2. Individuals that did not have coverage, and whose income was below the tax filing threshold for their filing status, qualify for a coverage exemption and should not make a payment.
      3. Individuals that are not U.S. citizens or nationals, and are not lawfully present in the United States, are exempt and do not need to make a payment.
      4. If an individual is responsible for the payment, he or she should pay it with his or her tax return or in response to a letter from the IRS requesting payment. Taxpayers should not direct payment to any individual or return preparer.
      5. The payment amount due is reported on Form 1040 in the "Other Taxes" section, and in the corresponding sections of Forms 1040A and 1040EZ. Individuals are only required to make a payment for the months they (or their dependents) did not have MEC or qualify for a coverage exemption.

      In most cases, the payment reduces an individual's refund. If an individual is not claiming a refund, the payment will increase the amount owed on his or her tax return.

      To learn more, visit the IRS Reporting and Calculating the Payment webpage, or use the IRS' interactive tax assistant tool.

      © 2012 - 2013 HR 360, Inc.