Health Care Reform Updates & Human Resource News Alerts

Health Care Reform News

HR360::Health Care Reform
  • 2019 Cost-Sharing Limits for Most Group Health Plans Released

    Posted on April 10, 2018
    Print

    HHS Issues Key Rule for 2019

    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.

    © 2018 HR 360, Inc.
  • New Rule Allows Brokers to Further Aid SHOP Enrollment

    Posted on April 10, 2018
    Print

    Rule Effective for Plan Year 2018

    The U.S. Department of Health and Human Services (HHS) has issued a new rule that allows employers to directly enroll in SHOP (Small Business Health Options Program) coverage through a SHOP-registered agent or broker. This enrollment approach is now generally available in federally-facilitated SHOPs (FF-SHOPs), including state-based Exchanges using the federal platform for SHOP, for plan years beginning on or after January 1, 2018. State-based Exchanges operating their own SHOPs can also adopt this new approach.

    For more information, please contact the SHOP that applies in your state.

    © 2018 HR 360, Inc.
  • Individual Mandate Exemptions Available for 2017 Tax Returns

    Posted on April 06, 2018
    Print

    Affordability, Tax Filing Threshold, and Other Exemptions Available

    Under the Affordable Care Act's (ACA) ''individual mandate'' (also called individual shared responsibility) provision, every individual must have minimum essential health coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return for tax year 2017.

    Among other exemptions, individuals may claim the following exemptions from the individual mandate by filing Form 8965, Health Coverage Exemptions, along with his or her 2017 tax return:

    • Affordability Exemption: The lowest-priced coverage available to the individual, through either a Health Insurance Marketplace or employer-based group health plan, would have cost the individual more than 8.16% of his or her household income for plan years beginning in 2017, as computed on the tax return.
    • Tax Filing Threshold Exemption: The individual’s gross income or household income was less than the applicable minimum threshold for filing a tax return (see ''2017 Federal Tax Filing Requirement Thresholds'').
    • Short Coverage Gap Exemption: The individual went without coverage for less than three consecutive months during the year.
    • Medicaid Expansion Exemption: The individual's household income is below 138% of the federal poverty line for his or her family size, and at any time during the year, the individual resided in a state that did not participate in the Medicaid expansion under the ACA. States that did not expand Medicaid for all of 2017 include: Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

    Click here to learn more about individual mandate exemptions.

    © 2018 HR 360, Inc.
  • Reminder: Significant Penalties Exist for Information Reporting Failures

    Posted on March 27, 2018
    Print

    IRS Electronic Filing Deadline is April 2

    With the April 2 deadline to electronically file Forms 1094 & 1095 with the Internal Revenue Service (IRS) approaching, employers are reminded that failing to comply with these information reporting requirements may result in significant penalties. These penalties are as follows:

    • Employers that fail to file correct information returns with the IRS and furnish correct payee statements are generally subject to a $260 penalty for each return for which such failure occurs, with a maximum annual penalty of over $3 million.
    • Employers that file correct returns and furnish correct statements on or before 30 days after the required filing date are generally subject to a $50 penalty for each return for which such failure occurs, with a maximum annual penalty of over $500,000.
    • Employers that file correct returns and furnish correct statements beyond 30 days after the required filing date but on or before August 1, 2018 are generally subject to a $100 penalty for each return for which such failure occurs, with a maximum annual penalty of over $1 million.
    © 2018 HR 360, Inc.
  • Electronic Filing Deadline for Forms 1094 and 1095 is April 2

    Posted on March 22, 2018
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    Deadline to File Paper Returns With IRS was February 28

    Employers subject to the Affordable Care Act’s (ACA) information reporting requirements are reminded that the deadline to electronically file ACA information returns with the IRS is April 2.  

    The reporting deadlines in 2018 are for the 2017 calendar year, and are as follows: 

    • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must electronically file Forms 1094-C and 1095-C with the IRS no later than April 2. The deadline to file paper returns was February 28.
    • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential health coverage, must electronically file Forms 1094-B and 1095-B with the IRS no later than April 2. The deadline to file paper returns was February 28.

    Note: Employers filing 250 or more Forms 1095-B or 1095-C are required to electronically file them with the IRS.

    Additional information on electronic filing can be found on the IRS's ACA Information Returns (AIR) Program webpage. 

    © 2018 HR 360, Inc.
  • Reminder: Counting Employees Vital to ACA Compliance

    Posted on March 16, 2018
    Print

    Company Size Impacts Application of "Pay or Play"

    Employers are reminded that it is important to know how many full-time employees they have in order to ensure compliance with the employer shared responsibility provisions ("pay or play") of the Affordable Care Act, which apply only to applicable large employers (ALEs).

    Determining ALE Status
    Whether an employer is considered an ALE for a particular calendar year depends on the size of its workforce during the preceding calendar year. For example, employers will use information about the size of their workforce during 2017 to determine if their company is an ALE for 2018. Employers with an average of at least 50 full-time employees in the preceding calendar year—including full-time equivalent employees (FTEs)—are generally deemed ALEs for the current calendar year.

    Identifying Full-Time Employees
    In general, for purposes of pay or play: 

    • A full-time employee is, for a calendar month, an employee who is employed on average at least 30 hours of service per week (130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week).
    • A full-time equivalent employee is a combination of employees, each of whom individually is not a full-time employee, but who, in combination, are equivalent to a full-time employee.

    For additional rules on determining who is a full-time employee, including what counts as an hour of service, click here.

    © 2018 HR 360, Inc.

    HR News and Alerts

    HR360::Health Care Reform
    • 2019 Cost-Sharing Limits for Most Group Health Plans Released

      Posted on April 10, 2018
      Print

      HHS Issues Key Rule for 2019

      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.

      © 2018 HR 360, Inc.
    • New Rule Allows Brokers to Further Aid SHOP Enrollment

      Posted on April 10, 2018
      Print

      Rule Effective for Plan Year 2018

      The U.S. Department of Health and Human Services (HHS) has issued a new rule that allows employers to directly enroll in SHOP (Small Business Health Options Program) coverage through a SHOP-registered agent or broker. This enrollment approach is now generally available in federally-facilitated SHOPs (FF-SHOPs), including state-based Exchanges using the federal platform for SHOP, for plan years beginning on or after January 1, 2018. State-based Exchanges operating their own SHOPs can also adopt this new approach.

      For more information, please contact the SHOP that applies in your state.

      © 2018 HR 360, Inc.
    • Individual Mandate Exemptions Available for 2017 Tax Returns

      Posted on April 06, 2018
      Print

      Affordability, Tax Filing Threshold, and Other Exemptions Available

      Under the Affordable Care Act's (ACA) ''individual mandate'' (also called individual shared responsibility) provision, every individual must have minimum essential health coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return for tax year 2017.

      Among other exemptions, individuals may claim the following exemptions from the individual mandate by filing Form 8965, Health Coverage Exemptions, along with his or her 2017 tax return:

      • Affordability Exemption: The lowest-priced coverage available to the individual, through either a Health Insurance Marketplace or employer-based group health plan, would have cost the individual more than 8.16% of his or her household income for plan years beginning in 2017, as computed on the tax return.
      • Tax Filing Threshold Exemption: The individual’s gross income or household income was less than the applicable minimum threshold for filing a tax return (see ''2017 Federal Tax Filing Requirement Thresholds'').
      • Short Coverage Gap Exemption: The individual went without coverage for less than three consecutive months during the year.
      • Medicaid Expansion Exemption: The individual's household income is below 138% of the federal poverty line for his or her family size, and at any time during the year, the individual resided in a state that did not participate in the Medicaid expansion under the ACA. States that did not expand Medicaid for all of 2017 include: Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

      Click here to learn more about individual mandate exemptions.

      © 2018 HR 360, Inc.
    • Reminder: Significant Penalties Exist for Information Reporting Failures

      Posted on March 27, 2018
      Print

      IRS Electronic Filing Deadline is April 2

      With the April 2 deadline to electronically file Forms 1094 & 1095 with the Internal Revenue Service (IRS) approaching, employers are reminded that failing to comply with these information reporting requirements may result in significant penalties. These penalties are as follows:

      • Employers that fail to file correct information returns with the IRS and furnish correct payee statements are generally subject to a $260 penalty for each return for which such failure occurs, with a maximum annual penalty of over $3 million.
      • Employers that file correct returns and furnish correct statements on or before 30 days after the required filing date are generally subject to a $50 penalty for each return for which such failure occurs, with a maximum annual penalty of over $500,000.
      • Employers that file correct returns and furnish correct statements beyond 30 days after the required filing date but on or before August 1, 2018 are generally subject to a $100 penalty for each return for which such failure occurs, with a maximum annual penalty of over $1 million.
      © 2018 HR 360, Inc.
    • Electronic Filing Deadline for Forms 1094 and 1095 is April 2

      Posted on March 22, 2018
      Print

      Deadline to File Paper Returns With IRS was February 28

      Employers subject to the Affordable Care Act’s (ACA) information reporting requirements are reminded that the deadline to electronically file ACA information returns with the IRS is April 2.  

      The reporting deadlines in 2018 are for the 2017 calendar year, and are as follows: 

      • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must electronically file Forms 1094-C and 1095-C with the IRS no later than April 2. The deadline to file paper returns was February 28.
      • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential health coverage, must electronically file Forms 1094-B and 1095-B with the IRS no later than April 2. The deadline to file paper returns was February 28.

      Note: Employers filing 250 or more Forms 1095-B or 1095-C are required to electronically file them with the IRS.

      Additional information on electronic filing can be found on the IRS's ACA Information Returns (AIR) Program webpage. 

      © 2018 HR 360, Inc.
    • Reminder: Counting Employees Vital to ACA Compliance

      Posted on March 16, 2018
      Print

      Company Size Impacts Application of "Pay or Play"

      Employers are reminded that it is important to know how many full-time employees they have in order to ensure compliance with the employer shared responsibility provisions ("pay or play") of the Affordable Care Act, which apply only to applicable large employers (ALEs).

      Determining ALE Status
      Whether an employer is considered an ALE for a particular calendar year depends on the size of its workforce during the preceding calendar year. For example, employers will use information about the size of their workforce during 2017 to determine if their company is an ALE for 2018. Employers with an average of at least 50 full-time employees in the preceding calendar year—including full-time equivalent employees (FTEs)—are generally deemed ALEs for the current calendar year.

      Identifying Full-Time Employees
      In general, for purposes of pay or play: 

      • A full-time employee is, for a calendar month, an employee who is employed on average at least 30 hours of service per week (130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week).
      • A full-time equivalent employee is a combination of employees, each of whom individually is not a full-time employee, but who, in combination, are equivalent to a full-time employee.

      For additional rules on determining who is a full-time employee, including what counts as an hour of service, click here.

      © 2018 HR 360, Inc.