WHAT'S NEW IN INSURANCE (Archives)
ER Individual Pay Reminder 9-30-2015
Important Reminder for Employers who help pay employees individual health insurance premiums
The Affordable Care Act specifically prohibits you from paying insurance premiums for your employees’ individual health plans. It makes no difference whether paid with pre or post tax dollars. The fine is stiff: $100 per employee per day. See IRS Notice 2013-54 & FAQ 4.16.15; DOL Notice 2013-13 & FAQ 11.6.14. The IRS provided “Transition Relief” to all small employers who had these types of payment arrangements from January 1, 2015 -June 30, 2015. The relief has now ended.
What can you do now to comply with this provision of ACA?
Employer Medicare Reimbursements 9-30-2015
Can I reimburse my employees for their Medicare Premiums?
Medicare Premium Reimbursement Arrangements for Employers
After June 30, 2015, such employers may be liable for the excise tax. Eligible employers are not required to file IRS Form 8928 (regarding failures to satisfy requirements for group health plans, including the ACA's market reforms) solely as a result of having these employer payment plans for the time periods above.
Note: To the extent such an arrangement is available to active employees, it may be subject to restrictions under other laws such as the Medicare secondary payer provisions.
Individual Reporting Requirements 8-26-2015
Q. What happens if I did not file a 2014 federal tax return to reconcile my advance payment of the premium tax credit, or APTC. What do I need to do?
Q. Where can I go if I need help filing their tax returns?
Q. What happens if you received advance payments of the Premium Tax Credit in 2014 and don’t file a 2014 tax return or Form 8962?
Q. How do I update and make changes to income, household or coverage to the Marketplace?
New IRS reporting requirements for Applicable Large Employers (ALE) under the Affordable Care Act (ACA) 6.22.15
If you are an “Applicable Large Employer” with over 50 full time employees (including full time equivalents) you will be required to complete certain new IRS forms in early 2016 to be distributed to each employee by January 31st and submitted to the IRS by February 29, 2016, or March 31, 2016, if filing electronically.
Form 1095-C must be distributed to each employee and 1094C is submitted to the IRS. The IRS released drafts of the two required forms on June 16th so you have an idea of what will be required.
Here is the IRS link for instructions: http://www.irs.gov/instructions/i109495c/ar01.html#d0e221
See below for a couple of excepts from the IRS instruction guide:
Hope this info helps you prepare for this new IRS requirement under the Affordable Care Act.
Update on Newest Change for Business Group Renewals 7.7.14
After more than four years of working on Healthcare Reform, one might expect the chaos to have settled down a bit. Unfortunately, the ambiguities of ACA (Affordable Care Act) and the Obama Administration’s shifting deadlines have extended and exacerbated the upheaval.
Some of this upheaval has resulted in good news for many of you. One of the shifting deadlines allowed you to keep your current pre-ACA group health insurance plan through 2014 and gave us all a chance to “let the dust settle” a little before being forced into the new ACA plans. (If you remember, everyone was going to have to go onto the new plans at renewal in 2014.)
Now, the newest shift in deadlines has just occurred and will allow many groups to keep your same current pre-ACA plan for yet another year ~ until your 2015 renewal!
Of course, upon receiving your upcoming renewal we will check your renewal against the new ACA plans to see what will be best and then make recommendations to you based upon the results.
I just wanted to give you a head’s up on what will be coming your way on this upcoming renewal so you will know ahead of time what to expect.
Thank you for letting Pope Insurance service your employee benefits plans. As always, it is our pleasure to take care of you and your employees.
Health Care Reform Update for Employers 6.3.14
One time Opportunity for Current Federal COBRA Enrollees to Move to New ACA Plan
The Department of Health and Human Services has provided a one-time-only Special Enrollment Period available until July 1, 2014, for individuals currently enrolled in a COBRA plan. This allows COBRA enrollees to move to a consumer market ACA plan and drop their COBRA coverage.
If you have any Florida employees who might benefit from this, have them contact me for help. This is a very small window of opportunity and may save them quite a bit of premium. If they are eligible for a subsidy, I will be able to help them with that, also.
Health Care Reform Update for Employers 5.27.14
Important News You Can Use:
On May 16, 2014, the Internal Revenue Service (IRS) issued a FAQ clarifying that it is illegal for an employer to pay for individual health coverage for employees inside or outside of the Marketplace with pre-tax dollars despite those who claim there are loopholes available that make such offerings permissible.
The IRS FAQ specifically clarifies that an employer who offers such an arrangement will be subject to an excise tax of $100 per day or $36,500 per year per employee.
A webinar last week by the law firm of Alston & Bird, LLT, put on at the request of our national professional association NAHU, scared me enough that I want to let all of you know that even if an employer raises the taxable wages of an employee to cover the cost of an individual plan with after tax dollars, the employer should not implicitly or explicitly indicate that the wage increase is attached to the health plan in any way, shape, or form. IRS is very serious about this.
So, please be aware of communications you may receive indicating you can avoid providing group coverage and save premium costs by sending your employees to purchase an individual plan and pay for their premiums on a pre-tax arrangement: health reimbursement account, medical reimbursement account, or some such thing. IRS is very explicit that this not allowed, and the fines are quite hefty.
For detailed information see: IRS Notice 2013-54 and the IRS May 16th FAQ. DOL has issued a notice in substantially identical form to Notice 2013-54, DOL Technical Release 2013-0, and HHS will shortly issue guidance to reflect that it concurs with Notice 2013-54. On Jan. 24, 2013, DOL and HHS issued FAQs that addressed the application of the Affordable Care Act to HRAs.
Health Care Reform Update 2.7.14
You are still required by law to have insurance this year.
These many problems yield great public confusion. The public is extremely confused about the law and how it is actually being implemented.
What should you do with this confusion? First, call us ~ we will be happy to advise you. And, here is some info for you to use: If you work and have group insurance provided through your employer, you can most likely rely on your employer to keep your plan compliant. If you purchase your own insurance, the current law is still in place and you are required to have a compliant Affordable Care Act plan with the 10 minimum essential benefits this year. So, as of today, you are still required by law to have insurance this year.
You can only purchase ACA compliant health plans until March 31st. Otherwise, you must wait until next open enrollment (October to December) to purchase a plan for January 1, 2015 unless you have a qualifying event or special exception during the year. The penalty for not having insurance this year is $95 per adult; half for each child; or, 1 % of your income ~ whichever is greater.
You do NOT have to go through the Federal Marketplace to purchase health insurance. You may go directly to the insurance company as you always have done. The Marketplace is for those who qualify for a subsidy. I am certified to help you both on and off of the marketplace.
Call us for help with your questions. This is all very confusing and we are daily helping people find the best value for the premium dollar ~~~ Carolyn
Health Care Reform Update 8.12.13
By now, we all know that most everyone must comply with the new PPACA law beginning January 1, 2014. Although the tax penalties have been delayed until January 1, 2015 for groups with 50+ employees, these large groups are still expected to comply with the law in 2014.
WHAT TO EXPECT FOR INDIVIDUALS AND GROUPS:
If you have a Grandfathered Plan, a plan purchased prior to March 23, 2010, and you have made very minor or no changes to it, you may keep your plan as it is and it will not be subject to many of the requirements under the new law.
If your plan began after March 23, 2010, you must comply with, and are subject to, the new requirements under the PPACA law on your renewal date in 2014 beginning with January renewals. You must purchase a PPACA compliant plan or be penalized.
IMPORTANT NEW FEDERAL REQUIREMENT FOR EMPLOYERS:
By October 1, 2013, you will be required to distribute a notice to your employees called New Health Insurance Marketplace Coverage Options and Your Health Coverage. This notice must be given to all of your employees (including part time). The purpose of this notice is to let all of your employees know about the Federally Facilitated Exchange, called "The Health Insurance Marketplace".
Health Care Reform Update 8.12.13 ~~ from Carolyn L. Pope
Health Care Reform Update 6.21.13
The new Federal Exchange Marketplace, which will be operating in Florida effective January 1, 2014, is still on target to open for business 10.1.13 for effective dates of 1.1.14. The open enrollment period this first year will be from October 1, 2013 to March 31, 2014. Thereafter, it will be from October 1st to December 7th of each year for an effective date of January 1st.
Remember, groups with less than 50 full time equivalent employees are NOT subject to the tax penalties associated with larger (50+) employer groups. And, although there are many required group insurance changes for you and your employees, most of those changes whether you are a large or small group, will not take place until your 2014 renewal.
Due to the great confusion surrounding how the exchanges will actually work, some insurance carriers will be offering groups who renew the first six months of next year (2014) an opportunity to renew early at the end of this year (2013). This will carry you through for almost 12 months, and into 2014 before the law would really affect you. This will give time for the proverbial dust to settle.
Lots more to come! Rules are still being written and open for public comment. We just had a 253 page set of rules on the Exchanges published in the Federal Registry on Tuesday and open to public comment for 30 days.
I am still steadily attending seminars, webinars, reading professional journals, taking professional courses and certifications and am ready for what is to come for all size groups!
Health Care Reform Update 6.21.13 ~~ from Carolyn L Pope
Health Care Reform Update 4.2.13
By now you are beginning to hear a lot more about the new Health Care Reform changes and the Federal Exchange Marketplace effective this coming January, 2014.
What should I do? Since the required group insurance changes will not take place until your 2014 renewal date you can relax for now. As a small group (defined as under 50 employees) the actions required by you in order to comply will be minimal, and, you do not have much to be concerned about right this minute. Be assured, I will help you with comply with the new law.
What are the penalties? Please understand that only groups with 50+ employees are subject to "Pay or Play" along with tax penalties (non-deductible) and the more stringent compliance issues. This is more good news for our small employers.
A couple of mandatory changes coming with your 2014 renewal:
Although the Federal Exchange will be available for small group insurance January 1, 2014, we will be able to continue current group coverage outside of the exchange. I will prepare and review both scenarios to find your best option once the information is available so you will be knowledgeable to make the best decision for you and your employees.
New H.S.A and F.S.A Changes under Health Care Reform
You need to know:
Beginning in 2011, HSAs and FSAs may no longer be used to purchase over-the-counter (OTC) medications, such as non-prescription pain relievers, cold medicines, antacids and allergy medications. Over-the-counter medications prescribed by a physician will still be reimbursable on a tax-favored basis by these plans.
This new rule does not apply to reimbursements for the cost of insulin, which will continue to be permitted, even if purchased without a prescription.
Increased Tax Penalty for HSA for non-qualified usage:
If you use your tax-qualified account to purchase OTC medicines or other drugs purchased without a prescription after 1/1/11, or for other nonqualified withdrawals, those nonqualified expenses will be includable in your gross income and subject to an additional tax of 20%. This penalty increased from 10% to 20%.
Health Care Reform Update 4.2.13 ~~ from Carolyn L Pope
For Group Insurance Plans
This is a brief description of changes effective 9/23/10. Most of these changes will occur with your next renewal:
NEW - Small Business Tax Credit - Do You Qualify?
In general, the credit is available to small employers paying at least half the cost of single coverage for their employees.
- How to Qualify? Generally, the tax credit is available to employers with fewer than 25 full-time equivalent (FTE) employees paying wages averaging less than $50,000 per employee per year.
However, since the eligibility formula is based in part on the number of FTEs, not the number of employees, many businesses will qualify even if they employ more than 25 individual workers.
- How much is the Credit? The maximum credit is 35 percent of premiums paid in 2010 by eligible small business employers and 25 percent of premiums paid by eligible employers that are tax-exempt organizations. In 2014, this maximum credit increases to 50 percent of premiums paid by eligible small business employers and 35 percent of premiums paid by eligible employers that are tax-exempt organizations.
Do you qualify for the Maximum Credit? The maximum credit goes to smaller employers - those with 10 or fewer FTEs - paying annual average wages of $25,000 or less. How to claim the credit: Eligible small businesses can claim the credit as part of the general business credit starting with the 2010 income tax return they file in 2011. For tax-exempt employers, the IRS will provide further information on how to claim the credit. Your CPA will guide you in claiming your tax credit.
Link for More Information on Frequently Asked Questions: