Affordable Care Act Review

Affordable Care Act Review

Category Archives: Private Employers

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The Surprise of Familiarity

Posted in Affordable Care Act, Coverage Mandates, Employee Leasing, Government Employers, Independent Contractors, Insurers and Brokers, Private Employers, Taxes
Watching from afar the Scouts attempting to earn their orienteering merit badges, we could see it on the boys’ faces.  They were lost; they were scared.  They should have reached their destination an hour ago.  Soon, these woods would be dark.   The compass holder, the map marker and the step counter resumed their running argument.… Continue Reading

And . . . the . . . CBO . . . Scooooores!

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
Here are the highlights we took (quickly) from this afternoon’s Congressional Budget Office Cost Estimate for the American Health Care Act. The AHCA “would reduce federal deficits by $337 billion over the 2017-2026 period.” In 2018, “14 million more people would be uninsured under the [AHCA] than under current law. Most of that increase would… Continue Reading

ACA Repeal: The Middle Part

Posted in Affordable Care Act, Coverage Mandates, Employee Leasing, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
Screenplays, new business ventures and major legislation typically have problems in Act II.  Hopes were raised so high in Act I.  Now, things seem to drag on and on, pointlessly.   Friends tell you to give up or start over and enemies . . . well. Last week, two House committees – Energy and Commerce, Ways… Continue Reading

Developments February 6 – 10: Is the Price Right?

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
During the week reviewed, no new bill was introduced which, if passed, would repeal or replace the Affordable Care Act, and little else happened at the three main ACA enforcement agencies – DOL, HHS and IRS. Department of Labor The Department of Labor still has no Secretary and the nominee, Andrew Puzder, has not yet… Continue Reading

2015 Form 1095-C Penalty Letters: Have You Got Mail?

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Private Employers, Taxes
Since late December, 2016, many Applicable Large Employer Members have received IRS Letter 5699 from a Tax Compliance Officer at an address in Florence, Kentucky.  The “Dear Taxpayer” letter is headed: “Request for Employer Reporting of Offers of Health Insurance Coverage (Forms 1094-C and 1095-C).”  We have assumed the authenticity of these letters. Each letter… Continue Reading

The End of the Beginning: Developments January 27 – February 5

Posted in Affordable Care Act, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
Nothing resembling a repeal/replace consensus bill emerged from any committee in either chamber during the survey period.  Instead, in a Fox News interview broadcast just before the Super Bowl, the President confessed that ACA repeal may require more than a year.  A concise summary by Peter Sullivan in The Hill is online here. Consistent with… Continue Reading

Hitch In the Giddy-up: Round-up of Developments January 19 – 27

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
As previously reported, § 2001 of the 2017 budget bill required all ACA repeal/replace bills to be filed and reported from assigned committees by Friday, January 27, 2017.  That didn’t happen.  Since our last posting, the bills listed below have been filed and assigned to committees, but no ACA bill has emerged from committee in either… Continue Reading

President Trump’s First ACA “Executive Action”

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
Shortly after his January 20 inauguration, President Trump signed an Executive Order (promptly published by Politico) titled, “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Appeal.”  It’s most notable for what it doesn’t do – i.e., compel any agency to take, or to refrain from taking, any particular ACA enforcement… Continue Reading

On Your Mark, Get Ready, to Go . . . Somewhere: Congressional Developments January 12-18

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Taxes
On January 13, the House passed the 2017 budget resolution (S. Con. Res. 3), which should be found on President Trump’s desk Monday morning.  As previously explained, this sets the stage for a filibuster-proof, budget reconciliation bill that can repeal and replace spending and tax provisions of the ACA. S. 106,  introduced January 12 by… Continue Reading

Fitness Enthusiasm Wanes Early: ACA-Related Congressional Actions January 5 – 12

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
On January 5, the House passed the “Regulations from the Executive in Need of Scrutiny Act of 2017” (H.R. 26), streamlining the process for Congressional review and rejection of administrative agency rules, including a 10-year sunset provision for rules that Congress has not expressly approved. In a late night “vote-a-rama” held January 11-12, the Senate… Continue Reading

ACA Repeal Reality Check

Posted in Affordable Care Act, carrots, Coverage Mandates, Exchanges, Government Employers, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes
We didn’t take ten weeks off because there was nothing to talk about.  Rather, we concluded around Labor Day that anything useful to be said about ACA compliance, pre-election, would be interpreted as political advocacy, so we decided to watch and wait.  The anti-ACA candidate won, and his party carried Congress, too.  That settles that,… Continue Reading

2016 Draft Forms 1094-C and 1095-C and Instructions: What’s New, Page-by-Page

Posted in Affordable Care Act, Employee Leasing, Government Employers, Independent Contractors, Insurers and Brokers, Private Employers, Taxes
In the ACA realm, change is the only constant, so don’t take this to the bank.  We’re telling you what we see for the first time, on a first reading of the draft 2016 Forms and Instructions that the IRS has released since July 7.  “Applicable Large Employers,” their contractors and consultants will use these… Continue Reading

ACA Retaliation: Let Us Tell You A Little Story about A Man Named Jed

Posted in Affordable Care Act, Employee Leasing, Government Employers, Independent Contractors, Private Employers
Jed, employed by Drysdale LLC, a janitorial contractor, recently began working nights at the Commerce Bank, supervised by the Bank’s Chief of Security.  Jed’s family had health insurance until his wife lost her job early this year.  Drysdale didn’t offer insurance, so Jed bought a policy through Healthcare.gov.  With the federal subsidy, his premium is… Continue Reading

EEOC Sample Notice for Employer-Sponsored Wellness Programs

Posted in Affordable Care Act, Government Employers, Private Employers
You know the drill.  A manufacturer advertises a new drug, warning, of course, that some users may suffer serious side effects.  A year or two later, lawyers counter-advertise for new clients with those conditions who took the drug.  There follows, in some cases, a campaign to remove the “bad drug” from the market.  On June… Continue Reading

2015 ACA Information Reporting: Parts Sold Separately, Some Assembly Required

Posted in Affordable Care Act, Government Employers, Private Employers
Ten days before the deadline for electronic filing of 2015 Forms 1094-C and 1095-C, many employers are discovering that they contracted for less than all the needed services. Here’s what we’re seeing all too commonly. Some vendors offered turnkey packages. They promised, in writing, to host or to manage your data, to use it to… Continue Reading

So I Made This Little 1095-C Mistake. Big Deal?

Posted in Affordable Care Act, Government Employers, Insurers and Brokers, Private Employers
The 2015 Instructions for Forms 1094-C and 1095-C tell Applicable Large Employers how to furnish and file corrections to incorrectly filed Forms 1095-C. They don’t answer these two questions that arise between the March 31, 2016 deadline for furnishing Forms 1095-C to full-time employees and the May 31 paper filing deadline or the June 30 e-filing deadline. What… Continue Reading

Heffalumps, Woozles and Limited Non-Assessment Periods: Very Confusel

Posted in Affordable Care Act, Government Employers, Private Employers
They’re far they’re near they’re gone they’re here. They’re quick and slick, they’re insincere. Beware, beware, be a very wary bear. A Heffalump or Woozle is very confusel. “Heffalumps and Woozles,” from “The Many Adventures of Winnie the Pooh.” So, you were a 2015 Applicable Large Employer. You waited too late to outsource your generation,… Continue Reading

Questionable Retaliation Theory Gets Traction

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Private Employers
Since our earliest postings, we have warned of a notion, prevalent among employee counsel, that an employer plan sponsor unlawfully retaliates against an employee by reducing her work hours in order to deprive her of ACA “full-time” coverage offer eligibility.  The musings that we have heard and read rarely distinguish claims under ERISA § 510 (29 U.S.C.… Continue Reading

ACA Myths That Just Won’t Die

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Private Employers, Taxes
Lawyers, politicians, economists, climate scientists, fad diet peddlers . . . we all know that it’s child’s play to persuade people of what they want to believe. Perhaps that explains the persistence of so many questionable beliefs about ACA compliance. Here are three examples. The Look –[way] back Measurement Method The ACA commands or allows employers… Continue Reading

How (and How Not) to Read This Blog

Posted in Affordable Care Act, Business Organizations, Community Health Needs Assessments, Coverage Mandates, Employee Leasing, Exchanges, Federal Contractors, Government Employers, Grandfathered Status, Independent Contractors, Insurers and Brokers, Private Employers, Providers - For Profit, Providers - Not-for-Profit, Taxes, Uncategorized
Nearly three years ago, having spent hundreds of hours immersed in ACA minutiae, we anticipated that clients would not react well to fees for services that consisted principally of telling them that they had asked the wrong question. So we decided, against tradition and much conventional wisdom, to sink lots of unpaid partner time into… Continue Reading

ACA Information Return Deadlines Extended

Posted in Affordable Care Act, Coverage Mandates, Employee Leasing, Government Employers, Insurers and Brokers, Private Employers, Taxes
On December 28, 2015, the IRS released its Notice 2016-4, granting much needed time for employers and their filing services to catch up to Affordable Care Act Information Return (AIR) Program developments. Here (nearly verbatim) are the extensions: The deadline for furnishing to individuals the 2015 Form 1095-B, Health Coverage, and the 2015 Form 1095-C,… Continue Reading

Coming Down Your Chimney: Market Reform Guidance, Information Reporting Penalty Relief and Cadillac Tax Delay

Posted in Affordable Care Act, Coverage Mandates, Employee Leasing, Federal Contractors, Government Employers, Independent Contractors, Insurers and Brokers, Private Employers, Taxes
It’s the “silly season” on the Hill and a busy season for ACA regulators. This article gives you brief notes about Notice 2015-87, information reporting relief and the § 4980I delay buried in the omnibus spending bill. IRS Notice 2015-87 first answers questions on the periphery of earlier guidance effectively killing stand-alone HRAs. Most notably, an… Continue Reading