Affordable Care Act Review

Affordable Care Act Review

Category Archives: Taxes

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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

How’s This for a Dramatic Entrance?

Posted in Affordable Care Act, Exchanges, Taxes
As of Thursday morning, January 5, the general direction and pace of ACA repeal / replace legislation is discernible (details below), but the details are not.  News reports suggest that, despite persisting, material differences of opinion among members of the majority, leaders have committed to deliver an ACA bill to the new President by Monday,… 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

Stand Alone, Fixed-Indemnity Plans Are Back, Maybe

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Insurers and Brokers, Taxes
In Central United Life Ins. Co. v. Burwell, D.C. Cir. No. 15-5310 (July 1, 2016), a D.C. Circuit panel affirmed, 3-0, a trial court injunction barring enforcement of the 2014 HHS regulation permitting individual fixed-indemnity policies to be sold only as supplements to ACA minimum essential coverage. You’ve heard this theme before. The Public Health… 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

RIP, Automatic Enrollment

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Insurers and Brokers, Private Employers, Taxes
Sixty-seven months ago, Congress ordered employers of 200 or more full-time employees to switch from opt-in to opt-out enrollment. See 29 U.S.C. § 218a. But the enforcement agencies could not write a rule that did more good than harm, so they gave up. A lame duck Senator killed a bipartisan repeal bill in his committee last… Continue Reading

Request for Information about ALE Reporting Status

Posted in Affordable Care Act, Coverage Mandates, Employee Leasing, Government Employers, Private Employers, Taxes
We work closely with employers (mostly ALEs) and an array of service providers – payroll processors, benefit plan consultants and administrators, software developers and transmitters, employee leasing firms, insurance brokers and insurers. We’re hearing from them and from others pretty consistent impressions of the state of employer readiness to furnish (by February 1, 2016) and to file… Continue Reading

What Parts of the ACA Will Congress Repeal by Budget Reconciliation?

Posted in Affordable Care Act, Coverage Mandates, Taxes
“None,” is our best guess, practically speaking. Congress passed much of what became the consolidated Affordable Case Act under “budget reconciliation” rules, which preclude a filibuster and enable a bill to pass the Senate with a simple majority vote. Tax and spending legislation may be passed and repealed that way. H.R. 3762, now on the… Continue Reading

Do Seasonal Workers “Count” for Forms 1094-C and 1095-C?

Posted in Affordable Care Act, Coverage Mandates, Government Employers, Private Employers, Taxes
We were asked that recently, proving that there is such a thing as a wrong question. Let’s break it down. The same person may be both a “seasonal worker” and a “seasonal employee,” but those terms are used to discuss separate ACA subjects. This has caused great confusion. Here’s how the Employer Shared Responsibility Cost… Continue Reading

Healthcare.gov: No 2015 Employer Subsidy Notices

Posted in Affordable Care Act, Coverage Mandates, Exchanges, Government Employers, Private Employers, Taxes
On Friday afternoon, September 18, the Centers for Medicare and Medicaid Services (CMS) published a set of “Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program.” The update is welcome for what it tells us about the subsidy certification appeal process beginning in 2016, summarized below. It’s troubling, however, for its confession… Continue Reading

Outside Counsel Should Handle Healthcare.gov Subsidy Appeals

Posted in Affordable Care Act, Government Employers, Private Employers, Taxes
Here’s the coming dilemma: let IRS assess employer mandate taxes based on errant Healthcare.gov subsidy certifications or appeal those errors to prevent those assessments.  “Where’s the dilemma?” you say.  Here:  once you know which employees received subsidies, you are exposed to ACA retaliation charges if you later take adverse action action against them.  The best time to escape this trap is… Continue Reading