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Petitioners in King v. Burwell could run up against the same logic that brought down Medicaid expansion under health care reform: it could be unconstitutional for the federal government to use draconian coercion to force states to set up exchanges. Justice Anthony Kennedy emerged as a potential swing vote when he raised that Constitutional balance-of-powers question, which […]
New IRS regulations define the way health insurers will pay fees under Section 9010 of the Affordable Care Act. In the rules, the IRS applies Notice 2014-47 and provides further guidance on how covered entities will pay the fees for 2015 and subsequent fee years. It also tells how covered entities will report and pay on behalf of […]
On Feb. 23, the Centers for Medicare and Medicaid Services put on public display final rules that require employer health plans to cover physician and hospital services in order to meet health care reform’s minimum value requirement. The rules also set the contribution self-insured health plans and insurers must make to a premium-stabilization fund for the individual […]
Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the Internal Revenue Service. IRS Notice 2015-17 reiterates IRS’ previous warning, in Notice 2013-54, that giving employees […]
Employers have been shifting more premium costs to workers and increasing their deductibles. That, in addition to the fact that price growth in the health sector outpaces growth for the rest of the economy, has resulted in a disproportionate increase in employee out-of-pocket costs, a new Commonwealth Fund report says. Growth in health plan costs […]
Proposed changes to the Summary of Benefits and Coverage rules under health care reform include additions and subtractions to the SBC template, as well as clarifications on how plan sponsors and insurers may apportion the responsibility to furnish the SBC to participants. A third example would be added to the cost-sharing examples required in the […]
Two specific types of limited wraparound coverage could qualify as “limited excepted benefits,” under health care reform rules proposed Dec. 19 by the U.S. Departments of Labor, Health and Human Services and the Treasury. “Excepted” status would be available on a temporary “pilot” basis to coverage that: wraps around a Multi-State Plan offered by the U.S. Office […]
Leading employee benefits attorneys recently discussed rules on calculating workforces and identifying to whom the employer must make an offer of coverage. Vanessa Scott, a partner with Sutherland Asbill & Brennan, Washington, D.C., and Malcolm Slee, of Counsel at the Groom Law Group, Washington, D.C.,discussed the counting and measuring rules spawned by health care reform during […]
Employer contributions to a Section 125 cafeteria plan can be deducted from the employee’s cost of a health plan for purposes of determining the affordability of coverage, final IRS rules on minimum essential coverage published on Nov. 26 (79 Fed. Reg. 70464) stipulate. In order to be deducted, the café plan benefit must not be […]
The Centers for Medicare & Medicaid Services has extended the deadline for contributing entities (or entities reporting on their behalf) to submit annual enrollment counts on which they will base their contribution amounts under health care reform’s transitional reinsurance program. The deadline is now 11:59 p.m. on Dec. 5, 2014. Reporting on that date also […]