Wednesday, July 3, 2013

Supreme Court Ruling on DOMA – What It Means for Employers

On June 26, 2013, the U.S. Supreme Court announced its decision regarding the constitutionality of the federal Defense of Marriage Act of 1996 (DOMA). The Court struck down Section 3 of DOMA, which limited marriage to opposite sex unions for purposes of federal law.
In a 5-4 decision, the court found this definition to be a violation of equal protection rights under the U.S. Constitution, holding that same-sex couples who are legally married under state law will be entitled to equal treatment under federal law with regard to income taxes and federal benefits. However, the Courts ruling does not establish a constitutional right to same-sex marriage.
The high courts decision will impact employers in states that…

Tuesday, July 2, 2013

***SPECIAL EDITION*** ACA EMPLOYER MANDATE DELAYED

Late this afternoon (7/2/2013), the Obama administration announced that it is DELAYING THE EMPLOYER MANDATE (also known as “employer shared responsibility” and “pay or play”) until 2015. In turn, the Treasury Department announced that – “it would delay its enforcement an entire year after hearing numerous concerns from employers about the challenges of its implementation”. Specifically, the assistant secretary for tax policy – Mark Mazur – said – “We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively.

Wednesday, June 26, 2013

To (PCORI) Fee…or Not to Fee. THAT is the Question!

One of the Affordable Care Act’s (ACA) 18 new Taxes, Elimination of Deductions, and New Fees is something called the Patient -Centered Outcomes Research Institute fee (or PCORI for short). The fee is applicable to virtually any health insurance plan (both fully insured and self-funded), specifically the following:
– Fully insured medical plans (individual and group)
– Self funded group health plans (including some HRA and FSA plans)
– Retiree only medical plans
– COBRA health insurance coverage
– Limited or Mini-Medical plans
– Federal/State/Local governmental health plans offered by an employer

Wednesday, June 19, 2013

Understanding Employer Shared Responsibility (per the ACA)

In my travels and presentations to various employer organizations around the country, I’m finding a great deal of misunderstanding concerning one of the more pressing aspects of the Affordable Care Act (or Obamacare) – the so called “employer shared responsibility” provision. Also referred to as the “employer mandate” and the “pay or play provision”, this aspect of the ACA poses two distinct types of penalty exposure to affected employers (generally those that employ at least 50 full time and full time equivalent employees). It’s extremely important to clarify that these penalties represent EXPOSURE, first and foremost; and only become actual payable penalties if specific action is taken by EMPLOYEE(s).

Monday, June 10, 2013

Notices, Summaries, and Forms, Oh My!

One of the most challenging aspects of Affordable Care Act (ACA) compliance is all the new forms, notices, and summaries required to be drafted, edited, approved, and ultimately distributed. The Department of Labor (DOL) recently issued guidance intended to assist employers in providing ACA related information to employees. This blog entry is intended to provide readers with a “heads up” on some new and revised notice/summary changes, and deadlines, resulting from the DOL’s guidance.
Employers were initially required by the ACA to provide notices to all current and newly hired employees regarding the existence of, and access to the new health insurance exchanges (now referred to…

Wednesday, June 5, 2013

Wellness Programs and the Affordable Care Act (ACA)

The “trinity” of ACA enforcement (i.e., Departments of Labor, Treasury, and Health and Human Services) issued final regulations relative to wellness programs and rewards, on May 29, 2013. There were no surprises to what we already knew from the law itself. But reviewing the briefing reminded me that there are two (2) profoundly different types of wellness programs:
1. “Participatory”; and 2. “Health-Contingent”. Program rewards for the later are regulated/limited by the ACA, beginning in 2014, to no more than 30% (an increase from the present amount of 20%). However, there are NO LIMITS placed/regulated for the former type – Participatory – wellness programs. It is also important to note that the ACA allows a penalty of up to 50% for programs related to tobacco use.

Wednesday, May 29, 2013

Insights on Affordable Care Act’s Health Ins. Exchanges or Marketplaces

There has been much speculation concerning the Affordable Care Acts so called “Health Insurance Marketplaces” (formerly referred to as Health Insurance Exchanges). Many questions have been hanging in the air such as:
1. will insurance cos. choose to participate in these exchanges?;
2. how many insurers will opt to participate?;
3. what will premiums look like inside the exchange?;
4. will the exchanges be operational in time to place coverage effective 1/1/14?
Today it was announced that the state of California’s exchange (which choose to operate its own exchange, rather than defaulting …

Wednesday, May 29, 2013

Consumer Driven Healthcare (CDH) Arrives…17 Years Later!

A recent Omaha World Herald article featured an article titled: Let the Comparison Shopping Begin. It’s about time! Back in 1996, the large scale health care reform law of its day – The Health Insurance Portability and Accountability Act (HIPAA) – included an extremely important provision referred to as the “Medical Savings Account (MSA) pilot project”. What we didn’t realize at the time, was this provision represented the birth of so called “consumer driven healthcare” or CDH. The idea was quite simple. Instead of relying on comprehensive health insurance coverage as the single source of funding of ALL health care; offer instead a two (2) pronged approach.

Wednesday, May 29, 2013

Insights on Affordable Care Act’s Health Ins. Exchanges or Marketplaces

There has been much speculation concerning the Affordable Care Act’s so called “Health Insurance Marketplaces” (formerly referred to as Health Insurance Exchanges).  Many questions have been hanging in the air such as: 1. will insurance cos. choose to participate in these exchanges?; 2. how many insurers will opt to participate?; 3. what will premiums lookLEARN MORE

Tuesday, May 28, 2013

IRS Announces 2014 HSA Limitations

The IRS has made their annual determinations relative to HSA contribution limits and allowable plan related out of pocket maximums for next year.
For 2014, the contribution maximums are increasing to:
2014: Individual – $3,330; Family – $6,550.
There is NO CHANGE to the MINIMUM DEDUCTIBLE on HSA qualified plans; but the maximum out of pocket limit increases to:
2014: Individual – $6,350; Family – $12,700.