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Showing results for tags 'affordable care act'.
Found 6 results
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Several of our clients have been approached by vendors to offer telemedicine products outside of their group health plans (e.g., to part-time employee groups who are not eligible for medical coverage). It has always been my understanding that telemedicine benefits would constitute a group health plan and be subject to Affordable Care Act requirements (preventive services, etc.) that would be functionally impossible for a telemedicine benefit to meet (e.g., the requirement to offer immunizations). I have seen some vendors make the argument that the telemedicine benefits could fall under the excepted benefits rules, as EAPs. However, in order for an EAP to be an excepted benefit, it cannot offer significant benefits in the nature of medical care. I find it hard to believe a telemedicine benefit could meet that requirement. Are you guys also seeing these products becoming very common? Is there some rule I am missing that is allowing employers to offer standalone telemedicine benefits to their employees? TIA for any thoughts!
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When an employer's group medical plan does not utilize at least 80% of the premiums for healthcare in a given year, the insurance company must provide a "refund" to the employer. This "refund" is then allocated to those employees who paid insurance premiums, and it is reported as taxable income on W2. Question: Is this "refund" received by the employee included in plan compensation the year the refund is received? The particular plan uses 415 Comp excluding reimbursements or other expense allowances, fringe benefits (cash or non-cash), moving expenses, deferred compensation (other than deferrals specified in k. above) and welfare benefits. thank you -
Hi. I am hoping someone point me in the right direction. We have an employee out on extended unpaid leave. I am told that due to the ACA, the Employer must keep the employee on our health plan indefinitely even in a situation where the employee cannot work due to his own health condition and he is on extended unpaid leave following FMLA. Thanks. -
An employer, since the beginning of its operations, has restrained every employee's work hours to no more than 20 in any week (and no more than 980 in any year). This employer (which has no subsidiary, affiliate, or other business that is treated as the same employer under IRC 414) believes it has no exposure (despite more than 50 full-time-equivalent employees) to the IRC 4980H play-or-pay excise tax. Is that correct? Is such an employer's only compliance requirement information-reporting about its non-offer of health coverage? -
Imagine a business that's big enough to be exposed to the excise taxes for a failure to offer sufficient health coverage but small enough that it chooses not to self-insure its group health plan. This employer wants to know that, assuming the employer's plan provides sufficient eligibility and makes every employee's contribution low enough that all offers are affordable, the group health insurance contract it might buy would meet all other conditions so that the employer is not exposed to play-or-pay excise tax. How will this employer know whether a group health insurance contract provides "minimum essential coverage" and "minimum value"? Does the contract itself state that it meets those conditions? If not, will an insurer furnish some other written assurance that the contract offered meets the conditions? If an insurer offers a group health insurance contract that does not meet "minimum essential coverage" or "minimum value", does some Federal or State law require an insurer to furnish an affirmative warning of that fact?
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An employer maintains a health plan. For the plan's eligibility provisions, the plan defines a full-time employee as one who regularly works at least 40 hours a week. Being a full-time employee is among the plan's conditions for eligibility. A consultant told the employer that it cannot maintain the 40-hours condition, and must change it to 30 hours. The employer replied that it is fully aware of the play-or-pay excise tax, and nonetheless prefers to maintain its 40-hours condition. The consultant continued to assert that the employer MUST change to 30 hours. Apart from offering coverage so as not to attract a play-or-pay excise tax, is there some other law that constrains an employer's choice about which of its employees is eligible for its health plan?
