Penalty for violating "no annual limits" provision of PPACA?

[Guest StainedGlass]

I've been searching high and low to determine what the penalty would be if a health plan kept an annual limit in place after this year. I haven't yet found anything. Anyone have any thoughts or comments?

[leevena]

Don't hold me to this, I am fairly confident that I am correct though. I would like to hear others opinions.

There is no penalty just because the employer violated the design requirements. The penalty is applied/levied when an employee goes to the exchange for a plan and recieves a subsidy.

[masteff]

Page 2 here agrees there is no new penalty for this: http://www.sibson.com/uploads/171cc0fb56ae8cfe8f882721c98bd153.pdf

[Flyboyjohn]

You'll want to look at 42 USC Chapter 6A (Public Health Service Act), Subchapter XXV (Requirements Relating to Health Insurance Coverage), Part A (Individual and Group Market Reforms), Subpart 2 (Enforcement), section 300gg-22

$100/day/participant with exceptions/limitations

[Guest Taxxy McTaxerson]

Flyboyjohn is correct. There is an excise tax under IRC 4980D of $100/day multiplied by the number of affected individuals. This is a pre-ACA code section tied to chapter 100 (group health plan requirements) of the code . The ACA inserted a provision in chapter 100 which incorporates the reforms referenced by Flyboyjohn. The provision is also enforceable under ERISA, which also incorporates the reforms.

[Peter Gulia]

Another of the several possible consequences is that a Federal court or State court in proceedings on an ERISA benefit claim could construe the plan as including the provisions the plan is required to provide, and as not including any provision that the plan is precluded from providing. The court could then apply the plan as so reformed, and could decide the claimant's benefits under the reformed plan.