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6 Matching News Items

1.  Association Health Plans and the Sale of Group Health Insurance 'Across State Lines'
Employment Matters, Mintz Levin Link to more items from this source
Feb. 22, 2018
"While the [DOL]'s proposed AHP regulation seeks to expand the reach of AHPs by encouraging small groups to band together to form larger, homogeneous risk pools, there is no shortage of state laws that seek to require small groups to remain a part of a single, state-wide, heterogeneous risk pool. There is no middle ground. If the Department of Labor's regulation is adopted as a final rule--and there is no reason to think that it will not be--this issue will likely have to be resolved by the courts."
2.  ACA Reporting Requirements for Carriers and Employers (Part 7 of 24): Mergers and Acquisitions
Mintz Levin Link to more items from this source
Sept. 1, 2015
"When it comes to mergers and acquisitions involving at least one applicable large employer (ALE), the substantive rules governing employer shared responsibility ... and the corresponding reporting rules ... share at least one thing in common: we don't yet know how they work. This leaves parties to corporate deals with some challenging questions: How should acquired employees be treated? Does the form of the transaction matter? Do 'successor employer' rules of the sort found in the COBRA final regulations apply? Are the parties free to apportion exposure? What presumptions might be invoked if the matter of [ACA] compliance is not addressed?"
3.  ACA Reporting Requirements for Carriers and Employers (Part 20 of 24): Reporting Affordability on Form 1095-C, Part II, Line 16
Mintz Levin Link to more items from this source
Dec. 2, 2015
"The attractiveness of this safe harbor is that the amount at which an employee's contribution is affordable may be known up front. The challenges, however, are many. In the case of hourly employees, the hourly rate is multiplied by 130 hours, despite that the employee may work more hours. Also, the rate of pay for an hourly employee can change if the rate of pay decreases (but not where it increases). Worse, the rate of pay safe harbor is unavailable in the case of non-hourly employees whose monthly salary is reduced mid-year. Thus, the safe harbor cannot be used, as a practical matter, for tipped employees or for employees who are compensated solely on the basis of commissions. For these employees, the employer must use one of the two other affordability safe harbors."
4.  IRS Regs Address Employer Shared Responsibility Under ACA
Mintz Levin Link to more items from this source
Jan. 16, 2013
"The proposed regulations include a series of clarifications and new rules that are generally employer-friendly. This is not to say that compliance will be a simple matter; it will not. The statutory scheme is too complex for that. Nevertheless, in a handful of instances, the proposed regulations adopted common sense rules that smooth over some of the Act's rougher edges."
5.  Misunderstandings Arise Over 'Offer[s] of Coverage on Behalf of Another Entity' in Applying ACA Shared Responsibility Rules
Mintz Levin Link to more items from this source
Oct. 27, 2014
"Applicable large employers faced with the prospect of complying with the [ACA's] employer shared responsibility rules must grapple with and understand what is means to make an offer of minimum essential coverage under an eligible employer-sponsored [group health] plan to their full-time employees... Identifying an employer's common law employees in a two-party arrangement is a simple matter. But this is not always the case in three-party arrangements (i.e., those in which workers are hired from or through commercial staffing firms or professional employer organizations)....The final regulations provide a special rule governing outsourced employees or 'offers of coverage on behalf of other entities.' This rule is welcome to be sure, but it also appears to be widely misunderstood, systematically over-utilized, and in a few cases subject to interpretations that (seem to us, anyway) stray pretty far from the text."
6.  Expanding Association Health Plans: Which Agencies Need to Do What
Mintz Levin Link to more items from this source
Oct. 24, 2017
"[The DOL] could fairly quickly expand access to 'single plan' AHPs through informal interpretations of ERISA ... It would be another matter entirely should the [DOL] seek to expand AHPs to cover collections of self-employed individuals with no common law employees. This would require a change to an existing final regulation ... [A]ny attempt to enable groups of unrelated self-employed individuals with no common law employees to participate in an AHP would require publication of a proposed rule with a notice period and opportunity for public comment."

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