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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
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[Guidance Overview]
Health Care Reform's Employer Shared Responsibility Penalties: A Checklist for Employers (PDF)
16 pages. Excerpt: "This checklist is intended to help employers: [1] Determine whether an employer is a 'large' employer ... [2] Calculate the potential penalties ... [3] Identify 'full-time employees' for purposes of calculating the penalties ... and [4] Design group health plans to avoid/minimize the penalties ... This checklist ... has been updated to reflect the final regulations published on February 12, 2014."
(Snell & Wilmer L.L.P.)
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[Guidance Overview]
The 28 Ways to Determine ALE Status for 2015
"The final regulations go into great detail about how an employer determines its [Applicable Large Employer (ALE)] status. A simpler approach [is to] sum up the hours of service accumulated by an employer's workforce for the calendar month; and never include more than 120 hours of service in any calendar month for an employee. Apply the two rules and divide the number by 120 to get an employer's ALE number for a calendar month. After an employer does this for all 12 calendar months in a calendar year sum up the total and divide by 12. If an employer's number is 50 or more, it is an ALE unless the seasonal worker exception applies.... The transition relief allows an employer to use any period that is at least six consecutive calendar months to determine its ALE status for 2015. As a result, an employer has 28 options for determining its ALE status for 2015. [A chart] shows all 28
options[.]"
(Moulder Law)
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[Guidance Overview]
Final ACA Employer Shared Responsibility Regs Released
"While the final regulations provide a transition period for the No Coverage Penalty, employers may still be subject to the Inadequate Coverage Penalty for failure to offer health coverage that meets minimum value and affordability requirements for each employee who receives a premium tax credit.... In determining full-time employees for 2015, subject to certain requirements, employers are permitted to use a six-month measurement period, even with a 12-month stability period, on a one-time basis."
(Morgan Lewis)
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[Guidance Overview]
Agencies Issue Final Regs Implementing Employer Shared Responsibility and Waiting Period Rules (PDF)
16 pages. Excerpt: "[T]he final regulations retain the look-back measurement method set forth in the proposed regulations for determining full-time employee status and create a new, alternative measurement method called the 'monthly measurement method.' The final regulations also extend most of the transition relief in the proposed regulations to the 2015 plan year and create new transition relief.... [S]imilar to the proposed regulations, employers may use a shorter measurement period (e.g., 6 months) that begins by July 1, 2014 for a longer 2015 stability period (e.g., 12 months), which gives employers more time to implement the look-back measurement method -- otherwise, employers with calendar year plans that wanted to use a 12-month stability period in 2015 would have needed to start the measurement period already."
(Groom Law Group)
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[Guidance Overview]
IRS Offers Health Care Tax Tips to Help Individuals Understand Tax Provisions in the ACA
"The IRS has designed the Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year, as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices. Although many of the tax provisions included in the law went into effect on Jan. 1, 2014, most do not affect the 2013 tax returns."
(Internal Revenue Service)
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[Guidance Overview]
HIPAA Requirements for Group Health Plans and Sponsoring Employers (PDF)
"[T]he 2014 OCR HIPAA Audits are expected to be about enforcement and disciplinary action. OCR officials have indicated that [group health plans] will be on the audit list again this year ... along with their service providers.... [T]he plan documents must provide that, before any disclosure of [protected health information (PHI)], the plan sponsor must certify that the plan documents: restrict uses and disclosures of PHI without authorization, ensure that any agents, including a subcontractor, to whom it provides PHI received from the group health plan agree to the same restrictions and conditions that apply to the plan sponsor; provide for certain rights of individuals ... and ensure adequate separation between the group health plan and plan sponsor."
(Clearwater Compliance)
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[Guidance Overview]
Surprise in ACA Waiting Period Rules Could Be Used to the Employer's Advantage
"Including the orientation period, employers technically have 120 days before they have to start offering healthcare coverage to their new employees. So it's entirely possible for some employers to add an orientation period to their employment conditions and buy themselves an extra 30 days of not having to pay for healthcare coverage for new hires -- as long as the feds don't see it as trying to skirt the law's requirements. One thing that's noticeably absent from the feds' proposed rule: What it takes for an employer's orientation period to be considered 'reasonable and bona-fide.'"
(HR Benefits Alert)
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More Employers Will Self-Insure If States Let Large Firms on Exchanges in 2017
"Beginning in 2017, states have the option of allowing large employers (i.e., more than 100 employees) to purchase a fully insured health plan through public insurance exchanges. If that happens, fully insured large group coverage sold through the exchanges must include the 10 essential health benefits (EHBs) and comply with other standards that now apply only to the individual and small-group market plans. It is likely that these same rules will apply to fully insured large group plans sold outside of the exchanges as well.... Large-group employers were happy that Congress exempted them from the premium rating rules, EHBs, actuarial value requirements and the single risk pool.... But the exemptions for large employers go away in 2017 if states opt to expand exchanges to include large employers."
(AISHealth)
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eHealth Inventory Report of Major Medical Health Plans Available Outside Government Exchanges (PDF)
"This study analyzes every major medical health plan available for enrollment at eHealthInsurance.com in 25 cities across the United States between January 25 and February 4, 2014. These plans meet all of the benefit standards of the [ACA] but are not available for enrollment on any government exchange and cannot be purchased with a subsidy.... The analysis includes monthly premiums, deductible, doctor visits and out-of-network benefits for a 29-year-old adult living in the [25 selected cities.]"
(eHealthInsurance)
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Expanding Health Coverage Provides Financial Protection Too
"As the share of Massachusetts residents with health coverage rose by about 7 percentage points, residents' credit scores improved, personal debt fell 22 percent on average, and the likelihood of bankruptcy fell 18 percent, after controlling for other personal and macroeconomic factors. The positive financial effects of health coverage were especially pronounced among residents who had lower credit scores prior to health reform, though residents across the income spectrum benefited."
(Center on Budget and Policy Priorities)
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Health Insurance Price Index, 4Q 2013 (PDF)
21 pages. Excerpt: "The present report examines the costs of plans selected by consumers shopping with eHealth during the fourth quarter of 2013 ... Consumers shopping through eHealth during this period were unable to apply government premium tax credits to their health insurance premiums. [Thus, this] report provides insights into the large, unsubsidized segment of the individual and family health insurance market, which is often overlooked by the media.... For the fourth quarter of 2013, individual premiums for 2013 plans averaged $171 per month; in the same period, individual premiums for 2014 plans averaged $309 per month.... Individual deductibles for 2013 plans averaged $4,900 per year while individual deductibles for 2014 plans averaged $3,768 per year."
(eHealthInsurance)
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Text of Brief by Little Sisters of the Poor, on Appeal to 10th Circuit in Challenge to Contraceptive Mandate (PDF)
74 pages. Excerpt: "[If] the government actually believed EBSA Form 700 to be legally meaningless, it would make no sense at all for the government to have contested the issue all the way to the Supreme Court, and to still be contesting the issue here. Nor would it make sense to threaten the Little Sisters with millions of dollars in fines to get them to sign a supposedly meaningless form. Actions speak louder than briefs, and the government's actions demonstrate that they view their Form as very important.... The government may think the Little Sisters should reason differently about law and morality, but their actual religious beliefs -- the beliefs that matter in this case -- have led them to conclude that they cannot sign or send the government's Form." [Little Sisters of the Poor v. Sebelius, No. 1:13-cv-02611-WJM-BNB (on appeal from D. Colo. Feb. 24, 2014)]
(The Becket Fund, on behalf of Little Sisters of the Poor and Christian Brothers Services)
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Kaiser Health Tracking Poll, February 2014
"[T]hose who are most likely to be customers in the [ACA's] new insurance exchanges (the uninsured and those who purchase their own coverage) are more likely to prefer less costly plans with narrow networks over more expensive plans with broader networks. Narrow network plans are a tougher sell among those with employer coverage, who tend to pay less of their health care costs directly since their employers pick up much of the cost."
(Kaiser Family Foundation)
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[Opinion]
Text of Comments by U.S. Chamber of Commerce to CMS on 2015 Letter to Issuers in the Federally-Facilitated Marketplace (PDF)
"Of the seven chapters in the Draft 2015 Letter, there are several areas of significant concern to the Chamber because of the significant impact that many of the proposed provisions would have on limiting choice, flexibility and variation in benefit plan design offerings on the Federally-facilitated Marketplace (FFM) ... In limiting choice and flexibility, these restrictions will also increase costs by limiting the tools that issuers and employers have historically used to control costs. Finally, the Chamber finds many of the proposals in the Draft 2015 Letter to be beyond the scope of the [ACA]."
(U.S. Chamber of Commerce)
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Benefits in General; Executive Compensation
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[Guidance Overview]
IRS Issues Final Regs Under Section 83
"Despite one commenter's concern that the regulations narrow the circumstances that would establish a substantial risk of forfeiture under IRC Section 83, according to the Treasury and the IRS, the clarifications set out in the regulations are consistent with the IRS's historical interpretations and therefore do not represent a change."
(Practical Law Company)
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Final Substantial-Risk-of-Forfeiture Rules Are Released
"The new regulations clarify that [1] a substantial risk of forfeiture may be established only through a service condition or a condition related to the purpose of the transfer; [2] in determining whether a substantial risk of forfeiture exists based on a condition related to the purpose of the transfer, both the likelihood that the forfeiture event will occur and the likelihood that the forfeiture will be enforced must be considered; and [3] except as specifically provided in Sec. 83(c)(3) and Regs. Secs. 1.83-3(j) ... and 1.83-3(k) ... transfer restrictions do not create a substantial risk of forfeiture."
(Journal of Accountancy)
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The Impact of Section 409A on Severance Payments
"The concern with conditioning severance pay on an executive signing a release is that if there is no time limit on when the release must be signed, the employee can affect the timing of payment by either signing the release quickly or delaying to a later date. This violates the strict requirements of 409A. It is important to recognize that it is not the employee's action or inaction that is the problem; it is the provision in the employment agreement."
(Drinker Biddle)
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Press Releases
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