Articles

IRS Released Additional §4980H Guidance

In mid-December, the Internal Revenue Service (IRS) released further guidance on a variety of Affordable Care Act (ACA) provisions that affect employer-sponsored group health plans via Notice 2015-87. The notice was provided in a Q&A format, with several of the responses clarifying §4980H (“employer mandate”) requirements, including guidance in regard to determining affordability, counting hours of service, and 2016 penalty (assessable payment) amounts.

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IRS Extends Deadline for Employer ACA Reporting

The IRS has issued Notice 2016-4 extending the due date for employers to complete their 2015 ACA Form 1095 and 1094 reporting. The deadline for employers to provide a Form 1095 (C or B) to applicable employees and other covered individuals has been extended from February 1, 2016 to March 31, 2016.

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EEOC Issued GINA Wellness Rules

On Friday, October 30, the Equal Employment Opportunity Commission (EEOC) issued proposed rules that would amend the regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA). These rules relate to incentives offered in exchange for health information about an employee’s spouse as part of an employer-sponsored wellness program. The proposed rules provide a narrow exception to the prohibition on incentives that are contingent on the provision of genetic information.

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Common Misconceptions about the ACA Reporting Requirements

As we approach year-end, many employers realize that the 1094/1095 ACA reporting, which seemed to be so far off, is right around the corner. As we have talked with employers about these requirements, we have heard quite a few misconceptions. The following are a few we felt would be helpful to share:

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PACE Act Changes the Definition of Small Group Insurance

President Obama has signed legislation recently passed by Congress which changes how “small group” health insurance will be defined for rating and underwriting purposes. Previously, under the Affordable Care Act (ACA), a small group was scheduled to be defined as employers with fewer than 100 employees beginning in 2016.

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Cadillac Tax – 2015 IRS Notices

The Internal Revenue Service (IRS) has released two separate notices this year requesting comments on how to administer the excise tax on high-cost health coverage (also known as the “Cadillac tax”) set to go into effect for the 2018 tax year.

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Medicare Part D Notice Reminder

As you may recall, with the introduction of Medicare Part D prescription drug benefits, the Centers for Medicare and Medicaid Services (CMS) imposed certain notice requirements on employers. Employers are required to notify all Medicare beneficiaries of the “creditable” or “non creditable” coverage status of their prescription drug plan.

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Employer Reporting – HRA Reporting Requirement

In the recent draft instructions released by the IRS in regards to employer reporting on Forms 1094 and 1095, the IRS indicates that reporting is required for health reimbursement accounts (HRAs) integrated with fully-insured plans. This comes as a bit of a surprise to many who assumed that HRAs integrated with a major medical plan, regardless of funding method, would be considered “supplemental coverage” and not require any reporting.

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SDI Gains Marketshare in the Northwest

Subcontractor Default Insurance (SDI) has become a much more visible feature on major construction projects in the Northwest. Our region was arguably the last to embrace SDI. But, with the huge spike in commercial construction, the influx of national contractors, and the now proven track record of the product, owners and contractors in the Northwest have embraced the product.

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Washington State’s Data Breach Notification Law Changes (House Bill 1078) and Data Breach Fiduciary Responsibilities for Healthcare Organizations

Effective July 24th, 2015, Washington State law H.B. 1078 amends the State’s data breach notification statue. The amendment:
– Expands the statute to cover breaches of non-computerized data (hard copy data – which almost every business still houses)
– Imposes a 45-day deadline for notification of affected consumers (as opposed to 60 days previously)
– Mandates the notification of Washington State Attorney General for breaches larger than 500 Washington state residents
– Introduces a safe harbor for personal information that is secured or encrypted in a manner that meets or exceeds the National Institute of Standards and Technology (NIST) requirements

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Small Group Market – Changing Definition

Beginning in 2016, the definition of “small employer” for insurance rating and underwriting purposes changes. In general, employers with 51–100 full-time equivalents (FTEs) may now fall into the small employer category, and such groups will be subject to community rating and be required to offer essential health benefits for the first time. However, transition relief issued by the Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) allows states and insurers to choose to renew current policies through October 1, 2016. In other words, depending upon which state the insurance policy is being issued out of, employers with 51–100 FTEs, may have the option to renew their current policies through October 1, 2016. As of July 15, neither Alaska nor Washington states have announced any intention of adopting this transitional relief.

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