Determining ‘Full-Time Employees’ Under ‘Pay or Play’

Designation Determined by Hours Worked, Not Employer Classification The employer shared responsibility provisions of the Affordable Care Act (also known as “pay or play”) require applicable large employers (ALEs)—generally those with at least 50 full-time employees, including full-time equivalent employees (FTEs)—to offer affordable health insurance that provides a minimum level of coverage to full-time employees…

Reminder: Certain Small Employer HRAs Now Exempt From ACA’s Market Reforms

QSEHRAs Must Satisfy Certain Requirements As a reminder, a recent law allows certain small employers to offer new “qualified small employer health reimbursement arrangements” (QSEHRAs) to reimburse employees for qualified medical expenses, including individual health insurance premiums. Background Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits)…

How to Correct Form 1094 & 1095 Errors

To avoid potential noncompliance penalties, employers should confirm the accuracy of all Affordable Care Act (ACA) information returns and correct any errors as soon as possible with both the IRS and their employees. Errors on Forms 1094-C and 1095-C Forms 1094-C and 1095-C are used by applicable large employers to satisfy their reporting obligations. To correct information…

New SBC Template Required For Use On or After April 1

New versions of the Summary of Benefits and Coverage (SBC) template, instructions, uniform glossary, and related documents are required for use on or after April 1, 2017. Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times…

Revised Model CHIP Notice Now Available

A revised model notice is now available for all employers that provide group health coverage in states with premium assistance through the Children’s Health Insurance Program (CHIP), or Medicaid, to inform employees of potential opportunities for assistance in obtaining coverage. The employer CHIP notice must be furnished to all employees annually before the start of…

SIMA at the ALA

SIMA was delighted to share information and good times with the members of the Association of Legal Administrators at their annual retreat this past month in Williamsburg, Virginia. Consultant Chris Nagle and Marketing Coordinator Kerri White discussed ways in which administrators in legal offices can work smarter, not harder, to alleviate many of the burdens…