UPDATE: American Health Care Act

May 4th the House passed the American Health Care Act (AHCA.) This chart (courtesy of NAHU.org) displays the content of the legislation. The bill will now be sent to the U.S. Senate where a number of changes are expected to be made. Until this bill is passed by the U.S. Senate and signed into law,…

How to Appeal a Marketplace Notice

Appeals Due Within 90 Days Health Insurance Marketplaces are now sending letters to notify certain employers that one or more of their employees has been determined eligible for advance premium tax credits and cost-sharing reductions and has enrolled in a Marketplace plan. Because these events may trigger penalties under the Affordable Care Act’s “pay or…

How to Determine ALE Status

ALEs Must Comply with ACA’s ‘Pay or Play’ Provisions An employer which has at least 50 full-time employees, including full-time equivalent employees (FTEs), on average during the prior year is generally considered an “applicable large employer” (ALE) under the Affordable Care Act (ACA) for the current calendar year. These employers are subject to the ACA’s…

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…