The Fee is $2.66 per Covered Life for Plan Years Ending in 2021 The IRS issued Notice 2020-84, which increases the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after Oct. 1, 2020, and before Oct. 1, 2021. Specifically, the PCORI fee amount for plan years ending on or after Oct. 1,…
On Nov. 6, 2020, the Departments published an interim final rule requiring Medicare, Medicaid and private insurers to cover a COVID-19 vaccine without any cost-sharing, once the FDA authorizes and approves a vaccine. This Legal Update provides an overview of the interim final rule’s COVID-19 vaccine coverage requirements.
Contribution Limit to Remain the Same in 2021 The IRS has announced that the contribution limit for health flexible spending arrangements (health FSAs) will remain at $2,750 in 2021. For 2020, the contribution limit was also set at $2,750.
2020 ACA Reporting is Due in Early 2021 The IRS has released final 2020 forms and instructions for use in early 2021 to report under IRS Code Sections 6055 and 6056 for the 2020 calendar year. 2020 Form 1094-B and Form 1095-B (and related instructions) will be used by providers of minimum essential coverage (MEC), including self-insured plan sponsors that…
The Adjusted Penalty Amounts for 2021 are $2,700 and $4,060 Under the Affordable Care Act’s employer shared responsibility (pay or play) rules, applicable large employers—generally those who have 50 or more full-time employees (including full-time equivalent employees)—may be subject to a penalty if they do not offer affordable coverage that provides minimum value to their…
The America First Health Care Plan aims to Protect People with Preexisting Conditions and Combat Surprise Medical Billing On Sept. 24, 2020, President Donald Trump introduced his plan for affordable, high-quality health care, called the America First Health Care Plan. This plan, issued in an executive order, is primarily aimed at protecting people with preexisting conditions and…
The IRS has delayed the deadlines by which employers must furnish 2020 Forms 1095-C and 1095-B in early 2021. For 2020, the furnishing deadline was Feb. 1, 2021, Since Jan. 31, 2021, is a Sunday. The IRS has provided an additional 30 days for furnishing the 2020 Form 1095-B and Form 1095-C, extending the due date from…
The ACA requires health insurers to spend a minimum percentage of their premium dollars, or MLR, on medical care and health care quality improvement. Issuers that do not meet these minimum requirements must provide rebates to consumers. This percentage is: 85% for issuers in the large group market; and 80% for issuers in the small and…
2020 has certainly presented more than its share of challenges. Here at SIMA, with gratitude to our dedicated employees and exceptional technology team, we haven’t missed a beat. But, things do look a little different and will continue to do so for some time. And that includes during your company’s open enrollment period. Here’s how…
2018 Final Rule Allows Policies Lasting up to 12 Months On July 17, 2020, a federal appeals court upheld a 2018 final rule expanding short-term, limited-duration insurance (STLDI) for purposes of the Affordable Care Act (ACA). The final rule: Provides a maximum coverage period for STLDI of up to 12 months; and Allows STLDI to continue for…
