Health Care Reform Updates & Human Resource News Alerts

Health Care Reform News

HR360::Health Care Reform
  • Small Businesses May Be Able to Keep Existing Health Coverage Through 2019

    Posted on April 19, 2018
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    Policies Renewed Under Extended Transitional Policy Must End by December 31, 2019

    A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been further extended to policy years beginning on or before October 1, 2019, provided that all policies end by December 31, 2019. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year.

    Policies subject to the transitional relief will not be considered to be out of compliance with key Affordable Care Act provisions, including:

    • The requirement to cover a core package of items and services known as essential health benefits;
    • The requirement that any variations in premiums be limited with regard to a particular plan or coverage to age, tobacco use, family size, and geography;
    • The requirements regarding guaranteed availability and renewability of coverage; and
    • The requirements relating to coverage for individuals participating in approved clinical trials.

    Click here to review the extended transitional policy.

    © 2018 HR 360, Inc.
  • 2019 Cost-Sharing Limits for Most Group Health Plans Released

    Posted on April 10, 2018
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    HHS Issues Key Rule for 2019

    A new rule from the U.S. Department of Health and Human Services (HHS) addresses, among other things, the requirement under the Affordable Care Act that non-grandfathered group health plans limit annual out-of-pocket cost-sharing for coverage of essential health benefits under the plan. Under the rule, these out-of-pocket expenses may not exceed $7,900 for self-only coverage or $15,800 for family coverage in 2019.

    © 2018 HR 360, Inc.
  • New Rule Allows Brokers to Further Aid SHOP Enrollment

    Posted on April 10, 2018
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    Rule Effective for Plan Year 2018

    The U.S. Department of Health and Human Services (HHS) has issued a new rule that allows employers to directly enroll in SHOP (Small Business Health Options Program) coverage through a SHOP-registered agent or broker. This enrollment approach is now generally available in federally-facilitated SHOPs (FF-SHOPs), including state-based Exchanges using the federal platform for SHOP, for plan years beginning on or after January 1, 2018. State-based Exchanges operating their own SHOPs can also adopt this new approach.

    For more information, please contact the SHOP that applies in your state.

    © 2018 HR 360, Inc.
  • Individual Mandate Exemptions Available for 2017 Tax Returns

    Posted on April 06, 2018
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    Affordability, Tax Filing Threshold, and Other Exemptions Available

    Under the Affordable Care Act's (ACA) ''individual mandate'' (also called individual shared responsibility) provision, every individual must have minimum essential health coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return for tax year 2017.

    Among other exemptions, individuals may claim the following exemptions from the individual mandate by filing Form 8965, Health Coverage Exemptions, along with his or her 2017 tax return:

    • Affordability Exemption: The lowest-priced coverage available to the individual, through either a Health Insurance Marketplace or employer-based group health plan, would have cost the individual more than 8.16% of his or her household income for plan years beginning in 2017, as computed on the tax return.
    • Tax Filing Threshold Exemption: The individual’s gross income or household income was less than the applicable minimum threshold for filing a tax return (see ''2017 Federal Tax Filing Requirement Thresholds'').
    • Short Coverage Gap Exemption: The individual went without coverage for less than three consecutive months during the year.
    • Medicaid Expansion Exemption: The individual's household income is below 138% of the federal poverty line for his or her family size, and at any time during the year, the individual resided in a state that did not participate in the Medicaid expansion under the ACA. States that did not expand Medicaid for all of 2017 include: Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

    Click here to learn more about individual mandate exemptions.

    © 2018 HR 360, Inc.
  • Reminder: Significant Penalties Exist for Information Reporting Failures

    Posted on March 27, 2018
    Print

    IRS Electronic Filing Deadline is April 2

    With the April 2 deadline to electronically file Forms 1094 & 1095 with the Internal Revenue Service (IRS) approaching, employers are reminded that failing to comply with these information reporting requirements may result in significant penalties. These penalties are as follows:

    • Employers that fail to file correct information returns with the IRS and furnish correct payee statements are generally subject to a $260 penalty for each return for which such failure occurs, with a maximum annual penalty of over $3 million.
    • Employers that file correct returns and furnish correct statements on or before 30 days after the required filing date are generally subject to a $50 penalty for each return for which such failure occurs, with a maximum annual penalty of over $500,000.
    • Employers that file correct returns and furnish correct statements beyond 30 days after the required filing date but on or before August 1, 2018 are generally subject to a $100 penalty for each return for which such failure occurs, with a maximum annual penalty of over $1 million.
    © 2018 HR 360, Inc.
  • Electronic Filing Deadline for Forms 1094 and 1095 is April 2

    Posted on March 22, 2018
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    Deadline to File Paper Returns With IRS was February 28

    Employers subject to the Affordable Care Act’s (ACA) information reporting requirements are reminded that the deadline to electronically file ACA information returns with the IRS is April 2.  

    The reporting deadlines in 2018 are for the 2017 calendar year, and are as follows: 

    • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must electronically file Forms 1094-C and 1095-C with the IRS no later than April 2. The deadline to file paper returns was February 28.
    • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential health coverage, must electronically file Forms 1094-B and 1095-B with the IRS no later than April 2. The deadline to file paper returns was February 28.

    Note: Employers filing 250 or more Forms 1095-B or 1095-C are required to electronically file them with the IRS.

    Additional information on electronic filing can be found on the IRS's ACA Information Returns (AIR) Program webpage. 

    © 2018 HR 360, Inc.

    HR News and Alerts

    HR360::Health Care Reform
    • Small Businesses May Be Able to Keep Existing Health Coverage Through 2019

      Posted on April 19, 2018
      Print

      Policies Renewed Under Extended Transitional Policy Must End by December 31, 2019

      A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been further extended to policy years beginning on or before October 1, 2019, provided that all policies end by December 31, 2019. Health insurance issuers that renew coverage under the extended policy are required to provide standard notices to affected small businesses for each policy year.

      Policies subject to the transitional relief will not be considered to be out of compliance with key Affordable Care Act provisions, including:

      • The requirement to cover a core package of items and services known as essential health benefits;
      • The requirement that any variations in premiums be limited with regard to a particular plan or coverage to age, tobacco use, family size, and geography;
      • The requirements regarding guaranteed availability and renewability of coverage; and
      • The requirements relating to coverage for individuals participating in approved clinical trials.

      Click here to review the extended transitional policy.

      © 2018 HR 360, Inc.
    • 2019 Cost-Sharing Limits for Most Group Health Plans Released

      Posted on April 10, 2018
      Print

      HHS Issues Key Rule for 2019

      A new rule from the U.S. Department of Health and Human Services (HHS) addresses, among other things, the requirement under the Affordable Care Act that non-grandfathered group health plans limit annual out-of-pocket cost-sharing for coverage of essential health benefits under the plan. Under the rule, these out-of-pocket expenses may not exceed $7,900 for self-only coverage or $15,800 for family coverage in 2019.

      © 2018 HR 360, Inc.
    • New Rule Allows Brokers to Further Aid SHOP Enrollment

      Posted on April 10, 2018
      Print

      Rule Effective for Plan Year 2018

      The U.S. Department of Health and Human Services (HHS) has issued a new rule that allows employers to directly enroll in SHOP (Small Business Health Options Program) coverage through a SHOP-registered agent or broker. This enrollment approach is now generally available in federally-facilitated SHOPs (FF-SHOPs), including state-based Exchanges using the federal platform for SHOP, for plan years beginning on or after January 1, 2018. State-based Exchanges operating their own SHOPs can also adopt this new approach.

      For more information, please contact the SHOP that applies in your state.

      © 2018 HR 360, Inc.
    • Individual Mandate Exemptions Available for 2017 Tax Returns

      Posted on April 06, 2018
      Print

      Affordability, Tax Filing Threshold, and Other Exemptions Available

      Under the Affordable Care Act's (ACA) ''individual mandate'' (also called individual shared responsibility) provision, every individual must have minimum essential health coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return for tax year 2017.

      Among other exemptions, individuals may claim the following exemptions from the individual mandate by filing Form 8965, Health Coverage Exemptions, along with his or her 2017 tax return:

      • Affordability Exemption: The lowest-priced coverage available to the individual, through either a Health Insurance Marketplace or employer-based group health plan, would have cost the individual more than 8.16% of his or her household income for plan years beginning in 2017, as computed on the tax return.
      • Tax Filing Threshold Exemption: The individual’s gross income or household income was less than the applicable minimum threshold for filing a tax return (see ''2017 Federal Tax Filing Requirement Thresholds'').
      • Short Coverage Gap Exemption: The individual went without coverage for less than three consecutive months during the year.
      • Medicaid Expansion Exemption: The individual's household income is below 138% of the federal poverty line for his or her family size, and at any time during the year, the individual resided in a state that did not participate in the Medicaid expansion under the ACA. States that did not expand Medicaid for all of 2017 include: Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

      Click here to learn more about individual mandate exemptions.

      © 2018 HR 360, Inc.
    • Reminder: Significant Penalties Exist for Information Reporting Failures

      Posted on March 27, 2018
      Print

      IRS Electronic Filing Deadline is April 2

      With the April 2 deadline to electronically file Forms 1094 & 1095 with the Internal Revenue Service (IRS) approaching, employers are reminded that failing to comply with these information reporting requirements may result in significant penalties. These penalties are as follows:

      • Employers that fail to file correct information returns with the IRS and furnish correct payee statements are generally subject to a $260 penalty for each return for which such failure occurs, with a maximum annual penalty of over $3 million.
      • Employers that file correct returns and furnish correct statements on or before 30 days after the required filing date are generally subject to a $50 penalty for each return for which such failure occurs, with a maximum annual penalty of over $500,000.
      • Employers that file correct returns and furnish correct statements beyond 30 days after the required filing date but on or before August 1, 2018 are generally subject to a $100 penalty for each return for which such failure occurs, with a maximum annual penalty of over $1 million.
      © 2018 HR 360, Inc.
    • Electronic Filing Deadline for Forms 1094 and 1095 is April 2

      Posted on March 22, 2018
      Print

      Deadline to File Paper Returns With IRS was February 28

      Employers subject to the Affordable Care Act’s (ACA) information reporting requirements are reminded that the deadline to electronically file ACA information returns with the IRS is April 2.  

      The reporting deadlines in 2018 are for the 2017 calendar year, and are as follows: 

      • Applicable large employers (ALEs)—generally those with 50 or more full-time employees, including full-time equivalents—must electronically file Forms 1094-C and 1095-C with the IRS no later than April 2. The deadline to file paper returns was February 28.
      • Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential health coverage, must electronically file Forms 1094-B and 1095-B with the IRS no later than April 2. The deadline to file paper returns was February 28.

      Note: Employers filing 250 or more Forms 1095-B or 1095-C are required to electronically file them with the IRS.

      Additional information on electronic filing can be found on the IRS's ACA Information Returns (AIR) Program webpage. 

      © 2018 HR 360, Inc.