By Danielle Capilla Chief Compliance Officer at United Benefit Advisors The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA). The six-to-three […]
By Danielle Capilla Chief Compliance Officer at United Benefit Advisors The employer shared responsibility (i.e., “play or pay”) requirements went into effect in 2015 for large employers only (those with 100 or more full-time or full-time-equivalent employees). Even though they generally will not be liable for penalties until 2016, mid-size employers (employers with 50 to […]
By Danielle Capilla Chief Compliance Officer at United Benefit Advisors Recently, federal agencies, including the Department of Labor (DOL), issued a short five-question FAQ on two ACA-related issues: limitations on cost-sharing and provider discrimination. The FAQ further clarified that the self-only maximum annual limitation on cost sharing applies to each individual, regardless of whether the […]
By Peter Freska Benefits Advisor at The LBL Group A UBA Partner Firm Employee Benefit News published an article titled, “Employers procrastinating on ACA recordkeeping compliance.” It is an interesting read, as it refers to a recent survey by PricewaterhouseCoopers in which “Only 10% of some 480 employers in 36 industries responding to a recent […]
By Danielle Capilla Chief Compliance Officer at United Benefit Advisors PPACA created a private non-profit corporation called the Patient-Centered Outcomes Research Institute (PCORI). The Institute’s job is to research the comparative effectiveness of different types of treatment for certain diseases, and to share its findings with the public and the medical community. The goal is […]
By: Danielle Capilla Chief Compliance Officer at United Benefit Advisors On May 11, 2015, the Department of Labor (DOL) along with other federal agencies issued an FAQ regarding the implementation of the Patient Protection and Affordable Care Act (PPACA) that focused on coverage of preventive services. Non-grandfathered group health plans and health insurance offered in […]
By Danielle Capilla Chief Compliance Officer at United Benefit Advisors Question: How is PPACA’s “IRS Form W-2 safe harbor” regarding affordability calculated? Answer: Under PPACA, coverage is considered affordable if it costs less than 9.5 percent of an employee’s household income. Because employers are often unaware of an employee’s household income, there are three safe […]
By Elizabeth Kay Compliance & Retention Analyst AEIS Advisors A UBA Partner Firm Self-funding is a very hot topic these days for a number of reasons. For small group employers offering a self-funded plan this means they can charge a composite premium rate based on the employee population versus the community rates that are based […]
By Jennifer Kupper In-house Counsel for iaCONSULTING, a UBA Partner Firm Health Insurance Providers Fee Section 9010 of the Patient Protection and Affordable Care Act (PPACA) imposes a fee on each covered entity engaged in the business of providing health insurance for United States health risks. This is known as the Health Insurance Providers (HIP) […]
By Danielle Capilla Chief Compliance Officer at United Benefit Advisors Under federal regulations, Medicare is a secondary payer for many individuals who have an employer group health plan available to them, either as an employee or the dependent spouse or child of the employee. Generally the Medicare Secondary Payer rules prohibit employers with more than […]