December 4, 2015
Employee Benefits & Executive Compensation
On December 2, 2015, in a lively Oral Argument, the U.S. Supreme Court debated whether ERISA will preempt (Vermont) state laws governing databases for collection of health information for state-based health plans. The case before the Court is Gobeille v. Liberty Mutual Insurance Company, and it stems from Vermont Federal District Courts and the Second Circuit Court of Appeals.
November 20, 2015
Employee Benefits & Executive Compensation
President Obama signs bill repealing auto-enrollment for group health plans
President Obama signed H.R. 1314, the “Bipartisan Budget Act of 2015,” which repealed the Affordable Care Act revisions to the Fair Labor Standards Act. Under FLSA, employers with more than 200 full-time employees were required to enroll full-time employees into their group health benefits plans automatically.
October 16, 2015
Employee Benefits & Executive Compensation
President Obama has signed the “Protecting Affordable Coverage for Employees Act” (PACE Act). It modifies the Affordable Care Act’s definition of the small group insurance market. Under the PACE Act, the federal definition of the small group market remains at 50 or fewer employees (rather than 100 employees), but allows each state to decide whether to expand its small group market to include employers with 100 or fewer employees. Several ACA insurance market reforms differ depending on market size, with the small group market subject to mandates such as community rating and the requirement to cover all essential health benefits.
October 9, 2015
Employee Benefits & Executive Compensation
Clarification of HRA Reporting.
The IRS has made recent efforts to clarify Form 1095-B reporting for health reimbursement accounts (“HRAs”). HRAs are, by definition, employer funded plans that reimburse employees for health expenses, thereby meeting the basic definition of a self-funded group health plan. This has caused confusion among employers wondering if they must report separately for HRAs even though they are usually integrated with major medical group health plans, such as by reimbursing part of the deductible or other out-of-pocket expenses. According to the Form 1095-B (final) Instructions and in Notice 2015-68 released in late September, the IRS has confirmed that an employer sponsoring an HRA along with either a fully-insured or a self-insured major medical plan need not separately report the HRA.
October 2, 2015
Employee Benefits & Executive Compensation
CMS publishes Enrollment Manual for FFMs and FF-SHOPS
CMS published a 144-page Enrollment Manual for Federally-facilitated Marketplaces (FFMs) and Small Business Health Options Programs (FF-SHOPs). Specific sections of the manual are relevant to “qualified employers” who do not have state-based SHOPs and are small enough to sponsor a group health plan through a FF-SHOP plan (see 45 CFR §155.20 definitions and state law to determine if “small” means less than 50 or less than 100 employees). The manual also discusses FF-SHOP minimum participation requirements, regular and special enrollment, premium payment requirements, retiree coverage, dental coverage, the application of COBRA, the scope of employer and employee choice with respect to levels of coverage available, and some of the employer’s notice obligations. The guidance in the manual is effective October 1, 2015.
September 19, 2015
Employee Benefits & Executive Compensation
IRS issued revised filing instructions for applicable large employer members
The IRS issued revised Instructions for IRS filing 1094-C and 1095-C. All “Applicable Large Employer Members” are required to report group health plan coverage provided to employees in calendar year 2015. Forms 1094-C and 1095-C are required to be filed by February 29, 2016, or March 31, 2016, if filing electronically.
Disclaimer:
These employee benefits “Bytes” are prepared on behalf of the American Bar Association Health Law Section, and are part of a weekly “Health Law Byte” e-mail publication that is available to ABA members. The weekly HL Byte publication includes updates from the other ABA Health Law Interest Groups: •Business & Transactions, •eHealth, Privacy & Security, •Employee Benefits & Executive Compensation, •Healthcare Facility Operations, •In-House Counsel Sub-Interest Group, •Healthcare Fraud & Compliance, •Healthcare Litigation & Risk Management, •Life Sciences, •Managed Care & Insurance, •Payment, & Reimbursement, •Physician Issues, •Public Health & Policy, •Tax & Accounting. If you are interested in this and other ABA Health Section benefits please visit: http://www.americanbar.org/groups/health_law.html