×

How to Comment:

Tap the quote mark to comment on articles.

Mercer

The good news is that employer ACA reporting was delayed for 2014. The bad news is that your employees may be prompted for the new Form 1095 when they file their taxes for 2014. The Form 1040 will prompt filers to indicate whether they had health care coverage in 2014. While a recent press release from the Departments of Treasury and HHS states that, for many with employer-sponsored health insurance, indicating coverage status will be as easy as "checking the box,"  what makes it more complicated is the taxpayer documentation required in order to "check the box" and/or have on file in the event of an audit later.

Helpful
Not Helpful
Expand Story

Last week I promised you more information about a topic that’s rising to the top of the priority list for every employer — ACA reporting. Here’s an overview of the purpose and types of reporting, along with the action items employers should address between now and January 1.

 

The ACA reporting requirements, despite being an administrative burden to employers, answer three important questions for IRS enforcement.

 

  • Did the employer offer the requisite coverage to satisfy the employer mandate?
  • Did the taxpayer have the requisite coverage to satisfy the individual mandate?
  • Was the taxpayer eligible for subsidized coverage?
Helpful
Not Helpful
Expand Story

Everyone is shifting into planning mode this month, thinking about open enrollment for 2016 benefits. Whether you are making major benefit plan changes, going out to bid for services, or keeping things status quo, here’s what you need to keep in mind relative to the ACA.

 

Reporting requirements. If you have not yet established processes for ACA reporting for 2015, you are not alone. Many employers are just now focusing on the requirements and looking for resources to support compliance. There are many third-party options available to help if your payroll or HRIS teams don't have the bandwidth. But it’s best to get started now.

 

Helpful
Not Helpful
Expand Story

As you finalize medical plan designs for 2016, make sure you consider these five compliance elements of the Affordable Care Act (ACA).

 

1. Embed individual out-of-pocket (OOP) limits. The ACA’s annual in-network OOP statutory limit for self-only coverage ($6,850) applies to all individuals, whether enrolled in self-only coverage or another tier (e.g., family). Be sure to confirm your medical carrier’s capabilities to adjudicate this benefit design feature. The penalty for non-compliance is $100 per day per individual.

 

 

Helpful
Not Helpful
Expand Story

The ACA reporting deadlines for minimum essential coverage and employer shared responsibility occur in the first quarter of 2016. Individual statements (Form 1095-Cs) have a Monday, February 1, 2016, deadline and the IRS electronic transmittal due date (Form 1094-C) is Thursday, March 31, 2016.

Helpful
Not Helpful
Expand Story

Plans that implement reference-based pricing (RBP) set a maximum amount payable for specific procedures. Higher-than-normal cost sharing applies for providers charging above reference price. Employers using or considering RBP need to stay on top of ACA rules and guidelines to avoid potential compliance problems:

Helpful
Not Helpful
Expand Story

This week, all eyes are on the presidential hopefuls as the primary election season kicks into high gear. With health care on the docket as one of the key domestic policy issues of this election, it’s important for voters to know where each candidate stands, relative to the ACA and Medicare.

Helpful
Not Helpful
Expand Story

Mercer met with Congressional staff on June 11 to provide input on developing legislation that would modify the ACA’s 40% excise tax on high-cost plans. Mercer recently submitted comments to the IRS on how to implement the tax starting in 2018, but more fundamental reform can only be achieved through enactment of new legislation.

Helpful
Not Helpful
Expand Story

It’s a done deal! Federal spending legislation cleared by Congress today for the President’s expected signature contains a two-year delay of the excise tax on high-cost plans. Assuming the tax does go into effect in 2020, the cost threshold will be the same indexed amounts they would have been without the delay. However, the U.S. Comptroller General will conduct a study on appropriate age and gender adjustments in consultation with NAIC.

 

Helpful
Not Helpful
Expand Story

Traditionally, employers have not thought of opt-out credits as increasing the cost of employee coverage. But in a recent HIPAA FAQ unrelated to affordability, regulators said that cash payments — or opt-outs — offered only to employees likely to generate high claims costs violate HIPAA’s prohibition against discrimination on the basis of health status.

 

Helpful
Not Helpful
Expand Story

Administrative burden tops list of employers concerns

 

For the first time since the law was passed, the administrative burden of ACA compliance surpassed the excise tax as the top concern for employers in Mercer’s seventh health care reform survey, conducted in January of this year. Since then, the government has issued the final regulations, draft forms, and instructions to comply with the 6055/6056 reporting requirements. We polled US employers about the requirements during a Mercer Select web briefing this week. More than half of them said they don’t yet know how they will comply; a third plan to complete the reporting in-house (at least for now), and the rest will rely on their benefits administration vendor, payroll vendor, or other third party. The biggest employer concerns about the reporting requirements were getting a system in place for 2015 and obtaining the required data from various sources. The focus of the web briefing was on reporting in 2016 for 2015.

Helpful
Not Helpful
Expand Story

It’s no surprise that administrative burden overwhelmingly tops the list of ACA concerns expressed by employers in Mercer’s recent survey, Health Care Reform in 2014: Are We There Yet? About a third of them say that complying with the new requirements is a very significant concern; another 44% say it’s a significant concern. One reason for that is the constant stream of FAQ, draft regulations, final regulations, changes, and delays that employers must factor into efforts to comply with all the requirements of the ACA.

 

Helpful
Not Helpful
Expand Story
Load More