The Force is with you, Jedi health care workers! This infamous Star Wars theme headlined an annual health care presentation, sponsored by the McLaren Greater Lansing Healthcare Foundation’s Business Partners in Health Committee. Continue reading The Force Awakens: Better Health, Better Care, Better Value in America
Please let this serve as a reminder that the Patient-Centered Outcomes Research Institute (PCORI) fee is due by July 31st and must be reported on Form 720. The fee will be used to partially fund the PCORI which was implemented as part of the Patient Protection and Affordable Care Act.
Instructions are found HERE (see Part II).
The Form 720 itself is found HERE (see Part II).
Form 720, as well as the attached Form 720-V to submit payment, must be used to report and pay the requisite PCORI fee to the IRS. While Form 720 is used for other purposes to report excise taxes on a quarterly basis, for purposes of this PCORI fee, it is only used annually and is due by July 31st of each relevant year.
As previously advised, plan sponsors of applicable self-funded health plans are liable for this fee imposed by Code section 4376. For plan years ending on or after October 1, 2013 and before October 1, 2014, the fee is $2.00 per covered life. For plan years ending on or after October 1, 2014 and before October 1, 2015, the fee is $2.08 per covered life. The fee increases per year and concludes with plan years ending on or after October 1, 2018 and before October 1, 2019. [For calendar year plans, the fee runs from 2012 through 2018 plan years.]
The fee is due no later than July 31 of the year following the last day of the plan year.
There are specific calculation methods to be used to configure the number of covered lives and special rules may apply depending on the type of plan being reported. For example, HRAs and health FSAs that are not excepted from reporting only must count the covered participant and not the spouses and dependents. The Form 720 instructions do not outline all of these rules.
This correspondence is intended to provide general information only, does not constitute legal advice, and cannot be used or substituted for legal or tax advice.
On Friday, June 26, 2015, the U.S. Supreme Court issued the 5-4 landmark decision in Obergefell v Hodges striking down same-sex marriage bans across the country as unconstitutional under the Fourteenth Amendment. Continue reading SCOTUS Same-Sex Marriage Decision May Impact Employee Benefits Plans
In a historic 6-3 decision, the Supreme Court today upheld that the federal tax subsidies available to Americans who purchase health insurance through the Federal Health Insurance Marketplace (Federal Marketplace) are legal under the Affordable Care Act (ACA). Continue reading Supreme Court of the United States Upholds Affordable Care Act Subsidies, Siding with the Administration in King v Burwell
Attorney Michael James spoke to the Michigan Association of CPAs yesterday on his presentation “Accountable Care Organizations 2.0”. The presentation addressed the hundreds of pages of recently proposed regulations related to ACOs that represent the most dramatic overhaul of the Medicare Shared Savings Program since its inception. Other insights in the presentation:
- Current Regulatory Environment for Integrated Models
- How the Environment Evolves Under Proposed Regulations
- Various Requirements Needed for ACOs
- Potential Risks Under Current ACO Models Continue reading Accountable Care Organizations 2.0
Employers and plan sponsors that maintain wellness programs need to carefully review those programs to ensure compliance with various employment and benefit laws, including recently released guidance under the Patient Protection and Affordable Care Act (“PPACA”) and Title I of Americans with Disabilities Act (“ADA”). Nondiscrimination compliance issues surrounding employer wellness programs have been a hot topic since the issuance of the final regulations related to the prohibition against discrimination based on health status pursuant to the PPACA in 2013. Continue reading Client Alert: New Guidance Related to Wellness Programs Released
Plan sponsors have work to do on their summary of benefits and coverage (“SBC”) in the coming months. The government recently published proposed regulations related to the Patient Protection and Affordable Care Act’s (“PPACA”) SBC requirement. The proposed regulations would modify the 2012 final regulations and are intended to streamline and shorten the SBC in order to make it more useful and user-friendly to individuals, issuers, and group health plans.
The proposed regulations also incorporate a number of clarifying FAQs released by the government after the adoption of the 2012 final regulations. In conjunction with the release of the proposed regulations, the government contemporaneously made available proposed revisions to the SBC template, Continue reading Client Alert: More Changes to the Summary of Benefits & Coverage (SBC)
The Internal Revenue Service (IRS) recently issued Notice 2015-16 commencing the regulatory process to develop guidance on what’s been called the Cadillac Tax, i.e., the excise tax on high cost employer-sponsored health coverage.
Employers and plan sponsors, especially those with negotiated collective bargaining agreements, need to start actively planning now to mitigate exposure to the Patient Protection and Affordable Care Act’s (“PPACA”) Cadillac Tax under Code section 4980I, which is scheduled to go into effect for taxable years beginning on or after January 1, 2018. Continue reading Client Alert: Cadillac Tax on High Cost Employer Health Plans Approaching
Unless subject to an exemption, employers must report the aggregate cost of employer-sponsored health coverage provided in 2014 on their employees’ Form W-2 (Code DD in Box 12) issued in January 2015. Please see IRS Notice 2012-9 and our previous e-mail alerts for more information.
For a helpful IRS link that includes a chart setting forth various types of coverage and whether reporting is required, click here. Please note this is a summary only and Notice 2012-9 should also be consulted. Continue reading Client Alert and Reminder: Form W-2 Reporting Due, Disclosure Due to CMS for Medicare Part D