Search
RSS
Subscribe

Enter your email address to receive new posts in your inbox:

Delivered by FeedBurner

Share

Like what you see? Share!

Our Attorneys

DISCLAIMER: This blog is published for general information only - it is not intended to constitute legal advice and cannot be relied upon by any person as legal advice.  U.S. Treasury Regulations require us to notify you that any tax-related material in this blog (including links and attachments) is not intended or written to be used, and cannot be used, for the purpose of avoiding tax penalties, and may not be referred to in any marketing or promotional materials.  While we welcome you to contact our authors, the submission of a comment or question does not create an attorney-client relationship between the Firm and you. 

Entries in Health Care Reform (42)

Tuesday
Mar262019

Form 1094 and Form 1095 Reporting for Expatriate Employees

Every IRS Form 1094/1095 filing season (roughly January and February of each year), we receive questions on reporting for expatriate employees.  The most common questions: do we need to furnish a Form to expat employees working in the U.S. (sometimes called “inpats”) who are covered under a regular or expat plan, and if so which Form?  The rule is fairly straightforward: in general any employee who works in the U.S. at least 30 hours per week or is covered by self-funded minimum essential coverage should receive a Form 1095-C, regardless of whether he or she is an expat or covered by an expat plan.  But like any rule under the ACA, the general answer is complicated by exceptions and differences in employer size and plan type.

Filing Requirement for Applicable Large Employers

Click to read more ...

Wednesday
Mar092016

Avoiding a Patchwork of Pitfalls: Gobeille v. Liberty Mutual Insurance Co.

In the first decision issued since the passing of Justice Scalia, the Supreme Court of the United States held that ERISA preempts a Vermont statute requiring third party administrators of self-insured group health plans to report claims information to state health care databases.  Gobeille v. Liberty Mut. Ins. Co. addresses two important issues for benefit plans: (1) the scope of ERISA preemption; and (2) mandated reporting to state maintained “all-payer claims databases” (APCDs), which an increasing number of states are attempting to create in an effort to assess the cost, quality, and utilization of health services.  Employers should benefit from the broad ERISA preemption standard re-affirmed in the majority opinion authored by Justice Kennedy.  Plan sponsors, insurance carriers, and third party administrators should also take comfort in avoiding a patchwork of state APCD reporting requirements that may create foot faults for these entities.

Click to read more ...

Friday
Jan222016

IRS Issues Guidance on Employer Health Plan Opt-Out Payment Arrangements

Late last month the IRS released, in the form of 26 Q/As in Notice 2015-87, guidance on the application of various provisions of the Affordable Care Act to employer-sponsored health coverage.  The Notice covers a number of important issues, including the effect of health reimbursement account contributions, cafeteria plan flex credits, and employer opt-out payments on an employee’s cost of coverage for purposes of determining affordability under Code § 4980H(b).  The Notice also addresses the application to government entities of the employer shared responsibility rules, information reporting for applicable large employers, health savings account matters for persons eligible for benefits through the Department of Veterans Affairs, COBRA continuation coverage for carried over health flexible spending account balances, and penalty relief for employers that make a good faith effort to comply with the ACA reporting rules. 

Regarding employer opt-out arrangements, for months the IRS has stated, informally in various settings, that an employer should include the value of an opt-out payment in determining and reporting an employee’s cost of coverage.  (An opt-out payment is taxable income provided to an employee for waiving coverage under the employer’s health plan.)  Under this rule an opt-out payment might cause an employee’s cost of coverage to become unaffordable, thereby potentially subjecting the employer to an assessable payment.  Though the statutory and regulatory basis for this position is somewhat thin, a senior official at the IRS confirmed this view to us last summer. 

Oddly enough, Notice 2015-87 both confirms and retreats from this position.  Specifically, it provides that until the issuance of further guidance a payment under any opt-out payment arrangement in place prior to December 17, 2015 need not be reported on Form 1095-C and will not, on its own, cause an employer to be subject to a shared responsibility penalty.  Further (as confirmed by communication with the principal author of the Notice) and again until IRS guidance states otherwise, a payment under a conditional opt-out arrangement (for example, one requiring an employee to show proof of coverage under the spouse’s plan in order to receive the payment) adopted at any time need not be reported on Form 1095-C and will not, on its own, cause an employer to be subject to a shared responsibility penalty. 

Though the Notice provides that, for the time being, opt-out payments under certain arrangements need not be added to an employee’s cost of coverage for purposes of reporting and determining affordability, such payments will be added to an employee’s cost of coverage for purposes of determining (i) the employee’s eligibility for a subsidy on the Exchange, and (ii) whether the employee might be exemption from a penalty under the individual mandate. 

Thursday
Jan142016

Client Advisory - Winter 2016

This Client Advisory highlights certain developments regarding the Affordable Care Act (most significantly, the delay of the ACA reporting requirements and the “Cadillac” tax), discusses the EEOC’s proposed rules for wellness programs and the outcome of recent EEOC wellness program litigation, reviews important cases recently decided by and pending before the U.S. Supreme Court, and provides updates regarding church plan litigation and the Department of Labor’s proposed fiduciary rule.  We also offer thoughts about what employers can expect to see in 2016 in the way of agency enforcement activities.  Since 2016 is a presidential election year, few observers expect to see much, if any, significant legislation enacted by Congress.  But regulatory agencies, entering the final year of the Obama administration, may be more active and productive in 2016.

Click to read more ...

Monday
Feb232015

Notice 2015-17: Small-Scale Excise Tax Relief for Small Employers

On February 18, 2015 the Internal Revenue Service issued Notice 2015-17, which provides temporary relief from the excise tax under Code section 4980D for employer programs that reimburse employees for the cost of health insurance coverage purchased on the individual market (including coverage obtained through an Exchange).  The Notice also extends limited excise tax relief to health care arrangements covering 2-percent shareholder-employees, employer reimbursements of Medicare Part B or D premiums, and programs that reimburse the medical expenses of employees enrolled in TRICARE. The Notice provides a brief but welcome respite for small employers that wish to reimburse employees for the cost of obtaining individual health insurance policies (on a pre-tax basis) rather than maintaining a group health insurance plan.

Click to read more ...