Health Care Reform News:
- Employer Reporting of Health Coverage Code Sections 6055 & 6056
- March 7, 2014-BB&T Insurance Services
- Excerpt: “The first final rule, on the section 6055 reporting requirements, requires health insurance issuers, self-insured health plan sponsors, government agencies that administer government-sponsored health insurance programs and any other entity that provides minimum essential coverage (MEC) to report information on that coverage to the IRS and covered individuals. This rule finalizes proposed regulations issued on Sept. 5, 2013… The second final rule, on the section 6056 reporting requirements, requires applicable large employers (ALEs) subject to the pay-or-play rules to report to the IRS and covered individuals information on the health coverage offered to full-time employees. This rule finalizes proposed regulations issued on Sept. 5, 2013. “
- IRS Issues Final Employer ACA Reporting Rules
- March 6, 2014-Littler
- Excerpt: “On Wednesday, the IRS released two new rules related to ACA employer reporting requirements. The first rule, Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, implements the information reporting requirements under § 6056 of the Internal Revenue Code (IRC), while the second rule, Information Reporting of Minimum Essential Coverage, implements the requirements imposed by IRC § 6055. These reporting requirements become effective with respect to the 2015 calendar year.”
- More Multiemployer Plan Relief – Final Rule Exempts Self-Insured/Self-Administered Plans from Transitional Reinsurance Fee in 2015 and 2016
- March 6, 2014-Proskauer
- Excerpt: “The Final Rule also helped answer the key question that was left open by the Proposed Rule – When is a plan is considered self-administered? Specifically, the Final Rule provides the following guidance: A self-insured plan is not considered self-administered if it uses a third party administrator in connection with its core functions, which are defined to include claims processing or adjudication (including the management of internal appeals) and plan enrollment.”
- ACA Requires All Health Plans to Obtain Health Plan Identifier (“HPID”)
- March 6, 2014-Faegre Baker Daniels
- Excerpt: “Under the HPID final regulations (published on September 5, 2012), large health plans must obtain an HPID by November 5, 2014. Small health plans with $5 million or less in annual receipts have an extra year (that is, until November 5, 2015) to register for an HPID…The preamble to the final regulations recognizes that, in practice, “very few self-insured group health plans conduct standard transactions themselves; rather, they typically contract with third-party administrators or insurance issuers to administer the plans. Therefore, there will be significantly fewer health plans that use HPIDs in standard transactions than health plans that are required to obtain HPIDs…”
- Health Care Reform Update: Government Releases 90-Day Waiting Restriction Final Rules and a Proposal
- March 3, 2014-Jackson Lewis
- Excerpt: “A proposed rule that would limit the maximum duration of an otherwise permissible orientation period to one month also was published in the Federal Register on February 24, 2014. (79 Fed. Reg. 10320.) The proposed rule clarifies that one month would be the maximum allowed length of any “reasonable and bona fide” employment-based orientation period. The proposal states, “To ensure that an orientation period is not used as a subterfuge for the passage of time, or designed to avoid compliance with the 90-day waiting period limitation, an orientation period is permitted only if it does not exceed one month. For this purpose, one month is determined by adding one calendar month and subtracting one calendar day, measured from an employee’s start date in a position that is otherwise eligible for coverage.”
- Big Changes Coming To Workplace Benefits
- February 28, 2014-Insurancenewsnet.com
- Excerpt: “The days of two or three traditional health plans -- along with insurance products such as life, long- and short-term disability and supplemental insurance from one or two carriers -- are rapidly ceding to a benefits mall where employees have choices among five or six plans offering health and insurance benefits catering to individual coverage…About 170 million Americans are insured through employer-sponsored health care, and a recent survey by AonHewitt found that the majority of employers will remain in the employer-sponsored health care game for the next three to five years…The coverage is likely to be offered through a private health care exchange as employers look to the exchanges to assume the burdens of health benefits administration and deliver a robust set of analytics to advise employees.”
In Other News:
- Can an Employee Decline FMLA Leave Even though the Absence is Covered by the Act?
- March 6, 2014-FMLA Insights
- Excerpt: “At issue in the appeal was whether an employee can affirmatively decline using FMLA leave, even though the underlying reason for leave would have been FMLA protected leave. To this question, the court answered, "yes." …In reaching its decision, the court focused on the FMLA regulations' expectation that the employer engage in an informal process to obtain additional information about whether the employee is seeking FMLA leave. Therefore, according to the court, the regulations suggest that "there are circumstances in which an employee might seek time off but intend not to exercise his or her rights under the FMLA" in order to preserve her FMLA leave for a later time. “
