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Healthcare Reform – Affordable Care Act (ACA)

Healthcare reform has had a significant impact on how companies of every type offer health insurance coverage. Benefit Masters, Inc. can help provide practical advice on the impact of healthcare reform on your organization. Our expertise on healthcare reform covers:

  • Requirements and necessary steps to remain compliant
  • Financial implications of non-compliance
  • Recommendations and cost estimates for current and future employee numbers

This page will provide you information on reporting, taxation, limitations and much more.

Click here to learn more about healthcare reform:

UPDATES ON HEALTHCARE REFORM:

  • Dates & Deadlines for 2017 Health Insurance – https://www.healthcare.gov/quick-guide/dates-and-deadlines/
  • Small Employer Group Market Changes
    • The Protecting Affordable Coverage for Employers (PACE) Act was passed last fall, putting the definition of a small employer as having one to 50 employees. However, states are permitted to elect to extend the definition of a small employer up to 100 employees.
    • How businesses are categorized will now be at a state-by-state level. Most states are using the PACE Act definition although a few states, including the large states of California and New York have chosen to use the expanded definition to 100.
  • Health Plan Transition Relief to Expire
    • Transition relief for the Employer Shared Responsibility payment for large employers with an average of 50 or more full-time equivalent employees during the prior year will expire January 1, 2017.
    • Depending on an employer’s eligibility and benefit plan start date, applicable large employers (ALE) must be compliant at some point this year or face penalties. Starting January 1, 2017, the non-calendar year transition relief expires and all ALEs are required to offer compliant coverage starting at the beginning of the new year.
    • Also expiring January 1, 2017, is flex contribution relief and grandfathered plans.  Organizations will need to review their contribution strategy if they include any of the various flex contribution benefits and make adjustments, as they will be considered a lost opportunity cost after this year.
    • Fifteen states in 2016 require the end to any grandfathered non-ACA compliant plans and the other 35 states will be in 2017. All medical plans will then be required to be fully ACA compliant.
  • IRS Reporting Penalties
    • This year when employers completed Forms 1094-C and 1095-C they were not assessed any penalties for incorrect or missing data. However, that good faith effort has not been extended for 2016 reporting. Employers need to identify any issues with their reporting and plan ahead whether they are gathering information themselves or using a third-party vendor. They need to set aside time for testing to correct any coding or processing errors.
    • Employers should also consider putting their employees’ Form 1095-Cs online and having them opt-in to access their information vs. incurring the cost of printing and mailing these forms.
    • Employers still have quite a few guidelines and regulations to stay abreast of and implement in order to remain ACA compliant and avoid future penalties.

Source:  Employee Benefit Plan Review. What Businesses Need to Know to Navigate the ACA Now.  June 2016.  PP10-12.

ACA IRS Tax Provisions – https://www.irs.gov/affordable-care-act/affordable-care-act-tax-provisions

HSA Chart for 2017

2017 Minimum Deductible Maximum Out-of-Pocket Contribution Limit 55+ Contribution
Single $1,300 $6,550 $3,400 +$1,000
Family $2,600 $13,100 $6,750 +$1,000

 

Compliance Forms Commonly Used for ACA:

1094-B Form

1094-C Form

1095-B Form

1095-C Form

Reporting Responsibilities Chart for 1094 and 1095 Forms

Full Time Equivalency (FTE) Form – Aetna

Full Time Equivalency Form (FTE) Form – CareFirst

Full Time Equivalency Form (FTE) Form – Evergreen

Full Time Equivalency Form (FTE) Form – United Healthcare

Medical Loss Ratio (MLR) Rebate Frequently Asked Questions (FAQ)

Medical Loss Ratio (MLR) Rebate Calculator