Health Insurance

2016 ACA Compliance Checklist

The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted over four years ago. Many of these key reforms became effective in 2014 and 2015, including health plan design changes, increased wellness program incentives and the employer shared responsibility penalties.

Additional reforms take effect in 2016 for employers sponsoring group health plans. To prepare for 2016, employers should review upcoming requirements and develop a compliance strategy.

U.S. Supreme Court Upholds ACA Subsidies in Federal Exchanges

Today, the Supreme Court issued its opinion in King v. Burwell, the case challenging the availability of subsidies in health insurance Exchanges run by the federal government. In a 6-3 decision, the Court upheld the availability of subsidies in both state and federal Exchanges. The Court rejected the argument that the language of the Affordable Care Act authorized subsidies only in states that had set up their own Exchanges. With this ruling, the Court determined that Congress intended for the subsidies to be available to everyone.
 

EEOC Reverses Stance On Wellness Program Incentives

The government has reversed itself and said employer-sponsored wellness programs don't necessarily discriminate against workers. But businesses offering the plans to their employees are still struggling to show the programs can cut health care costs.

The Equal Employment Opportunity Commission proposed a rule change, saying that cutting workers' insurance premiums as an incentive for them to get health screening tests or improve their health scores doesn't violate federal disabilities laws as long as Obamacare and federal privacy rules are met.

2014 Health Plan Design Benchmark Summary

The Zywave Health Plan Design Benchmark Report is based on data drawn from the largest database in the country, consisting of 50,000 health plan designs from over 31,000 employers during the 2014 calendar year.

The summary features various plan design measures, segmented by industry, region, group size and plan type.

The report provides benchmarking information on six key plan design measures:

DOL Issues Final Rule to Expand FMLA Protections for Same-sex Spouses

On Feb. 25, 2015, the DOL issued a final rule under the FMLA that expands federal family leave rights for same-sex spouses, regardless of where same-sex couples reside. The DOL’s new guidance for same-sex spouses takes effect on March 27, 2015. This Compliance Bulletin summarizes the final rule’s guidance, including its impact on FMLA leave for same-sex couples and their families.

Understanding Employer Reporting Requirements of the Health Care Law

The ACA created new reporting requirements under Internal Revenue Code sections 6055 and 6056, which require certain employers to provide information to the IRS about the health plan coverage they offer (or do not offer) to their employees. On Feb. 8, 2015, the IRS released final versions of forms and related instructions that employers may use to report under Sections 6055 and 6056 for 2014. Although these forms are not required to be filed for 2014, reporting entities may voluntarily file in 2015 for 2014 coverage, using these forms and instructions.

Michigan Small Firms at a Crossroads: Purchase Plans, Use Private Exchange, or Self-Insure?

There has been debate about whether Michigan technically qualifies as a battleground state in political elections, but what’s clear is that it provides insight into the health insurance exchange (HIX) market impact on small employers in terms of both health plan costs and selection.