Reminder: ACA Information Reporting Deadlines Approaching

 

Employers subject to the Affordable Care Act’s (ACA) information reporting requirements are reminded that the deadlines to file and furnish Forms 1094 and 1095 are quickly approaching. The reporting deadlines in 2017 are for reporting information on the 2016 calendar year, and are as follows:
· Applicable large employers (ALEs)-generally those with 50 or more full-time employees, including full-time equivalents-must file Forms 1094-C and 1095-C with the IRS no later than February 28, 2017 (or March 31, 2017 if filing electronically). ALEs must also furnish a Form 1095-C to all full-time employees by March 2, 2017 (which is a 30-day extension from the original due date of January 31).
· Self-insuring employers that are not considered ALEs, and other parties that provide minimum essential coverage, must file Forms 1094-B and 1095-B with the IRS no later than February 28, 2017 (or March 31, 2017, if filing electronically). These entities are also required to furnish a Form 1095-B to “responsible individuals” (may be the primary insured, employee, former employee, or other related person named on the application) by March 2, 2017 (which is a 30-day extension from the original due date of January 31).
Electronic Filing Requirements

 

Reporting entities filing 250 or more Forms 1095-B or Forms 1095-C must electronically file them with the IRS. Additional information on electronic filing can be found on the IRS ACA Information Returns (AIR) Program webpage.

 

New Executive Order Calls for Minimizing Fiscal Burdens of ACA

 

ACA Requirements Remain In Effect Pending Further Guidance or Legislation

 

President Trump has signed an executive order calling upon federal administrative agencies to minimize the economic burden of the Affordable Care Act (ACA), pending repeal of the law. Until further guidance is issued or legislation is signed, however, all ACA requirements remain in effect, including penalties for noncompliance.

 

In addition to making it clear that the Trump administration seeks the prompt repeal of the ACA, the executive order specifically calls upon agencies to exercise authority and discretion to:

 

· Waive, defer, grant exemptions from, or delay the implementation of any ACA provision or requirement that would impose a fiscal burden on states, individuals, health care providers, health insurers, and medical device and product producers (including fees, taxes, and penalties);
· Provide greater flexibility to states, and cooperate with them in implementing health care programs; and
· Encourage the development of a free and open market for the offering of health care services and health insurance.

 

The executive order must be implemented in a manner consistent with applicable law, including the Administrative Procedure Act, which requires extended review of and public comment on any federal rules which may be proposed as a result of the executive order.

 

New Guidance on Applicability of AVA’s Market Reforms to Family HRAs

 

The U.S. Departments of Labor, Health and Human Services, and Treasury have published new FAQs clarifying how family HRAs (HRAs available to reimburse the medical expenses of an employee’s spouse and/or dependents) can be integrated with other group health plan coverage to satisfy the market reforms of the Affordable Care Act (ACA).

 

Background
With the exception of qualified small employer HRAs, retiree-only HRAs, and HRAs consisting solely of excepted benefits, HRAs are considered group health plans that do not comply with the group market reform provisions of the ACA. Thus, stand-alone HRAs and HRAs used to purchase individual market coverage may be subject to a $100 per day excise tax per applicable employee, unless they are properly “integrated” with an underlying group health plan in accordance with agency guidance, as modified by IRS Notice 2015-87.

 

New Guidance
The new FAQs make clear that a family HRA may be integrated with:

 

· A non-HRA group health plan sponsored by the employer of the employee’s spouse that covers all of the individuals covered by the family HRA, so long as that non-HRA group health plan otherwise meets the applicable integration requirements (referred to as a “qualifying non-HRA group health plan”). For this purpose, an employer may rely on the reasonable representation of an employee that the employee and other individuals covered by the family HRA are also covered by another qualifying non-HRA group health plan.
· A combination of coverage under other qualifying non-HRA group health plans, provided that all of the individuals who are covered under the family HRA are also covered under other qualifying non-HRA group health plan coverage. For example, a family HRA covering an employee, spouse, and one dependent child may be integrated with the combination of (1) the employee’s self-only coverage under the non-HRA group health plan of the employee’s employer, and (2) the spouse and dependent child’s coverage under the non-HRA group health plan of the spouse’s employer, provided that both non-HRA group health plans are qualifying non-HRA group health plans.

 

This Qualified Small Employer HRA Basics guide summarizes how these new HRA’s can be used to reimburse employees’ individual health insurance premiums without violating the Affordable Care Act (ACA) rules. The guide includes:

 

Who can fund a qualified small employer HRA
How they must be structured
When they an be used
Free sample notice template

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