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Category Archives: Health Care Reform

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NLRB classification of athletes as employees highlights a health care reform land mine

Posted in Employment Issues, Health Care Reform

Employers have always been concerned about the potential for worker reclassification, but health care reform and a recent NLRB decision take this issue to an entirely new level.  “Large” employers who offer coverage will be required to offer coverage to “all” of their “full-time workers,” defined as at least 95% of employees working 30 hours per week. An employer that offers coverage to only 94% of its full-time employees, and has one employee who enrolled on an exchange with a premium credit, will be subject to annualized penalties of $2,000 per full-time employee, less the first 30 employees. This draconian …


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Affordable Care Act Update: Agencies Extend Reprieve for Employer Pay-or-Play Mandate

Posted in Health Care Reform, Other Articles

Hot off the press are the final regulations for the employer shared responsibility provisions of the Affordable Care Act (more commonly referred to as the “pay-or-play mandate”). In fact, the regulations are so new that they will not actually be published in the Federal Register until tomorrow, February 12. For those of you who are dying to get a first glimpse, a pre-publication version can be found here.

While the regulations are extensive (227 pages), many of the provisions of the proposed regulations have been retained. However, there are a couple important transition rules buried in the final regulations …


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October 1, 2013 Health Care Reform Exchange Notice Deadline for All Employers Subject to the FLSA

Posted in Health Care Reform

As a reminder, under health care reform, all employers to which the Fair Labor Standards Act (“FLSA”) applies, not just “applicable large employers,” are required to distribute health care exchange notices to their employees by October 1, 2013.  Given that health care reform is chock full of big penalties, it puzzled me that I couldn’t find a penalty for failure to provide this notice. Last week, the DOL published Frequently Asked Questions that confirmed, “there is no fine or penalty under the law for failing to provide the notice.” Nonetheless, health care reform involves so many inter-related statutes, pages of …


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Porter Wright Presents Employee Relations Seminar Halloween Edition: Toil and Trouble . . .

Posted in Health Care Reform, Other Articles

Employee Relations Seminar Halloween Edition:
Toil and Trouble…

Please join the labor and employment group of Porter Wright as we address issues that will help keep your workforce out of trouble.

Tuesday, Oct. 8, 2013
7:45 – 8:30 a.m.
Registration and Breakfast
8:30 a.m.- 11:45 a.m.
Program

Lockkeepers Restaurant
8001 Rockside Road
Valley View, OH 44125

Topics Include:

Beware! New Employment Cases That Will Curl Your Hair

Ghost Stories: What Is Happening Now In Workers’ Compensation

Ghosts, Goblins & Ghouls: Data and Devices That Never Stop Giving

Boo! Are You Afraid Of The Deadlines?  Health Care Law Update

There is …


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Health Care Reform Surprise: Obama Administration Delays Enforcement of Employer Mandate For One Year

Posted in Health Care Reform

In a surprising but generally welcome move, the Obama administration has moved to delay the enforcement of the employer mandate to provide health care coverage under the Affordable Care Act (the “ACA”), which otherwise was scheduled to go into effect in 2014. This delay in enforcement formally was announced in a statement released July 2, 2013 by Mark J. Mazur, Assistant Secretary for Tax Policy at the Department of the Treasury.

As background for this action, the administration cites a series of meetings it has been having with businesses from throughout the country relating to the new employer and insurer …


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Health Care Reform Update: Planning Now for Significant 2014 Deadlines

Posted in Health Care Reform

The Affordable Care Act (the “ACA”) makes sweeping changes to the current health insurance landscape. Though some of these changes are already in force, the most significant provisions of the ACA become effective on January 1, 2014. This includes the “pay or play mandate,” the individual coverage mandate, and certain significant taxes and fees that are imposed on employers.

While many employers are already in the midst of planning for these significant changes, other employers have yet to examine how these new requirements will impact business operations, health coverage costs, benefit plan design, and coverage of employees. Employers are required …


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Temporary Relief From ACA Provisions Extended To Insured Expatriate Plans

Posted in Health Care Reform, Other Articles

The Departments of Labor, Health and Human Services and the Treasury (collectively, the “Departments”) recently issued guidance in the form of a Frequently Asked Question (“FAQ”) that relates to the applicability of the market reform provisions of the Affordable Care Act (the “ACA”) to certain expatriate health care plans. The issuance of this new FAQ indicates that the Departments recognize that expatriate health care plans face special challenges in complying with certain provisions of the ACA, such as the need to reconcile multiple regulatory regimes that may apply to such plans. In addition, the Departments recognize that in some situations …


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Employer Excise Taxes Under Health Care Reform – Contraceptive Coverage Mandate, New Proposed Regulations and HHS Due Process and Privacy Report Deadline Was 1/1/13

Posted in Health and Welfare Plans, Health Care Reform

As you may have heard, the U.S Supreme Court denied Hobby Lobby an injunction against the PPACA contraceptive coverage mandate. Employers who maintain health care plans are required to pay excise taxes for failure to comply with a particular aspect of the law, regardless of whether coverage is affordable. As we previously explained, these nondeductible taxes are computed per affected individual, per day, and they may be substantial. Hobby Lobby will purportedly accrue taxes of $1.3 million per day if it continues to maintain its plan, but fails to provide the mandated coverage.

On December 28, the IRS issued


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Summary of Benefits and Coverage Required for Fall Open Enrollment

Posted in Health Care Reform

Thank you to everyone who attended our recent Health Care Reform seminar! During the seminar, we mentioned the Summary of Benefits and Coverage, or SBC, required to be distributed as early as Sept. 23, 2012. One of the questions that arose about the SBC was, “Does this mean that the insurers now have to provide us our renewal quotes earlier?” Well, that certainly would be helpful, but unfortunately, it does not look like that will be happening.

An SBC must be provided to participants and beneficiaries for open enrollment periods that begin on or after Sept. 23, 2012.  The SBC …


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Health Care Reform Survives Supreme Court Scrutiny – But Not Entirely Intact

Posted in Health and Welfare Plans, Health Care Reform

Health care reform just got a clean bill of health from the United States Supreme Court. The Court today ruled on the constitutionality of the Patient Protection and Affordable Care Act (“PPACA”), and generally upheld the legislation in a 5-4 decision written by Chief Justice John G. Roberts. Roberts was joined in his opinion by the four justices who had been appointed to the Court by Democratic presidents. In an expected development, certain individual justices wrote and/or joined concurring and dissenting opinions as well. The Court upheld the individual mandate to purchase health coverage, concluding that the mandate is permissible …


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Supreme Court Wraps Up Oral Arguments On Health Care Reform – Day Three

Posted in Health Care Reform

On Wednesday, March 28, the Supreme Court wrapped up three days of oral arguments related to the constitutionality of certain portions of the health care reform legislation. As noted in my immediately previous blog related to the arguments, the Court focused on two issues in this last day of argument including: (a) whether the entire health care reform legislation must be invalidated in the event that the individual mandate is struck down, and (b) whether the provision of the legislation that expands the Medicaid program, and thus increases the financial burdens imposed on the states under that program, is constitutional. …


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Health Care Reform Reaches The Supreme Court – Two Days Down, One to Go

Posted in Health Care Reform

The Supreme Court on Tuesday, March 27 heard oral arguments on the most pivotal issue concerning the implementation of the health care reform legislation. The issue before the Court on Tuesday concerned the constitutionality of the individual mandate that is at the heart of the recent legislation (i.e., the obligation imposed on all covered individuals, effective in 2014, to either purchase health care coverage or pay a penalty for refusing to do so). This was the sole issue before the Court during two hours of oral arguments. Although other issues are being reviewed during three days of oral arguments, this …


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Implementing $2,500 FSA Limits for Non-Calendar Year Plans – Start Now

Posted in Fringe Benefits, Health and Welfare Plans, Health Care Reform

Beginning January 1, 2013, the Patient Protection and Affordable Care Act (“PPACA”) requires plan sponsors to limit pre-tax health flexible spending account (“FSA”) contributions to no more than $2,500 per calendar year. There are currently no limits on health FSA contributions. Thus, many employers have plan-imposed contribution limits in excess of the new $2,500 limit.  This change is anticipated to be a revenue-raiser.  Because the new limit is lower than most existing plan-imposed pre-tax FSA contribution limits, affected employees will pay taxes on more of their salary.

Given the January 1, 2013 effective date, many employers think they can wait …


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Health Care Reform Finally Reaches The Supreme Court – Day One!

Posted in Health Care Reform

The health care reform legislation finally is having its day (well, actually several days) in court — in the United States Supreme Court no less. Other than for those fixated on the upcoming Final Four (unfortunately, the author’s team already has been eliminated and thus I am free to write this) or on the triumphant return of Tiger Wood to the pinnacle of golf, it has been quite difficult to miss all the media attention aimed at this week’s arguments before the Supreme Court concerning the health care reform legislation passed by Congress in 2009. The Court has scheduled six …


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Summary of Benefits & Coverage Q&A’s Posted

Posted in Health Care Reform

We now have Q&A’s on the health care Summary of Benefits and Coverage.  This guidance is incredibly late and is not binding, but it may be of assistance to everyone rushing to get this documentation put together and distributed. We only have a fraction of the time Congress allotted for this undertaking, and this needs to be given high priority to prevent substantial penalties.  Good thing you don’t have anything else to do, right?…


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The Early Retiree Reinsurance Program — Go Forth and Spend

Posted in Health and Welfare Plans, Health Care Reform, Retirement Plans

The Patient Protection and Affordable Care Act (“PPACA”) contained a provision that established the Early Retiree Reinsurance Program (“ERRP”), the goal of which was to encourage plan sponsors to retain health care coverage for retirees through at least 2013. The ERRP was designed to provide reimbursement to eligible sponsors of employment-based plans for a portion of the costs of providing health coverage to early retirees (and eligible spouses, surviving spouses and dependents of such retirees) during the period beginning on the date on which the program is established and ending on January 1, 2014. Under PPACA, $5 billion was appropriated …


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Health Care Plan Summary of Benefits and Coverage Distribution Deadline Quickly Approaching for Employers

Posted in Health and Welfare Plans, Health Care Reform

Employers who maintain health plans may recall from our prior blogs (see “Health Care Plan Annual Enrollment Triage: The Summary of Benefits and Coverage Standards Have Not Been Issued Yet and May Just Have to Wait“ and ”Health Care Plan Summary of Benefits and Coverage: Still No Final Model, But Substantial Excise Taxes are Looming Anyway“) that they would soon need to address the new Summary of Benefits and Coverage (“SBC”), although urgent action would need to wait until the issuance of final guidance. Well, the wait is over. The Departments of Treasury, Labor, and Health …


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Independent Contractor Misclassification

Posted in Health and Welfare Plans, Health Care Reform

On our sister blog – Employer Law Report – Sara Hutchins Jodka discusses the IRS Voluntary Compliance Settlement Program. This program was designed to provide eligible employers partial relief from the federal employment taxes and penalties that typically result from misclassifying workers as independent contractors. Given the amount of attention that federal and state agencies are paying to this issue, it is important to consider whether your independent contractor arrangements are likely to survive scrutiny. Being required to reclassify individuals as employees can have costly tax and employee benefit ramifications, particularly as we approach the prospect of “large” employer health …


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Health care compliance Form 8928 excise tax self-reporting requirements: Have you done your due diligence for 2011 and determined the due date for your return, if required?

Posted in Health Care Reform

While conducting a health care reform webinar recently, we received questions that suggested the need to remind employers sponsoring group health care plans about their self-reporting obligations, and significant potential exposure to excise taxes. We are referring to excise taxes that are effective right now, not the new excise taxes that are slated for 2014 and 2018.

Sections 4980B, 4980D, 4908E, and 4980G of the Internal Revenue Code impose excise taxes for various failures of health care coverage requirements. For example, Section 4980B excise taxes apply to COBRA failures, and Section 4980D excise taxes apply for failure to comply with …


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Supreme Court Gets Into The Act On Health Care Reform

Posted in Health Care Reform

The table now is set for the last chapter in our long (and, to many, excruciating) debate over the constitutionality of the health care reform legislation enacted in 2010. At a conference last Thursday, November 10, the members of the United States Supreme Court voted to consider an appeal of one of the lower court decisions dealing with the constitutionality of the landmark legislation. Oral arguments likely will be scheduled for March, 2012 (ironically around the two year anniversary of the passage of the legislation). In turn, a decision is expected around the end of the Court’s session in June, …


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Health Care Shared Responsibility’s Missing Link – Reconciliation With The Employer

Posted in Health and Welfare Plans, Health Care Reform

The Patient Protection and Affordable Care Act (PPACA) shared responsibility provisions require speculation about whether health care coverage will be affordable for an individual. Whether affordable coverage was available, whether an individual was eligible for a premium credit, and whether an employer was subject to penalties, cannot be determined until after the individual files a personal tax return. PPACA shared responsibility provisions address reconciliation of the speculation between the individual and federal agencies. Proposed regulations regarding premium tax credits and Notices 2011-36 and 2011-73 regarding shared responsibility for employers spotlight a missing linking: reconciliation with the employer.

PPACA Penalty for …


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Health Care Plan Summary of Benefits and Coverage: Still No Final Model, But Substantial Excise Taxes Are Looming Anyway

Posted in Health and Welfare Plans, Health Care Reform

In our prior blog, we explained that under principles of triage, employers may need to focus on the current annual enrollment and wait to take care of the Summary of Benefits and Coverage (“SBC”). Although the SBC does not need immediate attention, we caution employers not to wait too long or take the SBC responsibilities too lightly. The penalties for failing to satisfy the SBC requirements are severe. This blog will explain what those penalties are and the steps to take to avoid them. In a subsequent blog, we will provide more details regarding specific content requirements and the …


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Form W-2 Reporting of Employer Healthcare Coverage: IRS Webinar on October 31

Posted in Health Care Reform

As I mentioned at the Cleveland Employment Relations seminar yesterday, the IRS has begun its outreach regarding the new requirement (“ACA 9002″) to report employer health care coverage on Form W-2.  Here are links to our prior blog on the topic, FAQs subsequently posted by the IRS, and information on an IRS webinar that will occur on October 31.  If you issue more than 250 Forms W-2, you will be subject to this reporting requirement for the 2012 calendar year (reporting in January 2013), and you may want to attend the webinar.  Just be sure to check with …


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CLASS Dismissed – No Actuarially Sound Federal Long-Term Care Program Developed

Posted in Health and Welfare Plans, Health Care Reform

The Patient Protection and Affordable Care Act gave the Secretary of Health and Human Services, Kathleen Sebelius, a hefty to-do list. One of those tasks was to develop at least three actuarially sound long-term care benefit plans that met specified criteria and would remain solvent for 75 years. This was to pave the way for the Community Living Assistance Services and Support (“CLASS”) program. CLASS was a key aspect of health care reform, intended to help elderly and disabled individuals maintain independence, and according to the Congressional Budget Office, to help pay for health care reform by reducing the federal …


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