IRS Reduces Employer Mandate Penalties for 2025

On February 20, 2024

The Internal Revenue Service recently released guidance specifying the penalties that applicable large employers (ALEs) may face if they do not comply with the Affordable Care Act’s (ACA) Employer Shared Responsibility provisions during 2025.

On January 22, 2024

On January 9, 2024, the Department of Labor (DOL) issued a final regulation revising the standard businesses must use when determining if a worker is an employee or an independent contractor under the federal FLSA.

On January 15, 2024

Here is our list of the top problems that we see employers encounter and how to best mitigate them.

On January 9, 2024

Every broker working with group health plans must be mindful of compliance requirements that impact employer-sponsored plans. Here are ten compliance matters to keep in mind as you begin 2024.

IRS Releases Updated PCORI Fee Rates

On October 31, 2023

The Internal Revenue Service (IRS) has released the amount of the 2023 plan year Patient-Centered Outcomes Research Institute (PCORI) fee, which must be paid by group health insurance plan sponsors and health insurance issuers by July 31, 2024. The fee rate for plan years ending in 2023 are as follows: The PCORI fee was established […]

HHS RELEASES NEW FINE STRUCTURES

On October 30, 2023

The federal Department of Health and Human Services recently released new inflation-adjusted penalty amounts for various federal requirements that impact employers who offer group health insurance coverage and health insurance issuers. The new fine levels relate to compliance with the Health Insurance Portability and Accountability Act’s (HIPAA) privacy and data security requirements, various Affordable Care […]

IRS LOWERS ELECTRONIC FILING THRESHOLD FOR 2023 ACA REPORTING

On October 16, 2023

The Internal Revenue Service IRS issued updated instructions for preparing and submitting ACA health insurance coverage and employer reporting Forms 1094 and 1095 B and 1094 and 1095 C. In previous years, entities filing 250 or more 1095 forms were required to file electronically. Now, entities filing 10 or more of these forms will need to send them into the […]

UPDATE: UPCOMING GAG CLAUSE ATTESTATION REQUIREMENT

On September 25, 2023

The Consolidated Appropriations Act, 2021 (CAA) prohibits the inclusion of “gag clauses” in provider contracts with insurers and group health plans. According to the law, a gag clause is a contract provision that directly or indirectly restricts a plan or issuer from sharing specific cost and quality information with another party. For example, if a […]

Medicare Part D Creditable Coverage Notice deadline October 15th

On September 13, 2023

Each year, group health plans that offer access to pharmacy benefits must notify all plan participants who are eligible for Medicare about whether their benefits are as extensive as the standard Medicare prescription drug plan before Medicare’s annual election period begins on October 15th. If the group plan’s benefits are as generous, it is considered […]

New ACA COVERAGE AFFORDABILITY PERCENTAGE for 2024

On September 7, 2023

The Affordable Care Act’s “affordability percentage” for group health insurance coverage just nose-dived for 2024, and the change will significantly impact both applicable large employers subject to the ACA’s employer shared responsibility requirement (AKA the employer mandate) and their health insurance brokers. Many thought the affordability rate couldn’t go any lower than 2023’s 9.12%. However, […]