New FAQs Released

Federal agencies have released a new set of commonly asked questions and answers about Affordable Care Act implementation, which address coverage of preventive services, mental health benefits and women’s cancer benefits.

The links from the bullets below provide summarized answers to questions contained in the original document. For complete answers to the questions and to read the original document, follow this link.

Source: FAQs about Affordable Care Act Implementation (Part 31); published April 20, 2016

 

 

 

 

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New Marketplace Notice

The Health Insurance Marketplace is beginning to send a new notice to certain employers regarding the Affordable Care Act’s employer mandate1. The notice is sent because an employee:

  • enrolled in a qualified health plan on the Marketplace for 2016;
  • was determined eligible for advance payments of the premium tax credit or cost-share subsidies for at least one month during 2016 to help pay for Marketplace coverage; and
  • indicated that:
    • his or her employer did not offer employer-sponsored health coverage;
    • did have an offer of health coverage, but it was not affordable or did not provide minimum value; or
    • was in a waiting period and unable to enroll in health coverage.

Next steps
According to the Marketplace:

  • Employers may file an appeal within 90 days of the date of the letter if they believe there has been a mistake regarding the employee’s eligibility for premium tax credits or cost-share subsidies.
  • Filing an appeal could also eliminate reports from the Marketplace to the IRS that employees received premium tax credits or cost-share subsidies following an appeal decision in an employer’s favor.

However, filing an appeal won’t necessarily affect whether employers have to pay an employer mandate penalty to the IRS, because the IRS will determine independently whether employers face penalties. For more information, visit IRS.gov/aca or call the IRS at 800.829.4933 Monday through Friday from 7 a.m. to 7 p.m. (local time).

For employers that file appeals, the Marketplace will consider evidence provided by both the employer and employee to determine if the employee is eligible for premium tax credits or cost-share subsidies.

Follow this link for a sample notice.
1ACA’s Shared Responsibility for Employers Regarding Health Coverage Rule

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ACA Employer Mandate Webinar

An Internal Revenue Service webinar about the ACA employer mandate has been archived and is available for viewing.

View “ACA: Employer Shared Responsibility,” which aired on April 6, 2016, by visiting the IRS Video Portal.

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Free webcast by IRS on ACA Reporting of Minimum Essential Coverage (MEC) (6055)

The IRS will host a free webinar early next week on ACA Information Reporting including minimum essential Coverage (MEC), reporting requirements, forms and resources.

The webinar is scheduled for Tuesday, March 29th at 2 p.m. Eastern

Register for this event. You will use the same link to attend the event.

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How Covered Participants Receive Form 1095

In response to inquiries about how and when covered individuals will obtain Form 1095, the following information provides clarification of filing deadlines and resources available to aid plan sponsors (employers).

The IRS extended the deadlines for 6055 and 6056 reporting requirements. Plan sponsors of self-funded health benefit plans, and large employers (50 or more employees and their equivalents), must provide a statement (Form 1095) to full-time employees by March 31, 2016. Paper Forms 1094 and 1095 must be filed with the IRS by May 31, 2016, or electronically filed by June 30, 2016.

Plan sponsor of a self-funded health benefit plan, can review articles regarding the 6055 and 6056 reporting on this blog. Additional resources provided by Starmark are also available: Minimum Essential Coverage Reporting Requirements Sections 6055 and 6056 Reporting Requirements and 6055 and 6056 Reporting Frequently Asked Questions.

Further assistance regarding form 1095 can be found on the IRS.gov site:

Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

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Starmark Report to Assist Employers with 6055 and 6056 Reporting Now Available

To assist with 6055 and 6056 reporting requirements, Starmark is providing employers with a report that includes dependent SSNs on file for those covered by the employer’s self-funded benefit plan, as well as the date of birth and the months each person had coverage under the plan.

The report is now available in the Document Center of the Starmark website (www.starmarkinc.com). It reflects the information we have on file as of December 31, 2015, and will not be modified. View a sample of the report here.

Please note that the IRS recently extended the deadlines for 6055 and 6056 reporting requirements.

Now, employers must provide a statement to the primary covered individual by March 31, 2016. Paper returns must be filed by May 31, 2016, or electronic returns filed by June 30, 2016.

Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

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6055 and 6056 Reporting Deadlines Extended

This week, the IRS extended the deadlines for 6055 and 6056 reporting requirements.

Now, employers must provide a statement to the primary covered individual by March 31, 2016. Paper returns must be filed by May 31, 2016, or electronic returns filed by June 30, 2016.

Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

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Filed under Healthcare reform