The proposed rules on use of financial incentives within workplace wellness programs were published by the Equal Employment Opportunity Commission (EEOC) on April 16, 2015. These rules align the wellness provisions of the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) with the nondiscrimination rules in the Americans with Disabilities Act (ADA).
As employer groups with 51-100 employees renew or purchase health insurance coverage in 2016, they must abide by the rules and regulations governing the small group market, including those related to benefit coverage and essential health benefits; actuarial value, and premium rating restrictions, such as adjusted community rating and no medical underwriting.
The small group rules apply to fully insured plans, including those purchased in the Small Business Health Options Program (SHOP) marketplace.
In some markets, the state and insurance carriers may give employers the option to keep their plan for a while longer by:
- Changing their plan year to maximize the time the employer can keep their plan in 2016.
- Taking advantage of transitional relief, which allows employers in some states to keep their current plans through Sept. 30, 2017.
Employers that self-insure (self-funded) are not subject to these requirements.
Options and requirements vary by state, issuer and segment. For more information, please contact us for a consultation at 832-482-2494 or via email through the “contact us” page on our website.
Recently, your health insurance company may have requested your Social Security number, as well as the Social Security numbers of your spouse and your qualifying dependents. Due to a new reporting requirement, you will need to report qualifying health coverage (referred to as “minimum essential coverage”) on your yearly income tax return. This new reporting requirement will begin for the 2015 tax year, and your social security number is required by the Internal Revenue Service (IRS) for Form 1095-B. Here are some common questions you may have regarding this process.
The Internal Revenue Service announced new 2016 limits for Health Savings Accounts (HSAs) and their related qualifying High Deductible Health Plan (HDHP).
For 2016, the annual HSA contribution limit for an individual with self-only coverage under a high deductible health plan (HDHP) will be unchanged at $3,350, while contribution limits under a family HDHP will increase to $6,750.
The maximum out-of-pocket expense limit for self-only HDHP coverage for 2016 will be $6,550, while family HDHP coverage for 2016 will be $13,100.
For 2016, the deductibles under a HDHP must be at least $1,300 for self-only coverage and $2,600 for family coverage.
Keep in mind, to be eligible to contribute to a Health Savings Account, you must be enrolled in a qualifying health plan. SB&K Benefits can help you create a strategy to implement Health Savings Accounts into your benefit package.
Almost two-thirds of tax filers who received insurance via the state or federal insurance Marketplaces had to pay back an average of $729 of the Advance Premium Tax Credit (APTC), cutting their potential refund by almost one-third, according to analysis of filing data by H&R Block (NYSE: HRB), the world’s largest consumer tax preparation company. The Advanced Premium Tax Credit was designed to pay a portion of a person’s health insurance premium each month, the amount was based upon projected income amounts. The intent is to help make health insurance “affordable”. So, for example, if your health insurance premium on the individual exchange was $500 per month, and you got a premium tax credit, you might pay $250 and the government would pay the other $250.
However, if you projected your income incorrectly when you signed up, or it changed during the year, you might not qualify for the original subsidy amount. So you’d have to pay back part or all of the subsidy at tax time.
H&R Blocks research found that the average refund for those with an APTC who filed was $2,195. The average premium tax credit reconciliation repayment amount was $729, which equated to a 33-percent reduction from their average refund.
Here is a link to the H&R Block article: http://newsroom.hrblock.com/hr-blocks-final-aca-stats-refunds-impacted-received-advance-tax-credit/
The IRS recently released the final forms and instructions for Section 6055 and 6056 reporting. Additionally, the IRS released Publication 5196, Understanding Employer Reporting Requirements of the Health Care Law, in order to help employers prepare for reporting in 2016.
Forms 6055 and 6056 are not required to be filed for 2014, but employers may choose to voluntarily file in 2015 for 2014 coverage using the released forms and instructions.