With so many networks to choose from, finding doctors and hospitals using an insurance company’s website can be difficult. This video will show you how to look up providers on Humana’s NPOS network. This is especially helpful if you are not enrolled in a Humana plan yet.

Information about the Comparative Effectiveness Research Fee in 2019

The Affordable Care Act imposes an annual fee called the Comparative Effectiveness Research Fee (CERF) on insurers and plan sponsors of self-insured coverage to help fund the Patient-Centered Outcomes Research Institute (PCORI). This post includes a brief review of CERF.

CERF Payment Details
The fee is based on the average covered lives for the applicable 12-month policy or plan year. It is paid using IRS Form 720 by July 31 each year for the plan year that ended in the preceding calendar year. As a reminder, employers must use their ERISA plan year if it is different from the renewal date. The fees for 2019 are:

Final Rule Issued Allowing HRAs to be Used for Individual Coverage
June 17, 2019

On June 13, the U.S. Departments of the Treasury, Labor, and Health and Human Services (tri-agencies) issued a final rule allowing employees to use the dollars in employer-funded Health Reimbursement Arrangements (HRAs, also called Health Reimbursement Accounts) to purchase individual coverage both on and off the public Marketplace (or Exchange). The rule also creates a new excepted benefit HRA (EBHRA) to enable employees to be reimbursed for excepted benefit costs. This finalizes a proposed rule issued in Oct. 2018 largely as proposed, but with some modifications. The rule follows through on an Executive Order that directed the tri-agencies to consider ways to expand the flexibility of HRAs. 

The IRS issued Notice 2018-06 on Dec. 22, 2017, which extended by 30 days the 2018 due date for distributing 2017 health coverage information forms 1095-C or 1095-B to employees, regarding the health care coverage offered to them.

The new deadline for supplying these forms to employees is March 2, 2018. This 30-day extension is automatic. Employers and providers don’t have to request it.

The due dates for filing 2017 information returns with the IRS were not extended, however. For 2018, the due dates to file information returns with the IRS remain Feb. 28 for paper filers or April 2 for electronic filers.

Notice 2018-6 also extended good-faith transition relief to 2017 information reporting. This relief applies only to incorrect and incomplete information reported on Form 1095-C or 1095-B, and not to a failure to timely furnish or file the forms.

Below are links to the final forms and instructions on the IRS website:

• Form 1095-B, Health Coverage.
• Form 1094-B, Transmittal form accompanying Form 1095-B information returns.
• Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.
• Form 1094-C, Transmittal form accompanying Form 1095-C information returns.
• Instructions for Forms 1094-B and 1095-B.
• Instructions for Forms 1094-C and 1095-C.

The IRS had released draft versions of these forms and instructions in September.

The instructions to the Forms 1094-C and 1095-C were released with a few changes:

• Form 1094-C: A box in Line 22 called “Section 4980H Transition Relief” has been removed. It is not applicable in 2017.

• Forms 1095-B and 1095-C: A paragraph called “Additional information” in the instructions for recipients directs individuals to an IRS webpage providing information on the individual and employer shared-responsibility provisions and premium tax credits.

The forms for 1094 and 1095 healthcare reporting are available online from the Internal Revenue Service website.

As a refresher:

1. Form 1094-C is used by employers to give an overview of their plan and cost, and to prove they offered minimum essential coverage to their employees.
2. Form 1095-C is used by employees and employers to show if they had minimum essential health coverage during the year.

The Internal Revenue Service has the forms available online, along with instructions to help employers complete the forms.

Form 1094-C: https://www.irs.gov/pub/irs-pdf/f1094c.pdf

Form 1095-C: https://www.irs.gov/pub/irs-pdf/f1095c.pdf

Instructions for completing Forms 1094-C and 1095-C: https://www.irs.gov/pub/irs-pdf/i109495c.pdf

Keep in mind that the links above are for reports due for plan year 2015. Each year the IRS may adjust these forms and update them, so be sure you are using the form for the correct tax year.

For questions on how to find plan information or plan reports to complete these documents, check with your Benefit Advisor or your Third Party Administrator.