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4 Main Impacts of Yesterday's Executive Order

Yesterday, President Trump used his pen to set his sights on healthcare having completed the signing of an executive order after Congress failed to repeal ObamaCare.

Here’s a quick dig into some of what this order means and who might be impacted from yesterday's signing.

A Focus On Small Businesses

The executive order eases rules on small businesses banding together to buy health insurance, through what are known as association health plans, and lifts limits on short-term health insurance plans, according to an administration source. This includes directing the Department of Labor to "modernize" rules to allow small employers to create association health plans, the source said. Small businesses will be able to band together if they are within the same state, in the same "line of business," or are in the same trade association.

Skinny Plans

The executive order expands the availability of short-term insurance policies, which offer limited benefits meant as a bridge for people between jobs or young adults no longer eligible for their parents’ health plans. This extends the limited three-month rule under the Obama administration to now nearly a year.

Pretax Dollars

This executive order also targets widening employers’ ability to use pretax dollars in “health reimbursement arrangements”, such as HSAs and HRAs, to help workers pay for any medical expenses, not just for health policies that meet ACA rules. This is a complete reversal of the original provisions of the Obama policy.

Research and Get Creative

The executive order additionally seeks to lead a federal study on ways to limit consolidation within the insurance and hospital industries, looking for new and creative ways to increase competition and choice in health care to improve quality and lower cost.


What You Need to Know about Health Flexible Spending Accounts

Are you having a hard time figuring out how a FSAs works? Take a look at this great article from our partner, United Benefit Advisors (UBA) by Danielle Capilla and found out everything you need to know about FSAs.


A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket health care costs for a participant as well as a participant's spouse and eligible dependents. Health FSAs are employer-established benefit plans and may be offered with other employer-provided benefits as part of a cafeteria plan. Self-employed individuals are not eligible for FSAs.

Even though a health FSA may be extended to any employee, employers should design their health FSAs so that participation is offered only to employees who are eligible to participate in the employer's major medical plan. Generally, health FSAs must qualify as excepted benefits, which means other nonexcepted group health plan coverage must be available to the health FSA's participants for the year through their employment. If a health FSA fails to qualify as an excepted benefit, then this could result in excise taxes of $100 per participant per day or other penalties.

Contributing to an FSA

Money is set aside from the employee's paycheck before taxes are taken out and the employee may use the money to pay for eligible health care expenses during the plan year. The employer owns the account, but the employee contributes to the account and decides which medical expenses to pay with it.

At the beginning of the plan year, a participant must designate how much to contribute so the employer can deduct an amount every pay day in accordance with the annual election. A participant may contribute with a salary reduction agreement, which is a participant election to have an amount voluntarily withheld by the employer. A participant may change or revoke an election only if there is a change in employment or family status that is specified by the plan.

Per the Patient Protection and Affordable Care Act (ACA), FSAs are capped at $2,600 per year per employee. However, since a plan may have a lower annual limit threshold, employees are encouraged to review their Summary Plan Description (SPD) to find out the annual limit of their plan. A participant's spouse can put $2,600 in an FSA with the spouse's own employer. This applies even if both spouses participate in the same health FSA plan sponsored by the same employer.

Generally, employees must use the money in an FSA within the plan year or they lose the money left in the FSA account. However, employers may offer either a grace period of up to two and a half months following the plan year to use the money in the FSA account or allow a carryover of up to $500 per year to use in the following year.

See the original article Here.

Source:

Capilla D. (2017 August 29). What you need to know about health flexible spending accounts [Web blog post]. Retrieved from address http://blog.ubabenefits.com/what-you-need-to-know-about-health-flexible-spending-accounts-1


Survey: Small Businesses Keeping Pace with Health Benefits Offered by Employers Nationwide

Find out how small businesses compare to major corporations when it comes to their healthcare benefits in this informative article from our partner, United Benefit Advisors (UBA) by Bill Olson.

Small employers, those with fewer than 100 employees, have a reputation for not offering health insurance benefits that are competitive with larger employers, but new survey data from UBA’s Health Plan Survey reveals they are keeping pace with the average employer and, in fact, doing a better job of containing costs.

According to our new special report: “Small Businesses Keeping Pace with Nationwide Health Trends,” employees across all plan types pay an average of $3,378 toward annual health insurance benefits, with their employer picking up the rest of the total cost of $9,727. Among small groups, employees pay $3,557, with their employer picking up the balance of $9,474 – only a 5.3 percent difference.

When looking at total average annual cost per employees for PPO plans, small businesses actually cut a better deal even compared to their largest counterparts—their costs are generally below average—and the same holds true for small businesses offering HMO and CDHP plans. (Keep in mind that relief such as grandmothering and the PACE Act helped many of these small groups stay in pre-ACA plans at better rates, unlike their larger counterparts.)

PPO Plan Average Annual Cost per Employee

Think small businesses are cutting coverage to drive these bargains? Compared to the nations very largest groups, that may be true, but compared to average employers, small groups are highly competitive

See the original article Here.

Source:

Olson B. (2017 August 24). Survey: small business keeping pace with health benefits offered by employers nationwide [Web blog post]. Retrieved from address http://blog.ubabenefits.com/survey-small-businesses-keeping-pace-with-health-benefits-offered-by-employers-nationwide


The COBRA Payment Process

Great article from our partner, United Benefit Advisors (UBA) by Danielle Capilla.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

Grace Periods

The initial premium payment is due 45 days after the qualified beneficiary elects COBRA. Premium payments must be made on time; otherwise, a plan may terminate COBRA coverage. Generally, subsequent premium payments are due on the first day of the month. However, under the COBRA grace period rules, premiums will still be considered timely if made within 30 days after the due date. The statutory grace period is a minimum 30-day period, but plans may allow qualified beneficiaries a longer grace period.

A COBRA premium payment is made when it is sent to the plan. Thus, if the qualified beneficiary mails a check, then the payment is made on the date the check was mailed. The plan administrators should look at the postmark date on the envelope to determine whether the payment was made on time. Qualified beneficiaries may use certified mail as evidence that the payment was made on time.

The 30-day grace period applies to subsequent premium payments and not to the initial premium payment. After the initial payment is made, the first 30-day grace period runs from the payment due date and not from the last day of the 45-day initial payment period.

If a COBRA payment has not been paid on its due date and a follow-up billing statement is sent with a new due date, then the plan risks establishing a new 30-day grace period that would begin from the new due date.

Notification

The plan administrator must notify the qualified beneficiary of the COBRA premium payment obligations in terms of how much to pay and when payments are due; however, the plan does not have to renotify the qualified beneficiary to make timely payments. Even though plans are not required to send billing statements each month, many plans send reminder statements to the qualified beneficiaries.

While the only requirement for plan administrators is to send an election notice detailing the plan's premium deadlines, there are three circumstances under which written notices about COBRA premiums are necessary. First, if the COBRA premium changes, the plan administrator must notify the qualified beneficiary of the change. Second, if the qualified beneficiary made an insignificant shortfall premium payment, the plan administrator must provide notice of the insignificant shortfall unless the plan administrator chooses to ignore it. Last, if a plan administrator terminates a qualified beneficiary's COBRA coverage for nonpayment or late payment, the plan administrator must provide a termination notice to the qualified beneficiary.

The plan administrator is not required to inform the qualified beneficiary when the premium payment is late. Thus, if a plan administrator does not receive a premium payment by the end of the grace period, then COBRA coverage may be terminated. The plan administrator is not required to send a notice of termination in that case because the COBRA coverage was not in effect. On the other hand, if the qualified beneficiary makes the initial COBRA premium payment and coverage is lost for failure to pay within the 30-day grace period, then the plan administrator must provide a notice of termination due to early termination of COBRA coverage.

See the original article Here.

Source:

Capilla D. (2017 August 23). The COBRA payment process [Web blog post]. Retrieved from address http://blog.ubabenefits.com/the-cobra-payment-process-1


5 tips to make this the best open enrollment ever

Open enrollment season is right around the corner. Did you know that most people find open enrollment season more burdensome than tax season? As employers begin engaging their employees on healthcare offerings, check out these great tips by Kim Buckey from Benefits Pro on how you can make this year the best open enrollment yet.

Learn from last year’s enrollment

Look back on how your company fared during last year’s open enrollment period.

What were the most time-consuming tasks, and how can they be streamlined this year? What were the top questions asked by employees? Did you achieve your enrollment goals?

Hold a meeting with key internal and external stakeholders on the team and review what worked and what didn’t work last year. Knowing where you are, what your challenges are and will be, and where you’re on the right track will enable you to create a meaningful plan for this year.

Start with strategy

Once you know where you are, figure out where you want to be, how you’re going to get there, and how you’ll determine if you’ve achieved your goals. Make sure your strategy includes:

  • An assessment of all of your audiences. Remember, you’re not just communicating to employees, you’re reaching out to family members and to managers as well. Keep in mind that not every audience member has the same education level or understanding of even the most basic benefits concepts.
  • What’s changing. Are you adding or eliminating plans? Is cost-sharing changing? Is there a new vendor? Having a thorough understanding of what’s changing will help determine what your messaging should be.
  • Defining your corporate objectives. Are you looking to increase participation in a particular plan option, or shift a percentage of your population to a new plan offering? Increase participation in a wellness plan? What percentage? Define your objectives and how you plan on measuring success.
  • Your overall messages — and any specific messages targeted to your audiences. You may communicate differently to people already in the plan in which you want to increase participation, for example.
  • A schedule. People need to hear messages multiple times before they “register.” Make sure you’re communicating regularly — and thoughtfully — in the weeks leading up to, and during, the enrollment period.
  • Media. What messages will you deliver in print (newsletters, posters, postcards, enrollment guides)? What should be communicated in person, through managers or one-on-one enrollment support?

Make this year’s enrollment more active

Eighty percent of Americans spend less than an hour researching benefit options, and 90 percent keep the same plan from year to year. Yet for most employees, their circumstances change annually — whether it be the number of their dependents, their overall health and health care usage or their pay.

Active enrollment — where an employee must proactively choose a plan or go without coverage — can be an important step in getting employees more engaged in their benefits.

Active enrollment has benefits for the employer as well — it provides an opportunity to collect key data (such as current dependent information) and to direct employees to the most cost-effective plans for them.

But helping employees choose the “right” plan requires a robust communication plan, combining basic information about plan options, decision-making tools that address the total cost of coverage (both premium and point-of-service costs) and even one-one-one enrollment support.

Many employees don’t have the information they need to make good decisions, and aren’t likely to seek it out on their own — it must be ‘pushed’ to them.

Take demographics into consideration

When engaging employees around their benefits options, consider the wants, needs, and communication preferences of each demographic. Employees just starting their careers are the most underinsured (and generally least informed) group, often seeing student debt rather than health coverage as a more pressing priority.

Harris/Accolade poll reveals that when results are broken out by age cohort, workers under 30 are having the greatest difficulty finding their way through the healthcare labyrinth.

Only 56 percent say they are comfortable doing so, compared to 76 percent of retirees. They also report more challenges in making the best care decisions, including understanding cost, coordinating care, choosing and understanding benefits, and finding a doctor they can relate to.

Understand the limitations of decision support tools

Decision support tools enable people to take an active role in managing their health care. While they can certainly help, remember that employees must seek them out and use them, and these tools often assume a level of benefits knowledge your employees might not have.

And, these tools recently have come under scrutiny for their ultimate lack of measurable results. To see the return on investment and value, you must also provide education and communications to provide some context for, and drive usage of, these tools.

By applying these five steps along with setting your team up with designated roles, responsibilities, and deadlines, you’re well on your way toward a more seamless, efficient and effective open enrollment period and to saving both your organization and your coworkers time and money.

But remember, benefits communication isn’t “one and done” at enrollment. You’ll need a year-round plan to help employees make good decisions about their care once they’ve chosen their coverage.

See the original article Here.

Source:

Buckey K. (2017 Aug 25). 5 tips to make this the best open enrollment ever [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/08/25/5-tips-to-make-this-the-best-open-enrollment-ever?page_all=1


Preparing for 2018 Open Enrollment

As open enrollment season nears, make sure you are staying compliant and up-to-date with everything that is happening in ACA. Here are some great tips by Carl C. Lammers from Benefit News on what you need to know to prepare yourself for open enrollment this upcoming year.

Open enrollment for employer-sponsored health and welfare benefits comes every year; usually with little fanfare as employers generally have a system in place to seamlessly handle enrollments.

This changed with the passage of the Affordable Care Act in 2010, but now seven years later, employers again mostly have open enrollment standardized. This year brings a new challenge – the Summary of Benefits and Coverage document that was created by the ACA has undergone its first major restructuring since 2012 when employers were first required to provide the SBC.

The new SBC template must be used for open enrollments that occur on or after April 1, 2017. For calendar year plans, the upcoming 2018 open enrollment is the first open enrollment where the new SBC templates must be used.

If you need a quick refresher, the SBC summarizes group health plan coverage for employees, describing many important plan features, such as deductibles, co-pays, co-insurance, and services covered, so that employees can better understand and make more informed choices about the available coverage options.

SBCs have a required uniform format and must contain certain information and examples, so that employees can compare an employer’s coverage options and options from more than one employer.

The uniform standard definitions of medical and health coverage terms and the required SBC template are distributed by the IRS, DOL, and HHS.

While the insurance carrier or third party administrator normally provides the SBC to an employer for distribution with open enrollment materials, employers are ultimately responsible for the SBC’s accuracy and distribution and for the recently increased penalties – of $1,087 per failure – for failure to distribute the SBC.

Employers should review the SBC’s provided for the upcoming open enrollment to be sure they have changed to reflect the new rules. Employers should also distribute the Section 1557 nondiscrimination notice with the SBC to avoid potential penalties.

The new finalized guidance on SBCs was issued by the Departments in April of 2016. The guidance states that while all prior formatting must still generally be complied with; SBCs can now have certain language and formatting alterations, such as differing font styles and margins in order to maintain the four page requirement. Definitions were also added to the Uniform Glossary, and the Departments state that SBCs may hyperlink the terms to a micro-site that HHS will maintain.

The required content of the SBC has also changed, with some of the most significant changes being:
A description of what an SBC is and where consumers can find more information, located at the beginning of the SBC.

A description of how family members must meet their own individual deductibles before the overall family deductible is met, and what services are covered.

  • Changing of the term "person" to "individual."
  • A statement that copays may not be included in out-of-pocket limits.
  • The removal of the definitions of copayments and coinsurance.
  • Change of the "Limitations & Exceptions" column to "Limitations, Exceptions, & Other Important Information" which must now include:
  • When the plan does not cover a certain service category, or a substantial portion of a service category.
  • When cost sharing for covered in-network services does not factor into the out-of-pocket limit.
  • Visit and/or dollar limits.
  • When services require preauthorization.
  • Note: cross-referencing is allowed if including all information in this section would cause the SBC to exceed four pages.
  • New language about minimum essential coverage, minimum value, and language access services.
  • The addition of a third Coverage Example about costs for a fracture, and slightly altered formatting to the Coverage Examples section.
  • A statement regarding whether abortions are covered by the plan.

One thing that is not part of the new SBC guidance is also important for employers: SBCs are likely considered "significant communications" for purposes of the nondiscrimination rules found in Section 1557 of the ACA, and the notice required by Section 1557 should be included with the SBC.

The Section 1557 notice must be included with all “significant communications” involving the medical plan. It is not clear whether the Departments have considered the addition of the Section 1557 language and its impact on the four page SBC limit.

We suggest including the 1557 notice with the new SBCs, but not as part of the new SBCs, in order to maintain the four-page length. Be sure to review any draft SBCs prepared by your insurer or TPA before distribution to ensure they meet the new formatting requirements.

See the original article Here.

Source:

Lammers C. (2017 July 31). Preparing for 2018 open enrollment [Web blog post]. Retrieved from address https://www.benefitnews.com/opinion/preparing-for-2018-open-enrollment


Strategic Benefits Communication: Five Key Steps to Success this Open Enrollment Season

Make sure to check out this great article from our partner, United Benefit Advisors (UBA) by Kevin D. Seeker and find out the 5 key steps to having a successful open enrollment.

In previous posts, I have talked about several aspects of strategic benefits communication. Now it’s time to put those strategies into action. As we approach enrollment season, let’s look at five key steps to ensuring this year’s open enrollment is successful for you and your employees.

1. Determine your key objectives

What do employees need to know this enrollment season? As you review your benefit plan designs, think once again about your key objectives, and for each, how you will make employees aware and keep them engaged. What are the challenges employees face when making their benefits decisions?

  • Are you rolling out new medical plan options? Does this include HDHP options? An HSA? Are there changes in premiums and contribution levels?
  • Are there any changes to other lines of coverage such as dental, life insurance, disability insurance?
  • Are you adding new voluntary plans this year? How do they integrate with your medical plans? Do they plug gaps in high deductibles and out-of-pocket expenses? Are there existing voluntary plans with low participation?
  • Are there other important topics to share with employees, like new wellness programs, or health-driven employee events?

Once you’ve gathered this information, you can develop a communication strategy that will better engage employees in the benefits decision-making process.

2. Perfect your script

What do you know about your employee demographics? Diversity doesn’t refer only to age or gender. It could mean family size, differences in physical demands of the job, income levels, or simply lifestyle. It isn’t a one-size-fits-all world anymore. As you educate employees on benefits, you will want to give examples that fit their lives.

You will also want to keep the explanations as simple as possible. Use as much plain language as you can, as opposed to “insurance speak” and acronyms. Benefit plans are already an overwhelming decision, and as we have seen in our research, employees still don’t fully understand their options.

3. Use a multi-faceted communications strategy

Sun Life research and experience has shown that the most appreciated and effective strategies incorporate multiple methodologies. One helpful tactic is to get a jump-start on enrollment communication. As enrollment season approaches, try dynamic pre-enrollment emails to all employees, using videos or brochures. Once on-site enrollment begins, set up group meetings based on employee demographics. This will arm employees with better knowledge and prepared questions for their one-to-one meeting with a benefits counselor.

Consider hard-to-reach employees as well, and keep your websites updated with helpful links and provide contacts who are available by phone for additional support.

Also, look to open enrollment as a good time to fill any employee data gaps you may have, like beneficiaries, dependents, or emergency contacts.

4. Check your tech!

We have talked in previous posts about leveraging benefits administration technology for effective communications. For open enrollment, especially when you may be introducing new voluntary insurance plans, it is important to check your technology. I recommend this evaluation take place at least 6 to 8 weeks before open enrollment if possible.

Working with your UBA advisor, platform vendor and insurance carriers, some key considerations:

  • Provide voluntary product specifications from your carrier to your platform vendor. It is important to check up front that the platform can handle product rules such as issue age and age band pricing, age reduction, benefit/tier changes and guarantee issue rules. Also, confirm how the system will handle evidence of insurability processing, if needed.
  • Electronic Data Interface (EDI). Confirm with your platform partner as well as insurance carriers that there is an EDI set-up process that includes testing of file feeds. This is a vital step to ensure seamless integration between your benefits administration platform, payroll and the insurance carriers.
  • User Experience. Often benefits administration platforms are very effective at moving data and helping you manage your company’s benefits. As we have discussed, when it comes to your employee’s open enrollment user experience, there can be some challenges. Especially when you are offering voluntary benefits. Confirm with your vendor what, if any, decision support tools are available. Also, check with your voluntary carriers. These could range from benefit calculators, product videos, and even logic-driven presentations.

5. Keep it going

Even when enrollment season is over, ongoing benefits communications are a central tool to keeping employees informed, educated, and engaged. The small window of enrollment season may not be long enough for people to get a full grasp of their benefits needs, and often their decisions are driven by what is easily understood or what they think they need based on other people’s choices. Ongoing communications can be about specific benefits, wellness programs, or other health and benefit related items. This practice will also help new hires who need to make benefits decisions rather quickly.

See the original article Here.

Source:

Seeker K. (2017 August 16). Strategic benefits communication: Five key steps to success this open enrollment season [Web blog post]. Retrieved from address http://blog.ubabenefits.com/strategic-benefits-communication-five-key-steps-to-success-this-open-enrollment-season


IRS Issues Strong Warnings About ACA Compliance: Should HR be worried?

With all the confusion surrounding the ACA over the past few months, employers have been wondering if the IRS was gonna enforce the ACA reporting mandate. The IRS  has just recently released the ACA employers' and individual mandates to make sure everyone is in compliance for the healthcare reporting for 2017. Take a look at this article published by Jared Bilski from HR Morning hightlight eveything you need to know about reporting your healthcare information with the IRS.

Despite lots of warnings, the IRS has yet to impose any non-compliance penalties on employers during the two years the ACA reporting provisions have been mandatory. And with all of the efforts to kill or water down Obamacare, many employers are wondering if they should even make ACA compliance a priority at all.

Now, the agency is reminding folks that the ACA reporting mandate is still in full effect and compliance isn’t optional. It’s also assuring skeptical businesses it’s ready to start issuing penalties.

So should you believe the feds?

It sure sounds like it.

Most recently, the agency released four information letters about the ACA’s employer and individual mandates, and reminding employers exactly what they have to do to stay in compliance.

In addition, IRS sure warned employers it’s primed and ready to collect reporting penalties in a recent government report the folks at FreedomCare called a “game changer.”

Sweeping noncompliance tool

The Treasury Inspector General for Tax Administration (TIGTA) just released a report titled “Assessment of the Efforts to Implement the Employer Mandate under the Affordable Care Act.”

You can view the entire report here.

If you don’t have time to scour a 43-page document, here’s the one key fact: IRS has a new system in place for identifying potentially non-compliant employers, and the system has a very wide reach.

The feds’ ACA Compliance Validation System (ACV) will not only identify potentially non-compliant Applicable Large Employers, it will also calculate the “A” penalty under the Employer Mandate. Plus, the system will allow the feds to mass identify non-compliant employers and send notices to those non-compliant firms for any and all reporting years.

Questions and answers

By this point, you’ve probably got a few questions about the IRS’ new Obamacare compliance weapon, like:

When will the system be in place and ready?

Answer: According to the feds, the ACV should be ready by May 2017. Once it’s up and running, IRS should be able to start issuing large scale penalties.

Hasn’t IRS said it’s ready to start imposing ACA penalties before? Why should we believe them this time?

Answer: Granted, IRS has stated it planned to start penalizing firms before, but this seems different. Initially, the feds have been developing this ACV system since July 2015 and planned to have it ready by January 2017.

But as the report said, “the implementation of the ACV System has been delayed to May 2017.”

With the release of this detailed report, it’s clear the feds are ready to start collecting on all the noncompliance penalties that are long overdue. IRS has stated it expects to pull in $228 billion in ACA penalties.

Plus, with ACA repeal efforts currently on hold, now is a very good time for the agency to come after firms that have been pushing their compliance obligations to the back burner.

Bottom-line: Employers can’t afford to operate as if the delay in IRS reporting penalties is a permanent situation. If you’ve put this task on hold, now is the time to get everything in order.

Key correction steps

So what should employers do if they’ve already missed ACA reporting deadlines? File ASAP.

The sooner you correct an issue, the less likely you’ll wind up in a long, drawn out federal audit. Plus, as employment attorney David M. Pixley points out, IRS has a number of different penalties depending on how late the ACA reporting actually is.

For example, correcting a reporting failure within 30 days of the due date cuts the penalty to $50 per return, with a $532,000 cap.

When firms correct reporting failures after 30 days, but on or before August 1, the penalty is $100 per return, and the cap is $1,596,500.

And of course, late-filing is much safer (i.e., less costly) than not filing at all.

Reason: The standard per return penalty of $260 (max $3,193,000/year) jumps drastically for violations due to “intentional disregard” to a per-return penalty of $530 (no penalty cap).

See the original article Here.

Source:

Bilski J. (2017 August 16). IRS issues strong warning about ACA compliance: should HR be worried? [Web blog post]. Retrieved from address http://www.hrmorning.com/irs-issues-strong-warnings-about-aca-compliance-should-hr-be-worried/


The IRS Is Still Enforcing The Individual Mandate, Despite What Many Taxpayers Believe

Did you know that there are many people who still don't believe that they will be hit by tax penalty if they do not have health insurance? Here is an informative article by Timothy Jost from Health Affairs on why everyone should be keeping up with their health insurance in-order to avoid a tax penalty by the IRS.

There has been considerable speculation since President Trump’s Inauguration Day Affordable Care Act Executive Order as to whether the Internal Revenue Service is in fact enforcing the individual and employer mandates. The IRS website has insisted that the mandates are still in force, despite the Executive Order and despite the fact that the IRS decided not to implement for 2016 tax filings a program rejecting “silent returns” that did not indicate compliance with individual mandate requirements.

There is evidence, however, that many taxpayers do not believe it. An April report from the Treasury Inspector General for Taxpayer Services found that as of March 31, a third fewer taxpayers were paying the penalty than had been the case a year earlier. More importantly, insurers seem to believe that the IRS is not enforcing the mandate, or at least that taxpayers do not believe the IRS is enforcing the mandate, and are raising their rates for 2018 to account for the deteriorating of the risk pool that nonenforcement of the mandate will cause.

It is of note, therefore, that Robert Sheen at the ACA Times has identified several letters from the IRS reaffirming that it is still in fact enforcing the individual, and employer, mandates.

One is a letter reportedly sent in April by the IRS General Counsel to Congressman Bill Huizenga (R-MI) in response to an inquiry as to whether the IRS could waive the employer mandate with respect to a particular employer. The IRS replied that there was no provision in the ACA for waiver of the mandate penalty when it applied and that: “The Executive Order does not change the law; the legislative provisions of the ACA are still in force until changed by the Congress, and taxpayers remain required to follow the law and pay what they may owe.”

In a second letter in June, responding to an individual who had written to President Trump, the IRS similarly responded:

The Executive Order does not change the law; the legislative provisions of the ACA are still in force until changed by the Congress, and taxpayers remain required to follow the law, including the requirement to have minimum essential coverage for each month, qualify for a coverage exemption for the month, or make a shared responsibility payment.

Of course, whether taxpayers believe it, and whether insurers believe taxpayers believe it, is another question.

See the original article Here.

Source:

Jost T. (2017 August 21). The IRS is still enforcing the individual mandate, despite what many taxpayers believe [Web blog post]. Retrieved from address http://healthaffairs.org/blog/2017/08/21/the-irs-is-still-enforcing-the-individual-mandate-despite-what-many-taxpayers-believe/


ACA Revamp Odds Slip as Senate Gets New Expiration Date

Timeframe to repeal and replace has just shortened. Find out how this new timeline for the repeal of ACA will impact Senate and their plan for healthcare in this informative column by Laura Litvan from Think Advisor.

The Senate parliamentarian told lawmakers that Republicans’ ability to pass an Affordable Care Act change bill with just 51 votes expires at the end of this month, Sen. Bernie Sanders said Friday.

The preliminary finding complicates any further efforts by Republican leaders in Congress to pass a comprehensive GOP-only overhaul of the health care law.

Sanders, a Vermont independent, in a statement called the determination a "major victory" for those who oppose Affordable Care Act de-funding.

Senate Republicans, who control the chamber 52-48, failed to win enough support for their ACA de-funding and change bill in July as three GOP lawmakers joined Democrats to oppose the measure. Republican leaders haven’t ruled out reviving their effort, and some party members — including Lindsey Graham of South Carolina, Bill Cassidy of Louisiana and Ted Cruz of Texas — say they’re talking to colleagues about a possible broad-based bill.

At the same time, some senators are discussing a scaled-back, bipartisan health measure. It takes 60 votes to overcome a Democratic filibuster, and Democrats are united against de-funding of the Affordable Care Act, or the kinds of Affordable Care Act program changes proposed in the bills that have reached the House or Senate floor.

The Senate Health, Education, Labor and Pensions Committee has scheduled four hearings this month to examine bolstering the Affordable Care Act public health insurance exchange system.

Committee Chairman Lamar Alexander, a Tennessee Republican, and the panel’s top Democrat, Patty Murray of Washington, have pledged a bipartisan effort to shore up the exchanges, which provide consumers a place to purchase individual coverage with help from Affordable Care Act subsidies.

Earlier guidance from Senate Parliamentarian Elizabeth MacDonough dogged Republicans in their Affordable Care Act change effort throughout the summer. In late July, she issued a preliminary finding that key parts of a proposal drafted by Senate Majority Leader Mitch McConnell didn’t qualify for consideration under the budget reconciliation rules, dramatically complicating the already slimming prospects of passing a bill.

Republicans can still try to use the budget reconciliation process to get an Affordable Care Act change bill through the Senate with just a 51-vote majority, rather than a 60-vote majority, during the fiscal year that starts Oct. 1.

The House Budget Committee has drafted a fiscal 2018 budget that could be used for both de-funding the Affordable Care Act and tax reform. That budget may come to the floor in mid-September, and the Senate Budget Committee hopes to release its version of the budget in the coming weeks. Still, putting a tax overhaul and Affordable Care Act de-funding in the same legislation would be time-consuming and unlikely.

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Source:

Litvan L. (2017 September 1). ACA revamp odds slip as senate gets new expiration date [Web blog post]. Retrieved from address http://www.thinkadvisor.com/2017/09/01/aca-revamp-odds-slip-as-senate-gets-new-expiration?t=health-insurance?ref=channel-top-news