IRS DECREASES 2024 ACA AFFORDABILITY TO 8.39% The IRS has announced a reduction in the Affordable Care Act (ACA) affordability percentage for plan years starting in 2024, lowering it from 9.12% in 2023 to 8.39%. This affordability percentage determines the maximum portion of an employee’s household income that can be spent on self-only coverage while still complying … Continued
PROPOSED CHANGES TO SHORT-TERM, LIMITED-DURATION INSURANCE On July 7, 2023, the U.S. Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury proposed changes to modify the definition of short-term, limited-duration insurance (STLDI) and the conditions for fixed indemnity insurance to be considered an excepted benefit. The … Continued
PCORI FEE DUE DATE APPROACHES Employers offering self-funded medical plans, including health reimbursement arrangements (HRAs) must report and pay fees to the Patient-Centered Outcomes Research Institute (PCORI) by July 31. If the plan was fully insured, employers can rely on their insurance carriers to handle the fee payment. The current annual fees are: For plan years … Continued
CLAIMS SUBSTANTIATION FOR PAYMENT OR REIMBURSEMENT OF MEDICAL AND DEPENDENT CARE EXPENSES A memorandum released by the IRS Chief Counsel responds to a request for assistance regarding the reimbursement of medical and dependent care expenses. Addressed is whether reimbursements of medical expenses from a health flexible spending arrangement (FSA) provided in a cafeteria plan should … Continued
2024 BENEFIT PARAMETERS FOR MEDICARE PART D CREDITABLE COVERAGE DISCLOSURES ANNOUNCED The Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D. These factors are used to determine the actuarial value of defined standard Medicare Part D coverage under CMS guidelines. Each year, Medicare Part D requires … Continued
IRS RELEASES 2024 EMPLOYER SHARED RESPONSIBILITY PROVISION PENALTIES The dollar amount used to calculate the employer shared responsibility provision penalties (ESRP) has been provided for 2024. As background, the penalties can be assessed under Code § 4980H(a) if an applicable large employer (ALE) fails to offer minimum essential coverage to the required number of full-time … Continued
The Centers for Medicare & Medicaid Services (CMS) issued a consumer-facing fact sheet to help people know what to expect at the end of the COVID-19 Public Health Emergency (PHE). The Department of Health and Human Services is planning for the federal PHE and the COVID-19 national emergency to expire at the end of the day … Continued
When the COVID-19 public health emergency and national emergency were declared in 2020, no one anticipated they would still be in place in 2023. On January 30, 2023, the President announced the intent to end the emergencies on May 11, 2023. The impact of the emergencies on employer-sponsored benefits affected certain coverages, reimbursements, and timelines. … Continued
Jan. 23, 2023 Since 2015, federal agencies have been required to annually review the laws and regulations they enforce to adjust applicable penalties for inflation. These adjustments, or so the theory goes, provide higher incentives for plan sponsors to ensure their benefit plans and programs remain compliant. Specifically, the U.S. Department of Labor (DOL) must … Continued
By way of background, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to study clinical effectiveness and health outcomes. To finance the Institute’s work, a small annual fee—commonly called the PCORI fee—is charged on group health plans. Grandfathered health plans are not exempt. Most employers do not have to take any … Continued
Raleigh Office:
9121 Anson Way
Suite 200
Raleigh, NC 27615
Phone
919.571.0883
Email
info@jrwassoc.com
© 2017 JRW Associates. All Rights Reserved
