1 Waiting Period and Rehire Rules. What a Mess. Eric Johnson
2 90 Day Waiting Period Final Rules Orientation Period Proposed Rules 85 Pages! 27 Pages
3 Group Health Plan Includes both: Insured Plans Self-Insured Plans
4 PHS Act section 2708 Provides that a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period (as defined in PHS Act section 2704(b)(4)) that exceeds 90 days.
5 PHS Act section 2708 PHS Act section 2708 does not require an employer to offer coverage to any particular individual or class of individuals, including part-time employees. PHS Act section 2708 prevents an otherwise eligible individual from being required to wait more than 90 days before coverage becomes effective. PHS Act section 2708 applies to both grandfathered and non-grandfathered group health plans and group health insurance coverage for plan years beginning on or after January 1, 2014.
6 Waiting Period The regulations define waiting period as the period that must pass before coverage for an employee or dependent who is otherwise eligible to enroll under the terms of a group health plan can become effective.
7 Otherwise Eligible to Enroll Being otherwise eligible to enroll in a plan means having met the plan's substantive eligibility conditions For example: being in an eligible job classification achieving job-related licensure requirements specified in the plan's terms satisfying a reasonable and bona fide employment-based orientation period).
8 90 Days Means 90 Days After an individual is determined to be otherwise eligible for coverage under the terms of the plan, any waiting period may not extend beyond 90 days. All calendar days are counted beginning on the enrollment date, including weekends and holidays
9 Administratively Difficult 90 days First of the month following 60 days
10 Orientation Periods Orientation periods are commonplace and the Departments do not intend to call into question the reasonableness of short, bona fide orientation periods. The danger of abuse increases, however, as the length of the period expands. Accordingly, the final regulations provide that one month is the maximum allowed length of an employment-based orientation period. The creation of a clear maximum prevents abuse and facilitates compliance.
11 Must be legit While a plan may impose substantive eligibility criteria, such as requiring the worker to fit within an eligible job classification or to achieve job-related licensure requirements, it may not impose conditions that are mere subterfuges for the passage of time.
12 One-Month Orientation Period Under these final regulations, one month would be determined by adding one calendar month and subtracting one calendar day, measured from an employee's start date in a position that is otherwise eligible for coverage. For example, if an employee's start date in an otherwise eligible position is May 3, the last permitted day of the orientation period is June 2. Similarly, if an employee's start date in an otherwise eligible position is October 1, the last permitted day of the orientation period is October 31.
13 One-Month Orientation Period If there is not a corresponding date in the next calendar month upon adding a calendar month, the last permitted day of the orientation period is the last day of the next calendar month. For example, if the employee's start date is January 30, the last permitted day of the orientation period is February 28 (or February 29 in a leap year). Similarly, if the employee's start date is August 31, the last permitted day of the orientation period is September 30.
14 Cumulative Hours of Service Requirement (1,200 Hour Rule) The proposed regulations also addressed cumulative hours-of-service requirements, which use more than solely the passage of a time period in determining whether employees are eligible for coverage. If a group health plan or group health insurance issuer conditions eligibility on the completion by an employee (part-time or full-time) of a number of cumulative hours of service, the eligibility condition is not considered to be designed to avoid compliance with the 90-day waiting period limitation if the cumulative hours-of-service requirement does not exceed 1,200 hours. The plan s waiting period must begin on the first day after the employee satisfies the plan s cumulative hours-of-service requirement and may not exceed 90 days. Furthermore, this provision continues to be designed to be a one-time eligibility requirement only; these final regulations do not permit, for example, re-application of such a requirement to the same individual each year.
15 IV. The 90-Day Limit on Waiting Periods EMPLOYER MANDATE FINAL RULES
16 90 Day Waiting Period For plan years beginning on or after January 1, 2014, a group health plan or health insurance issuer offering group health insurance coverage may not apply any waiting period that exceeds 90 days. Section 2708 of the PHS Act does not require the employer to offer coverage to any particular employee or class of employees, but prevents an otherwise eligible employee (or dependent) from waiting more than 90 days before coverage becomes effective. IV. The 90-Day Limit on Waiting Periods (Public Health Service Act Section 2708)
17 90 Day Waiting Period Here s something else Bob. I have 8 different bosses right now. There are times when an employer will not be subject to an assessable payment with respect to an employee although the employer does not offer coverage to that employee during that time. However, the fact that an employer will not owe an assessable payment under section 4980H for failure to offer coverage during certain periods of time does not, by itself, constitute compliance with section 2708 of the PHS Act during that same period. IV. The 90-Day Limit on Waiting Periods (Public Health Service Act Section 2708)
18 1 st of the 4 th Month Under the employer mandate, employers must be offering coverage to employees by the first day of the fourth month that the employee is working 30 hours/week or face a potential penalty. Penalty: $2,000 per full-timer if coverage is no offered to at least 70% of full-timers $3,000 per full-time employee that gets a subsidy if coverage is offered to at least 70% of full-timers
19 Similarly From the 90 Day Waiting Period Final Rule: Compliance with these final regulations is not determinative of compliance with section 4980H of the Code, under which an applicable large employer may be subject to an assessable payment if it fails to offer affordable minimum value coverage to certain newly-hired full-time employees by the first day of the fourth full calendar month of employment.
20 For Example An applicable large employer that has a one-month orientation period may comply with both PHS Act section 2708 and Code section 4980H by offering coverage no later than the first day of the fourth full calendar month of employment. However, an applicable large employer plan may not be able to impose the full one-month orientation period and the full 90-day waiting period without potentially becoming subject to an assessable payment under Code section 4980H. To illustrate, if an employee is hired as a full-time employee on January 6, a plan may offer coverage May 1 and comply with both provisions. However, if the employer is an applicable large employer and starts coverage May 6, which is one month plus 90 days after date of hire, the employer may be subject to an assessable payment under Code section 4980H.
21 No Effect on Other Laws Compliance with this section is not determinative of compliance with any other provision of State or Federal law (including ERISA, the Code, or other provisions of the Patient Protection and Affordable Care Act). See e.g., , which prohibits discrimination in eligibility for coverage based on a health factor and section 4980H, which generally requires applicable large employers to offer coverage to full-time employees and their dependents or make an assessable payment.
22 RE-HIRE RULES
23 Waiting Period Rules A plan or issuer may treat an employee whose employment has terminated and who then is rehired as newly eligible upon rehire and, therefore, required to meet the plan s eligibility criteria and waiting period anew, if reasonable under the circumstances (for example, the termination and rehire cannot be a subterfuge to avoid compliance with the 90-day waiting period limitation).
24 Employer Mandate Rules Gone for less than 13 weeks: ongoing employee Exception: 26 weeks for educational organizations Exception: Gone for at least 4 weeks but gone longer than the employee worked for the company
25 THE CHALLENGES
26 Problems with the Waiting Period & Rehire Rules Using the optional orientation period will confuse insurance companies because the date of hire on the enrollment form will make it appear that the company exceeded the maximum waiting period. Using the orientation period + full 90 day waiting period or 1,200 hour rule could cause applicable large employers to pay a penalty. Keeping up with employees hours is administratively difficult. The re-hire rules found in the 90 day waiting period final rules are different from the re-hire rules in the employer mandate. Following the employer mandate re-hire rules will necessitate a lot of phone calls to the insurance companies and manual overrides by the carriers. For re-hires who have already declined coverage or who were previously enrolled through a 125 plan, it s unclear whether they should be offered coverage, forced back on the plan, etc.
27 MORE DETAILS
28 Look-Back Measurement Method The proposed regulations provide a method, referred to as the look-back measurement method, under which employers may determine the status of an employee as a full-time employee during a future period (referred to as the stability period), based upon the hours of service of the employee in a prior period (referred to as the measurement period). The look-back measurement method for identifying full-time employees is available only for purposes of determining and computing liability under section 4980H and not for purposes of determining status as an applicable large employer. VII. C. 1. In General
29 Look-Back Measurement Method Under the look-back measurement method for ongoing employees, an applicable large employer member determines each ongoing employee's full-time employee status by looking back at a standard measurement period of at least three months but not more than 12 months, as determined by the employer. The applicable large employer member determines the months in which the standard measurement period starts and ends, provided that the determination must be made on a uniform and consistent basis for all employees in the same category. If the applicable large employer member determines that an employee was employed on average at least 30 hours of service per week during the standard measurement period, then the applicable large employer member treats the employee as a full-time employee during a subsequent stability period, regardless of the employee's number of hours of service during the stability period, so long as the worker remains an employee. VII. C. 1. In General
30 Administrative Period Under the proposed and final regulations, an applicable large employer member using the look-back measurement method may, at its option, elect to add an administrative period of no longer than 90 days between the measurement period and the stability period. Under the proposed regulations, the term administrative period is defined as an optional period, selected by an applicable large employer member, of no longer than 90 days beginning immediately following the end of a measurement period and ending immediately before the start of the associated stability period. VII. C. 3. Administrative Period
31 Administrative Period Seasonal & Variable Hour EEs However, the proposed regulations also provide that the period between a variable hour or seasonal employee's start date and the beginning of the initial measurement period must be taken into account in determining the administrative period. The definition of administrative period in the final regulations is revised to reflect that it also includes periods before the initial measurement period. Thus, the combined length of the period before the start of the initial measurement period and the period beginning immediately after the end of the initial measurement period and ending immediately before the beginning of the associated stability period is subject to an overall limit of 90 days. VII. C. 3. Administrative Period
32 Administrative Period Commenters requested that the maximum permissible administrative period be extended from 90 days to three full calendar months. The proposed regulations regarding the administrative period in these circumstances were intended to allow employers to structure their plans to coordinate with section 2708 of the PHS Act (relating to the application of the 90-day limitation on waiting periods) in all circumstances. For this reason, the final regulations do not adopt this suggestion. VII. C. 3. Administrative Period
33 Look-Back Measurement Method The proposed regulations also provide look-back measurement method rules for new employees, including rules for employees who are reasonably expected to be full-time employees at the start date, and those who are variable hour employees or seasonal employees. A variable hour employee or seasonal employee will have his or her status as a full-time employee determined after an initial measurement period. The proposed regulations then provide transition guidance under which a new employee transitions into having his or her status as a full-time employee determined under the look-back measurement method rules applicable to ongoing employees. VII. C. 1. In General
34 Variable Hour Employees The proposed regulations treat an employee as a variable hour employee if, based on the facts and circumstances at the employee's start date, the applicable large employer member cannot determine whether the employee is reasonably expected to be employed on average at least 30 hours of service per week during the initial measurement period because the employee's hours of service are variable or otherwise uncertain. For this purpose, the applicable large employer member may not take into account the likelihood that the employee may terminate employment with the applicable large employer (including any member of the applicable large employer) before the end of the initial measurement period. VII. C. 6. Variable Hour Employees
35 Initial Measurement Period The proposed regulations define the initial measurement period, in part, as a period of at least three consecutive calendar months but not more than 12 consecutive calendar months. The final regulations clarify that the initial measurement period need not be based on calendar months but instead may be based on months, defined as either a calendar month or as the period that begins on any date following the first day of the calendar month and that ends on the immediately preceding date in the immediately following calendar month (for example, from March 15 to April 14). In contrast, a stability period must be based on calendar months. VII. C. 12. Clarifications Regarding the Initial Measurement Period
36 Periods During Which Section 4980H Liability Does Not Apply In various circumstances, the final regulations provide that an employer will not be subject to an assessable payment under section 4980H for a certain period of time and the term limited non-assessment period for certain employees is added to the final regulations to describe these periods. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
37 Periods During Which Section 4980H Liability Does Not Apply In particular, the final regulations provide, consistent with the proposed regulations, that section 4980H liability does not apply with respect to an employee who is in the initial measurement period (or the associated administrative period), for a period of time after an employee experiences a change to full-time employee status during the initial measurement period, or with respect to a new employee who is reasonably expected to be a full-time employee and to whom coverage is offered on the first of the month following the employee's initial three full calendar months of employment. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
38 Periods During Which Section 4980H Liability Does Not Apply The final regulations add a rule under the monthly measurement method under which an employer will not be subject to a section 4980H assessable payment with respect to an employee for the first full calendar month in which an employee is first otherwise eligible for an offer of coverage and the immediately subsequent two calendar months. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
39 Periods During Which Section 4980H Liability Does Not Apply Further, the final regulations provide that with respect to an employee who was not offered coverage by the employer at any point during the prior calendar year, if an employee is offered coverage by an applicable large employer, for the first time, on or before April 1 of the first calendar year for which the employer is an applicable large employer, the employer will not be subject to an assessable payment under section 4980H by reason of its failure to offer coverage to the employee for January through March of that year. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
40 Periods During Which Section 4980H Liability Does Not Apply The final regulations clarify that each of these rules is only available if the employee is offered coverage by the first day of the month following the end of the applicable period, and for an employer to not be subject to an assessable payment under section 4980H(b) the employer must offer coverage that provides MV at the end of the period. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
41 Periods During Which Section 4980H Liability Does Not Apply In addition, the final regulations clarify that these rules only apply with respect to a calendar month if during the calendar month during the relevant period the employee is otherwise eligible for an offer of coverage (except that this rule does not apply with respect to the rule regarding an employer that is an applicable large employer for the first time, as described in section V.F of this preamble). For purposes of these rules, an employee is otherwise eligible to be offered coverage under a group health plan for a calendar month if, pursuant to the terms of the plan as in effect for that calendar month, the employee meets all conditions to be offered coverage under the plan for that calendar month, other than the completion of a waiting period, within the meaning of VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
42 Periods During Which Section 4980H Liability Does Not Apply The final regulations also clarify that an employer will not be subject to an assessable payment with respect to an employee for the first month of an employee's employment with the employer, if the employee's first day of employment is a day other than the first day of the calendar month. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
43 Periods During Which Section 4980H Liability Does Not Apply Note that the relief from the section 4980H assessable payment provided by the rules described in this section does not affect an employee's eligibility for a premium tax credit. For example, an employee or related individual is not eligible for coverage under the employer's plan (and therefore may be eligible for a premium tax credit or cost-sharing reduction through an Exchange) during any period when coverage is not actually offered to the employee by the employer, including any measurement period or administrative period, even if the employer is not subject to an assessable payment under section 4980H for this period. VII. D. Clarification of Periods During Which Section 4980H Liability Does Not Apply
44 Rehire Rules and Break-in-Service Rules for Continuing EEs VII. E. Rehire Rules and Break-in-Service Rules for Continuing Employees
45 Rehire Rules The proposed regulations provide that, solely for purposes of section 4980H, an employee who resumes providing service to an applicable large employer after a period during which the employee was not credited with any hours of service may be treated as having terminated employment and having been rehired, and therefore may be treated as a new employee upon the resumption of services, only if the employee did not have an hour of service for the applicable large employer for a period of at least 26 consecutive weeks immediately preceding the resumption of services. VII. E. 1. Rehire Rules
46 Rehire Rules In addition, the proposed regulations permit an employer to apply a parity rule, under which an employee may be treated as rehired after a shorter period of at least four consecutive weeks during which no hours of service were credited if that period exceeded the number of weeks of that employee's period of employment with the applicable large employer immediately preceding the period during which the employee was not credited with any hours of service. For example, if an employee started employment and worked for six weeks, then had a period of eight weeks during which no hours of service were credited, the employer could treat the employee as a rehired employee, subject to the rules for new employees under these regulations, if the employee resumed providing services after the eight-week break. VII. E. 1. Rehire Rules
47 Rehire Rules Comments were received on these rehire rules. Several employers and employer groups commented that the rehire rules in general, and the rule of parity in particular, are difficult to implement because they require the employer to maintain records of service of former employees across the employer's controlled group (the group of applicable large employer members that together are treated as an applicable large employer). Commenters requested that employers be permitted to determine, using any reasonable good-faith method, whether an employee resuming services after a break in service constitutes a new employee or a continuing employee. Other commenters requested that the length of the break in service required before a returning employee may be treated as a new employee be reduced from 26 weeks to some shorter length, such as four or ten weeks. VII. E. 1. Rehire Rules
48 Rehire Rules The Treasury Department and the IRS believe that it would be inequitable to employees who had become eligible for coverage prior to the break in service to be subjected to a new period of exclusion from the plan (which can be over a year for variable hour employees) based upon a brief break in service. The Treasury Department and the IRS also remain concerned that without an objective standard for determining when an employee who returns after a break in service may be treated as a new employee, there is a potential for an employer to attempt to evade the requirements of section 4980H through a pattern of terminating and rehiring employees and then treating the returning employees as new employees. VII. E. 1. Rehire Rules
49 Rehire Rules However, the Treasury Department and the IRS agree with the commenters suggesting that a break-inservice period shorter than 26 weeks would be sufficient to curtail the potential for abuse. Accordingly, the final regulations retain the rehire rules contained in the proposed regulations but reduce the length of the break in service required before a returning employee may be treated as a new employee from 26 weeks to 13 weeks (except for educational organization employers as described in this section of the preamble). This break-in-service period applies for both the look-back measurement method and the monthly measurement method. VII. E. 1. Rehire Rules
50 Rehire Rules To avoid the treatment of employees of educational organizations as new employees resuming services after a scheduled academic break, however, the final regulations provide that for employees of educational organizations, the 26-week break-in-service period under the rehire rules provided in the proposed regulations continues to apply. The final regulations also retain the rule of parity, which, as under the proposed regulations, is optional on the part of the employer and need not be used if the employer does not maintain sufficient records of the periods of service of former employees or prefers not to use it for other reasons. VII. E. 1. Rehire Rules
51 Break-in-Service Rules for Continuing Employees For purposes of applying the look-back measurement method to a returning employee not treated as a new employee, the proposed regulations provide an averaging method for special unpaid leave that is applicable to all employers choosing to use the look-back measurement method. For this purpose special unpaid leave is unpaid leave subject to the Family and Medical Leave Act of 1993 (FMLA), 103, 29 U.S.C et seq., or to the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA), 103, 38 U.S.C et seq., or on account of jury duty. Comments were received on the averaging rules for special unpaid leave, and those comments generally favored the approach provided in the proposed regulations. VII. E. 2. Break-in-Service Rules for Continuing Employees
52 Break-in-Service Rules for Continuing Employees The proposed regulations also provide an averaging method for employment break periods that is applicable to educational organizations that use the look-back measurement method. For this purpose, an employment break period is a period of at least four consecutive weeks (disregarding special unpaid leave), measured in weeks, during which an employee is not credited with hours of service. VII. E. 2. Break-in-Service Rules for Continuing Employees
53 Break-in-Service Rules for Continuing Employees Under the proposed averaging method, in the case of an employee returning from absence who would be treated as a continuing employee (that is, an employee whose break in service was shorter than one resulting in treatment as a rehired employee), the employer would determine the employee's average hours of service for a measurement period by computing the average after excluding any special unpaid leave (and in the case of an educational organization, also excluding any employment break period) during that measurement period and by using that average as the average for the entire measurement period. VII. E. 2. Break-in-Service Rules for Continuing Employees
54 Break-in-Service Rules for Continuing Employees Alternatively, the employer could treat the employee as credited with hours of service for any periods of special unpaid leave (and, in the case of an educational organization, any employment break period) during that measurement period at a rate equal to the average weekly rate at which the employee was credited with hours of service during the weeks in the measurement period that are not part of a period of special unpaid leave (or, in the case of an educational organization, an employment break period). The two alternative methods were intended to be different expressions of an equivalent calculation, therefore having the same results. In no case, however, would the employer be required to exclude (or credit) more than 501 hours of service during employment break periods in a calendar year (however no such limit applies for special unpaid leave). VII. E. 2. Break-in-Service Rules for Continuing Employees
55 Break-in-Service Rules for Continuing Employees In the preamble to the proposed regulations, the Treasury Department and the IRS specifically requested comments on whether the employment break period rules should be applied to all employers, including employers that were not educational organizations. With respect to the averaging rules for employment break periods, commenters differed in their responses to the proposed regulations. VII. E. 2. Break-in-Service Rules for Continuing Employees
56 Break-in-Service Rules for Continuing Employees Some employers stated that the rules should be eliminated because they were complicated and required administrative recordkeeping that employers do not currently undertake. Some employers and employer groups also requested that the employment break period rules not be extended to employers that are not educational organizations. Other commenters requested clarification on whether the employment break period rules apply to employers that are not educational organizations but that provide services to educational organizations, such as school bus operators. In contrast, some employee organizations supported the employment break period rule, stating that it more accurately reflected positions intended to be full-time employee positions and assisted in curbing potential employer actions to prevent employees from attaining full-time employee status. However, some employers and employees also suggested that the employment break period rule would not result in an expansion of coverage to employees not currently offered coverage, but rather in limiting hours to ensure that those employees were not classified as full-time employees. VII. E. 2. Break-in-Service Rules for Continuing Employees
57 Break-in-Service Rules for Continuing Employees The final regulations retain the averaging rules for special unpaid leave and employment break periods as provided in the proposed regulations (that is, for purposes of applying the look-back measurement method to an employee who is not treated as a new employee under the rehire rules described in section VII.E.1 of this preamble). The commenters did not identify a compelling reason to extend the employment break period rule to employers that are not educational organizations. VII. E. 2. Break-in-Service Rules for Continuing Employees
58 Break-in-Service Rules for Continuing Employees However, the final regulations provide that with respect to the determination of full-time employee status, the Commissioner may prescribe additional guidance of general applicability, published in the Internal Revenue Bulletin (see (d)(2)(ii)(b)), which may include extension of the employment break period to other industries. In addition, the reduction in the break-in-service period under the rehire rule from 26 to 13 weeks in the final regulations (for employers that are not educational organizations) shortens the periods for which an individual may be credited with no hours of service that can be included in a measurement period (thereby lowering the average hours of service per week), addressing in part the issue that the employment break period also is intended to address. The employment break period rule continues to apply only to educational organizations, and the breakin-service period for employees of educational organizations continues to be 26 weeks. Neither the special unpaid leave rule nor the employment break period rule apply under the monthly measurement method, regardless of whether the employer is an educational organization. VII. E. 2. Break-in-Service Rules for Continuing Employees
IRS Eases Employers Into Employer Mandate February 2014 The Treasury and Internal Revenue Service (IRS) released final regulations on the employer mandate under the Patient Protection and Affordable Care
This document is scheduled to be published in the Federal Register on 02/24/2014 and available online at http://federalregister.gov/a/2014-03809, and on FDsys.gov [Billing Codes: 4830-01-P; 4510-029-P;
GUIDANCE ON 90-DAY WAITING PERIOD LIMITATION UNDER PUBLIC HEALTH SERVICE ACT 2708 NOTICE 2012-59 I. INTRODUCTION The Departments of Labor, Health and Human Services (HHS), and the Treasury (the Departments)
Brought to you by Higginbotham 90-day Waiting Period Limit For plan years beginning on or after Jan. 1, 2014, the Affordable Care Act (ACA) prohibits group health plans and group health insurance issuers
DEPARTMENT OF HEALTH & HUMAN SERVICES Washington, DC 20201 Date: August 31, 2012 From: Center for Consumer Information and Insurance Oversight (CCIIO), Centers for Medicare & Medicaid Services (CMS) Title:
IRS Releases Proposed Regulations on the Affordable Care Act s Play or Pay Mandate 1710/14380-001 Current/20681029v1 NETWORK smart partners Table of Contents A special report on IRS Proposed Regulations
February 25, 2014 Authors: Kathryn Bjornstad Amin, Jon W. Breyfogle, Lisa Christensen, Christine L. Keller, Tamara S. Killion, Emily C. Lechner and Brigen L. Winters If you have questions, please contact
Vol. 79 Monday, No. 36 February 24, 2014 Part III Department of the Treasury Internal Revenue Service 26 CFR Part 54 Department of Labor Employee Benefits Security Administration 29 CFR Part 2590 Department
Brought to you by Higginbotham Documenting Method for Identifying Full-time Employees Beginning in 2015, the Affordable Care Act (ACA) imposes a penalty on applicable large employers (ALEs) that do not
and Calculating Penalties Pursuant to the Employer Shared Compliance Practice of Arthur J. Gallagher & Co. As a preliminary step, employers must determine if their organization is subject to the mandate.
FREQUENTLY-ASKED-QUESTIONS FROM EMPLOYERS REGARDING AUTOMATIC ENROLLMENT, EMPLOYER SHARED RESPONSIBILITY, AND WAITING PERIODS Notice 2012-17 INTRODUCTION Many provisions of the Patient Protection and Affordable
2120 L Street, NW, Suite 700 T 202.822.8282 HOBBSSTRAUS.COM Washington, DC 20037 F 202.296.8834 MEMORANDUM To: From: Re: Tribal Health Clients Hobbs, Straus, Dean & Walker LLP IRS Final Rule on the Affordable
IRS Issues final regulations on employer shared responsibility requirements Volume 37 Issue 46 April 17, 2014 The employer shared responsibility requirements commonly called the employer mandate are one
Determining Full-Time Employees for Purposes of Shared Responsibility for Employers Regarding Health Coverage ( 4980H) Notice 2012-58 I. PURPOSE AND OVERVIEW This notice describes safe harbor methods that
Brought to you by Cottingham & Butler Pay or Play Penalty Special Rules for Temporary Staffing Firms The Affordable Care Act (ACA) imposes a penalty on large employers that do not offer minimum essential
THE AFFORDABLE CARE ACT: DECISIONS THAT NEED TO BE MADE NOW April 2014 Introduction Speakers Anne Pachciarek Partner Employee Benefits and Executive Compensation DLA Piper Mark Boxer Partner Employee Benefits
PENALTIES Employer Shared Responsibility under the Affordable Care Act (ACA) What employers need to know to make informed decisions about ACA compliance. Employer Shared Responsibility Under the employer
DETERMINING FULL-TIME EMPLOYEE STATUS Employer Shared Responsibility Under the Affordable Care Act (ACA) What employers need to know to make informed decisions about ACA compliance This document is intended
Overview of 4980H Penalties and IRS Reporting Forms 1094 and 1095 (B and C forms) Measurement Method Basics Monthly Measurement Method Look-Back Measurement Method Ongoing Employees New Employees Look-Back
Health Care Reform 2015 Update Presented to: Employee Health Benefits Committee Presented by: Pamela A. Boyer Information is current as of time of presentation: Oct. 15, 2015 1 Overview of Presentation
HEALTH CARE REFORM Summary of the Final Employer Shared Responsibility (Free Rider Penalty) Regulations On Monday, February 10th the Internal Revenue Service (IRS) released long-awaited final regulations
Definition of Full-Time Employee and Waiting Period Part of the Patient Protection and Affordable Care Act (PPACA) The following provides an overview of recent confirmation (through Regulations) of important
TM MISSOURI SCHOOL BOARDS ASSOCIATION HELPING SCHOOL BOARDS SUCCEED School District Obligations Under the New Federal Health Care Law: Is Your District Going to Play or Pay the Penalty? Click to jump to
ACA: Temporary and Variable Hour Employees Presented by: Larry Grudzien We re proud to offer a full-circle solution to your HR needs. BASIC offers collaboration, flexibility, stability, security, quality
October, 2014 Patient Protection and Affordable Care Act Compliance Checklist for Employers Under the Employer Mandate in the Affordable Care Act, effective January 1, 2015, employers with 50 or more full-time
March 28, 2013 Federal Agencies Propose Rule on 90-Day Waiting Periods and Elimination of HIPAA Certificate Requirement Executive Summary IRS has issued proposed regulations on the maximum 90-day waiting
Health Care Reform: Health Plans Overview Presented by: Brian Lenzo, Preferred Benefits Services Agenda What is the legal status of the law? Which plans must comply? Grandfathered plans Reforms currently
A special thanks to the following who provided technical assistance in drafting this guidance: Leza Conliffe National School Boards Association Ken Mason Spencer Fane Britt & Browne LLP Don Tatman Tatman
New ACA Pay or Play Penalty Regulations and Update on P.A. 152 Mary V. Bauman The materials and information have been prepared for informational purposes only. This is not legal advice, nor intended to
ROGUE COMMUNITY COLLEGE GENERAL INFORMATION AND ADMINISTRATIVE PROCEDURES Procedure: AFFORDABLE CARE ACT COMPLIANCE (AP-006) Contact: Director of Human Resources and Risk Management, Ext. 7017 1. INTRODUCTION
Health Care Reform - 2016/2017 Strategic Analysis Employers sponsoring health can expect to see no slow-down in Affordable Care Act (ACA) rules, clarifications, and requirements. Understanding these changes,
HEALTH CARE REFORM: Grandfathered Health Plans Guidance concerning grandfathered health plan status was issued on June 17, 2010, by the Departments of Labor, Treasury and Health and Human Services with
What s News in Tax Analysis That Matters from Washington National Tax The Impact of the Affordable Care Act on International Assignees and Their Health Care Plans Employers and individuals in the United
Guidance issued on employer shared responsibility requirements The shared responsibility requirements are one of the most significant provisions that employers need to address under the Affordable Care
Health care reform at-a-glance Employer duty to provide coverage The Affordable Care Act (ACA or health care reform law) says an employer with 50 or more full-time (or full-time equivalent) employees will
March 4, 2014 Practice Group(s): Employee Benefits Benefits, ESOPs, and Executive Compensation The Affordable Care Act s Employer Mandate: Guidance for Educational By Lynne Shore Wakefield and Emily D.
The Affordable Care Act: An Update on the Employer Mandate William A. Dombi, Esq. MARCH ON WASHINGTON Conference & Exposition March 24, 2014 Health Care Reform Framework Health insurance reforms Expanded
Q&A from Assurex Global Webinar Employer ACA Reporting Requirements Questions Q: Where will these forms come from? will the IRS provide them? A: IRS has provided draft Forms 1094 and 1095 along with draft
FAQs: Variable Hour Employees Working on Campus and the Affordable Care Act (ACA) As you may know, Health Care Reform (the Affordable Care Act or ACA) is underway and new aspects of the regulations become
ACA Reporting August 18, 2015 Norbert F. Kugele April A. Goff 2015 Warner Norcross & Judd LLP. All rights reserved. WNJ.com Overview Overview of Reporting Requirements Why have reporting Status of forms
AFFORDABLE CARE ACT TRAINING SESSION ONE Waiting Periods/Eligibility for Coverage & Determining Applicable Large Employer Status Slide 1 Presenters Alison Cline Earles, Associate General Counsel, GMA Patrick
December 2013 Determining Full-Time Employees under the Affordable Care Act Information for Businesses Employing 50 Employees or More Harrisonburg, VA 22801 Phone: (800) 366-3846 Fax: (540) 434-9670 www.ldbinsurance.com
January 21, 2013 IRS Proposed Regulations on "Play or Pay" -- Part II: Counting Hours, and Determining Full-Time Employees Executive Summary This is Part II of our two-alert package on the IRS's proposed
Health Care Reform Effects on the Wood County Employee Health Benefits Plan For Plan Year 2013 Employee Health Benefits Committee October 18, 2012 1 Health Care Reform (HCR) Affordable Care Act (ACA) The
Brought to you by Hammitt Benefits Group IRS Guidance on Employer Shared Responsibility Penalty Beginning in 2014, the Affordable Care Act (ACA) imposes pay or play requirements on large employers to help
HUMAN CAPITAL PRACTICE ALERT JULY 2014 www.willis.com HEALTH CARE REFORM LAW 90-DAY WAITING PERIOD AND ORIENTATION PERIOD: FINAL REGULATIONS EXPLAINED Final regulations governing the 90-day waiting period
Employee Benefits Compliance Pay or Play Delay, Does it Apply and Strategies to Comply Wells Fargo Insurance 2014 Issues and beyond. U.S. citizens and legal residents are required to have "minimum essential
Health Care Reform Implications for Employers with Seasonal Employees Many industries (e.g. ski resorts, retail, restaurants, agriculture, fishing and tourism) have a significant number of seasonal employees.
This document is scheduled to be published in the Federal Register on 02/12/2014 and available online at http://federalregister.gov/a/2014-03082, and on FDsys.gov [4830-01-p] DEPARTMENT OF THE TREASURY
Community THE AFFORDABLE CARE ACT ( ACT ), NEW EMPLOYER MANDATES, AND IMPACTS ON EMPLOYER- SPONSORED HEALTH INSURANCE PLANS Prepared for the 2014 Massachusetts Municipal Association Annual Meeting On March
IRS Notice Provides Additional ACA Employer Shared Responsibility Guidance The IRS recently issued Notice 2015-87, which among other things, provides important clarification of its position on a number
Treasury and IRS Issue Final Regulations for Reporting Compliance With Affordable Care Act Mandates April 2014 The Treasury Department and the Internal Revenue Service (IRS) issued final regulations on
Sample Employee FAQs Explaining Benefits Eligibility To assist employers in providing an explanation to their employees of how measurement, administrative, and stability periods will be used to determine
EmPowerHR Legislative Brief: PAY OR PLAY PENALTIES LOOK BACK MEASUREMENT METHOD EXAMPLES The Affordable Care Act (ACA) imposes a penalty on applicable large employers (ALEs) that do not offer health insurance
A Timely Analysis of Legal Developments A S A P February 24, 2014 IRS Final Rule Partially Delays ACA Employer Shared Responsibility Requirement By Ilyse Schuman On February 12, 2014, the Internal Revenue
September 23, 2014 If you have questions, please contact your regular Groom attorney or one of the attorneys listed below: Katie Bjornstad Amin email@example.com (202) 861-2604 Christine L. Keller firstname.lastname@example.org
The Affordable Care Act: Summary of Employer Requirements February 2013 Disclaimer Any US tax advice contained herein was not intended or written to be used, and cannot be used, for the purpose of avoiding
February 18, 2016 Submitted via email to Notice.email@example.com CC:PA:LPD:PR (Notice 2015-87) Room 5203 Internal Revenue Service P.O. Box 7604 Ben Franklin Station Washington, DC 20044 Re:
Updates to Affordable Care Act: Law, Regulatory Explanation and Analysis, 2014 Chapter 2. Individuals 205. Individual Health Insurance Mandate In December 2013, the Administration announced that individuals
Brought to you by The Insurance Exchange Affordable Care Act (ACA) Violations Penalties and Excise Taxes The Affordable Care Act (ACA) includes numerous reforms for group health plans and creates new compliance
The Affordable Care Act (ACA) brings many changes to employers and health plans. One such change essentially amounts to a requirement for some employers to offer a certain level health care to their employees
FAQS ABOUT AFFORDABLE CARE ACT IMPLEMENTATION (PART XVIII) AND MENTAL HEALTH PARITY IMPLEMENTATION January 9, 2014 Set out below are additional Frequently Asked Questions (FAQs) regarding implementation
ACA Affordable Care Act Effective January 1, 2015, the Patient Protection and Affordable Care Act (ACA) requires large employers (50 or more employees) such as Wellesley College to offer health insurance
Group Health Insurance Q & A HEALTH CARE REFORM: FREQUENTLY ASKED QUESTIONS (Group, Individual, Seasonal) 1. Will small employers continue to have 12 month rates as they exist today? a. Yes. Employer groups
Yes, Employers, There Is an Escape Clause! Christmas Eve Guidance Exempts Some EAPs and Limited Scope Dental and Vision Plans From HIPAA and Affordable Care Act January 2014 On December 24, 2013, the Departments
PAY OR PLAY TIME TO ACT Bob Blum Hanson Bridgett LLP April 2, 2013 Hanson Bridgett LLP Talk To Your Lawyer This presentation is a general discussion of the pay or play rules based on proposed regs It is
P4P Preparing for PPACA Session #15: Traps for the Unwary: Open PPACA Issues Heading into 2013-2014 September 20, 2012 4980H Determining Full-Time Status Two just-released notices Notice 2012-58 and Notice
Attorneys at Law Friday, January 29, 2016 IRS NOTICE 2015-87: ADDITIONAL GUIDANCE ON HRAS, ACA REPORTING, HEALTH FSA CARRYOVERS AND MORE By: Gabriel S. Marinaro, Esq. In December of 2015, the IRS issued
Health Care Reform Guidance on PPACA Annual Dollar Limit Waivers, Provider Nondiscrimination, Clinical Trials and Transparency Reporting Summary The Departments of Labor (DOL), Health and Human Services
IRS Releases 2015 Forms and Instructions for 6055/6056 Reporting Background Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable
Broader Perspective. Business Solutions. Health Care Reform: Ready or Not, Here it Comes! Presented by: Ryan Fridborg, MAOD, SPHR Executive Vice President, Employee Benefits firstname.lastname@example.org Marilyn
American Farm Bureau Federation Overview of Health Care Reform and its Impact on Agricultural Employers 1 (as of October 2012) This is an overview of the employer mandate contained in the Patient Protection
Brought to you by Commercial Insurance Employer Penalties IRS Examples for Determining Full-time Status Under section 4980H of the Affordable Care Act (ACA), large employers may be subject to a penalty
BENEFITS 6.1 Health Insurance PERSONNEL POLICIES AND PROCEDURES Personnel Policy Adopted by Res.: 1323 (2014) Personnel Procedures Approved: 11-5 -2014 1. PURPOSE: To establish the policy and procedures
PPACA Shared Responsibility Ensuring Healthcare Reform Compliance Summary As the impact of healthcare reform increases, employers must prepare for their new obligations and responsibilities under the Patient
Does the Affordable Care Act Require Health Insurance Coverage for Substitutes? On January 2, 2013, the IRS issued proposed rules addressing key issues for employers under the Affordable Care Act (ACA).
Employer Health Coverage Reporting Requirements for 2015 Summary The Affordable Care Act (ACA) includes reporting requirements for health care coverage in 2015. The reports will give information to the
AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless
Tuesday, July 1, 2014 2 3 p.m. Central time Health Care Reform Where Are We Now? Preparing for 2015 David Hunt, CHBC Senior Managing Consultant BKD, LLP email@example.com Philip Floyd, CFP, CFS Senior Managing
PROGRAM MEMORANDUM INSURANCE COMMISSIONERS INSURANCE ISSUERS Department of Health and Human Services Centers for Medicare and Medicaid Services Transmittal No. 04-01 Date March 2004 Title: Subject: Market:
Contingent Workers: Is the Staffing Agency or the Client Employer Liable under the Employer Mandate? The Issues by Lisa Klinger, JD Many employers hire temporary and contract workers (often called contingent
Health Care Reform Is Here To Stay What Do Employers Do Now? L. Scott Austin David Mustone Webinar Presentation - January 17, 2013 Presenters L. Scott Austin, Partner Tax & Erisa Dallas/Atlanta Offices
CLICK HERE TO ADD TITLE HEALTH CARE REFORM & ITS EFFECTS ON YOUR BUSINESS Presented by Jenny Arthur, SPHR AGENDA Background/History The Past: Previously Implemented HCR Provisions The Present: Current/Pending
Helbling Benefits Consulting Your Health Care Reform Partner Will you be hit with penalties due to health care reform? Once the employer mandate becomes effective, some employers may have to pay a penalty
Affordable Care Act (ACA) Background Core of law is an attempt to reduce # of uninsured Multiple approaches to expanding insurance coverage Requires most in US to have health insurance Creates state-based
The Patient Protection and Affordable Care Act ( ACA ) and Your Facility By Christine Garrity: Chief Administrative Officer & General Counsel for The Professional Golfers' Association of America President
IRS Releases Final Forms and Instructions for Affordable Care Act Reporting March 24, 2015 In February 2015, the IRS released final forms and instructions related to information reporting under the Affordable
Heffernan Benefit Advisors Presents Health Care Reform: What Non-Profits Need to Know The session will begin shortly Sound should come through your speakers when the session begins Verify that the volume