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HR Questions and Answers on Health Care Reform
 

    
 

Actuarial Value: What is the actuarial value of a benefit plan and how is it determined? 

Administrative Issues: When the W-2 reporting requirement for the cost of an employee’s health benefits goes into effect, will employees be taxed for their health care?  

Adult-Child Coverage: Are employers required, under the recent health care reform act, to impute the value of employer-provided health care benefits for those employees with adult-aged children covered by their group health care plan?

Appeals: What do I need to know about the internal and external appeals process requirements under health care reform?  

• Annual and Lifetime Limits: What annual and lifetime limits does the health care reform place on essential health benefits?

Automatic Enrollment: Is automatic enrollment required under the PPACA? 

Dependents: Definition of "dependent" under the PPACA

Dependents: Will group health premiums for dependents up to age 26 be considered imputed income by the IRS? 

Dependents: Are employers required to retroactively reinstate coverage for adult children who were considered ineligible dependents and dropped prior to the Patient Protection and Affordable Care Act ’s enactment? 

Dependents: Are grandfathered plans required to cover dependents up to age 26? 

Dependents: Are self-insured plans required to cover dependents to age 26? 

Dependents: Can marital status or student status be considered in dependent child eligibility? 

Dependents: Does the Patient Protection and Affordable Care Act (PPACA) require employers to provide coverage for the children of dependent children (grandchildren)? 

Dependents: How do state laws on dependent child coverage interact with the Patient Protection and Affordable Care Act (PPACA)? 

Dependents: What are the penalties for failing to cover an eligible dependent child under the Patient Protection and Affordable Care Act (PPACA)?  

 Early Retiree Reinsurance Program: How does the PPACA affect retiree reinsurance subsidy? 

Eligibility: Will seasonal full-time employees have to be provided health care coverage beginning in 2015 to avoid the penalties? 

 Eligibility: What is a standard measurement period under PPACA, and why would an employer select a longer (12-month) period rather than a shorter period?

Employer Reporting and Fee Requirements: What government reporting and fee requirements are imposed by the PPACA?

Exchanges: What is the "exchange notice" requirement under PPACA? 

Fees: What are the patient-centered outcome fees and how to they affect self-insured health plans

Fees: What government reporting and fee requirements are imposed by the PPACA?

FSA, HRA, HSA, Archer MSA Plan Changes: FSA grace periods and PPACA: How does the PPACA affect FSA grace periods? 

FSA, HRA, HSA, Archer MSA Plan Changes: What are the consequences under the PPACA for withdrawals from HSAs or MSAs for non-health-related expenses? 

FSA, HRA, HSA, Archer MSA Plan Changes: What is the impact of the PPACA on FSAs, HSAs, Archer MSAs and HRAs? 

FSA, HSA or HRA: Does the PPACA no annual maximum provision apply to health FSA, HSA or HRA plans? 

Grandfathered Plans: How does the PPACA affect grandfathered plans? 

Medicare Part D Subsidy: How does the PPACA affect Medicare Part D notice requirements? 

Medicare Tax: What additional Medicare taxes must be withheld?

Non-Discrimination Rules: How does the health care reform affect nondiscrimination rules for group health plans?

Part-Time Employees: How do part-time employees affect the implementation of health care reform in my company?

Part-Time Employees: How do we determine average hours worked for benefits plan eligibility?

Part-Time Employees: Can an employer with 25 or more employees qualify for the small employer health care tax credit if some of its employees are part-time?

Penalties: What are the consequences for employers that offer coverage but employees claim a tax credit under the PPACA? 

Penalties: What are the consequences under PPACA if an employer offers no health coverage? 

Preventive Services: What is the preventive services provision under PPACA and what plans must comply? 

Preventive Services: What are the preventive services provisions under the federal Patient Protection and Affordable Care Act, and what plans must comply? 

Qualified Health Plans: What benefits are required to be included in a plan under the PPACA?

 Rebates: How should employers disburse medical loss ratio (MLR) rebates from insurance carriers? 

Rescinding Coverage: What is the no-rescission of coverage provision under health care reform?

Small Business Tax Credit: What is the definition of a “small employer” under the PPACA? 

Small Business Tax Credit: Can a tax-exempt employer claim the small employer health care tax credit if it has no taxable income for the year?  

Small Business Tax Credit: Can a tax-exempt organization be a qualified employer? 

Small Business Tax Credit: Can an employer (other than a tax-exempt employer) claim the small employer health care tax credit if it has no taxable income for the year?  

Small Business Tax Credit: Can an employer with 25 or more employees qualify for the small employer health care tax credit if some of its employees are part-time?  

Small Business Tax Credit: Can the small employer health care tax credit be reflected in determining estimated tax payments for a year?  

Small Business Tax Credit: Does taking the small employer health care tax credit affect an employer’s deduction for health insurance premiums?  

Small Business Tax Credit: For the small employer health care tax credit, are seasonal workers counted in determining the number of FTEs and the amount of average annual wages?  

Small Business Tax Credit: For the small employer health care tax credit, do family members of a business owner who work for the business count as employees?  

Small Business Tax Credit: For the small employer health care tax credit, how is the amount of average annual wages determined?  

Small Business Tax Credit: For the small employer health care tax credit, if an owner of a business also provides services to it, does the owner count as an employee?  

Small Business Tax Credit: For the small employer health care tax credit, is it expected that any transition relief will be provided for tax years beginning in 2010 to make it easier for taxpayers to meet the requirements for a qualify. 

Small Business Tax Credit: How does an employer claim the small employer health care tax credit?  

Small Business Tax Credit: How is eligibility for the small employer health care tax credit determined if the employer is a member of a controlled group or an affiliated service group?  

Small Business Tax Credit: How is the small employer health care tax credit reduced if the number of FTEs exceeds 10 or average annual wages exceed $25,000?  

Small Business Tax Credit: May an employer reduce employment tax payments (i.e., withheld income tax, social security tax, and Medicare tax) during the year in anticipation of the small employer health care tax credit?  

Small Business Tax Credit: What expenses are counted in calculating the small employer health care tax credit?  

Small Business Tax Credit: What is the average premium for the small group market in a State (or an area within the State)?  

Small Business Tax Credit: What is the maximum credit for a tax-exempt qualified employer? 

Small Business Tax Credit: What is the maximum small employer health care tax credit for a qualified employer (other than a tax-exempt employer)?  

Small Business Tax Credit: How is the number of FTEs determined for purposes of the credit?  

Small Employer Tax Credit: Which employers are eligible for the small employer health care tax credit? 

Summary of Benefits and Coverage (SBC): What is the Summary of Benefits and Coverage under Patient Protection and Affordable Care Act?

Union Employees/Collective Bargaining Agreements: When does PPACA affect collectively bargained plans?

W-2 Reporting: IRS guidance chart for employer-sponsored health plans

W-2 Reporting: What are the new reporting requirements for W-2s under PPACA?

W-2 Reporting: When the W-2 reporting requirement for the cost of an employee’s health benefits goes into effect, will employees be taxed for their health care?

• Waiting Periods: What are the restrictions on waiting periods under health care reform? 

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