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To avoid penalties and put in place effective health benefit strategies under the Affordable Care Act (ACA), employers must comply with the law's numerous and complex requirements.
How Tom Price Could Transform Employer Health CoverageRep. Tom Price, R-Ga., president-elect Donald Trump's choice to be secretary of Health and Human Services, supports allowing a defined-contribution health care approach and capping the tax exclusion available to employer-provided health plans.
IRS Delays Employers' Deadline to Distribute ACA Reporting Form 1095 to EmployeesThe IRS is giving employers an extra 30 days to distribute the Affordable Care Act's tax year 2016 reporting forms to employees, extending the deadline from Jan. 31 to March 2. But the deadline for filing Forms 1094 and 1095 with the IRS remains unchanged: Feb. 28 for paper/mail submissions or March 31 for electronic filing.
ACA Likely to Change Substantially Under Trump AdministrationThe employer mandate to provide coverage—and all the tracking and reporting requirements that go with it—could go away, even without a full repeal of the Affordable Care Act (ACA). The Cadillac tax on high-value plans is also on the block. A look at the prospects for major reform of health care reform.
IRS Sets PCORI Fees for 2017The annual fee to fund the Patient-Centered Outcomes Research Institute (PCORI), paid by employers
that sponsor self-insured health plans, is going up next year, the IRS announced.
2016 Transitional Reinsurance Fee Submission Due Nov. 15The deadlines for the 2016 transitional reinsurance fee are approaching. To determine the 2016 reinsurance fee, insurers or self-insured group health plan sponsors must submit plan enrollment counts to the federal Centers for Medicare & Medicaid Services by Nov. 15. Also, the second contribution for the 2015 reinsurance fee must be made by that date.
Self-Insured Plans May Struggle to Get SSNs from EmployeesThe IRS has proposed a "three tries" approach that self-insured employers can follow to show they acted responsibly to get the Social Security numbers of health plan participants, including spouses and dependents, as required by the Affordable Care Act.
Are You Down With OOPs?: Opt-Out Payments Under the ACAIRS proposed regulations address opt-out payments—made to employees who decline enrollment in an employer's group health plan—on affordability under the Affordable Care Act (ACA). The proposal clarifies that "unconditional" opt-out payments increase the employee's cost of coverage and, accordingly, impact whether the coverage is affordable under the ACA.
ACA Midyear Checkup: Count Your Contingent WorkersNow is a good time to catalog and assess your existing and planned staffing arrangements to determine who are and who may be deemed to be your employees
Employers Project Health Premium Hike of 6% in 2017The good news: health premiums are not growing at a faster clip year after year, as they were a decade ago. The bad news: the increase in health plan costs still outpaces general inflation
2017 ACA Information Reporting: Prepare Now for Earlier DeadlinesBy the end of January 2017, large employers must provide 1095-Cs reflecting 2016 health care coverage to their employees. That won't leave much time, and HR should prepare now to move quickly.
IRS Eases Penalties for Late ACA ReportsEmployers still have an opportunity to submit Affordable Care Act (ACA) information returns without facing penalties, even though the filing deadline has passed.
Respond Quickly to New Marketplace NoticeEmployers' quick response to new notices from the government's health insurance marketplaces, informing that then employees have received federal subsidies to purchase policies on a public exchange—may limit employer-mandate liability under the Affordable Care Act.
EEOC Offers Model Notice for Employer Wellness PlansThe Equal Employment Opportunity Commission (EEOC) issued a sample notice that will help employers comply with wellness program rules.
After ACA Repeal, Most Employers Would Keep Some ProvisionsThe future of the Affordable Care Act (ACA) will be hotly debated this election season. If it were to be repealed, over two-thirds of employers would favor keeping in place at least some of the mandated changes that they’ve made to their health plans.
EEOC Issues Final Rules on Wellness ProgramsThe Equal Employment Opportunity Commission (EEOC) has issued final rules that describe how wellness programs can comply with the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act, and that clarify limits on financial incentives for participating in voluntary wellness programs.
Health Plans Can’t Discriminate Under New RuleA final rule under the Affordable Care Act bars health care discrimination, including on the basis of sex and gender identification.
Health Costs and Consumerism at Midsize FirmsWhen given the choice, over one-third of employees at midsize firms select a high-deductible health plan, with Millennials the most likely to do so. Here’s a look at average plan costs in the midsize space.
IRS Sets 2017 HSA Contribution Limits2017 health savings account (HSA) contribution limits for individual (self-only) coverage will increase by $50; most other HSA-related limits, including for HSAs linked to family coverage, remain unchanged from 2016.
Agencies Issue Final SBC Template and GlossaryFederal agencies have issued the final summary of benefits and coverage (SBC) template and uniform glossary for use during the fall 2017 open enrollment season.
All Health Care Reform Compliance Q&As
For additional information on implementing the Patient Protection and Affordable Care Act, please contact the
SHRM Knowledge Center.
Affordable Care Act: Coverage Terms
2016 Reporting Requirements
Clarifying Two Separate ACA Appeals: HHS Appeals and IRS Appeals. Via Health Care Attorneys P.C.
IRS Due Dates for ACA Information Reporting. Via SHRM Online.
Understanding Electronic Filing Requirements for ACA Information Returns. Via IRS
IRS Forms and Instructions for ACA Reporting. Via SHRM Online
Q&A on ACA Reporting Requirements. Via IRS
Q&A on Information Reporting by Employers on Form 1094-C and Form 1095-C, Via IRS
ACA Information Center for Applicable Large Employers. Via IRS
Brochure: Understanding Employer Reporting Requirements of the Health Care Law. Via IRS
Four Steps Required Prior to ACA E-Filing. Via International Foundation of Employee Benefit Plans
Types of Employer Payments and How They Are Calculated. Via IRS
Health Reform Implementation Timeline. Via Kaiser Family Foundation.
SHRM Toolkits and How-To Guides:
Complying with and Leveraging the Affordable Care Act
How to Use the Look-Back Measurement Method to Determine Full-Time Status Under the Affordable Care Act
Communicating with Employees About Health Care Benefits Under the Affordable Care Act
Click below to read articles on:
Pay or play interactive tool. Via Unum.
Pay or play decision tree. Via Unum.
Estimated-penalty calculator. Via Littler.
Full-time employee worksheet. Via BenefitMall.
Subsidy calculator. Via Kaiser Family Foundation.
Actuarial value calculator /
Minimum value calculator. Via Centers for Medicare and Medicaid Services.
Employer Shared Responsibility Penalties: A Checklist for Employers. Via Snell & Winter LLP.
Excluding Certain Classes of Employees from your Health Plan May Increase Risk of Penalty. Via Warner Norcross & Judd
Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016. Via Buck Consultants.
Complying with and Leveraging the Affordable Care Act. A SHRM toolkit (members only).
Out-of-Pocket Limits for 2014 and 2015; Preventive Services Requirements. Via Segal Consulting.
Compliance Checklist for Plan Sponsors. Via Snell & Wilmer LLP.
The 95% Coverage Rule—The Critical Details. Via Moulder Law.
Applying PPACA Market Reforms to HRAs, FSAs and Other Health Accounts. Via Towers Watson.
DOL Plan Audits: Are You Prepared? Via McKenna Long & Aldridge LLP.
DOL's Self-Compliance Tool. Via the Department of Labor.
ACA Notice Requirements. Via Segal Consulting.
State-Specific Employer Guidance.
Triggering Loss of 'Grandfathered' Status. Via Sibson Consulting.
DOL Health Care Reform Webpage. Via U.S Department of Labor.
Healthcare.gov Website. Via U.S. Department of Health & Human Services.
Small Business Health Care Tax Credit. Via IRS.
SHRM Member-Only Excel Spreadsheets:
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