Tag Archives: Congressional Research Service

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

New report on the ACA’s transitional reinsurance program
The Congressional Research Service has published the report “The Patient Protection & Affordable Care Act’s (ACA’s) Transitional Reinsurance Program.” The report provides an overview of the risk mitigation program. The first section of the report provides background information on reinsurance and the ACA risk-mitigation programs. The second section describes the components of the transitional reinsurance program, as well as implementation of and experience with the program. The third section discusses questions regarding the scope of HHS’s authority to administer the transitional reinsurance program, including those raised by a 2016 Government Accountability Office report.

To download the entire report, click here.

CDC report on health insurance coverage
The Centers for Disease Control (CDC) published a report providing health insurance estimates from the first quarter of the 2017 National Health Interview Survey. Highlights from the report include:

• In the first 3 months of 2017, 28.1 million (8.8%) persons of all ages were uninsured at the time of interview—0.5 million fewer persons than in 2016 (a nonsignificant difference) and 20.5 million fewer persons than in 2010.
• Among adults aged 18–64, 70.5% (138.8 million) were covered by private health insurance plans at the time of interview in the first 3 months of 2017. This includes 4.8% (9.4 million) covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges.
• The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan (HDHP) increased, from 39.4% in 2016 to 42.3% in the first 3 months of 2017.

To download the entire CDC report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS extends due dates for furnishing to individuals with 2016 Form 1095-B and Form 1095-C
The Internal Revenue Service (IRS) released Notice 2016-70, which extends the due dates for certain information reporting requirements for 2016 imposed by the Patient Protection and Affordable Care Act (ACA) under section 6055 and 6056 of the Internal Revenue Code.

Specifically, this notice extends the due date for furnishing to individuals the 2016 Form 1095-B, Health Coverage, and the 2016 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, from January 31, 2017, to March 2, 2017. This notice also provides for transitional good-faith relief from the penalties imposed by sections 6721 and 6722 of the Internal Revenue Code relating to the 2016 information reporting requirements under sections 6055 and 6056.

To read the entire notice, click here.

The ACA transitional reinsurance program
The Congressional Research Service (CRS) released “The Patient Protection and Affordable Care Act’s Transitional Reinsurance Program.” The first section of the report provides background information on reinsurance and the ACA risk-mitigation programs. The second section describes the components of the transitional reinsurance program as well as the amounts currently collected and remitted through the program. The third section discusses questions, including those raised by a recent Government Accountability Office (GAO) report, regarding the scope of the authority of the Department of Health and Human Services to administer the transitional reinsurance program. The last section briefly summarizes relevant legislation regarding the transitional reinsurance program.

To read the entire report, click here.

Registration now open for 2017 advance monthly payments of the Health Coverage Tax Credit
The IRS opened the new registration and enrollment process for qualified taxpayers to receive the benefit of the Health Coverage Tax Credit (HCTC) on an advance monthly basis during 2017.

Eligible taxpayers can have 72.5% of their qualified health insurance premiums paid in advance directly to their health plan administrators each month. Each payment made on their behalf to the health plan administrators lowers their out-of-pocket premium costs.

To learn more, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS announces PCORI fee
The Internal Revenue Service (IRS) released Notice 2016-64, which provides that the adjusted applicable dollar amount that applies for determining the Patient-Centered Outcomes Research Institute (PCORI) fee for policy years and plan years ending on or after October 1, 2016, and before October 1, 2017, is equal to $2.26. This adjusted applicable dollar amount has been determined using the percentage increase in the projected per capita amount of the National Health Expenditures published by the U.S. Department of Health and Human Services (HHS) in July 2016.

To read the entire notice, click here.

Report issued on expiring healthcare provisions
The Congressional Research Service (CRS) released “Health care-related expiring provisions of the 115th Congress, first session.” The report provides descriptions of selected healthcare provisions that are scheduled to expire during the 115th Congress and calendar year 2017.

The expiring provisions included in the report are those related to Medicare, Medicaid, the State Children’s Health Insurance Program (CHIP), and private health insurance programs and activities. The report also includes other healthcare provisions that were last extended under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

To read the entire report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Drafts of ACA 2016 reporting Forms 1095-C, 1094-C released
The Internal Revenue Service (IRS) released drafts of two forms for reporting 2016 health coverage information under the Patient Protection and Affordable Care Act (ACA).

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, and Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, are to be filed in early 2017. The draft forms are for employer planning purposes and may change before their final release later in 2016.

For more information about Form 1095-C, click here.
For more information about Form 1094-C, click here.

ACA-HIPAA grandfathered and non-grandfathered group health plan checklists
The Center for Consumer Information and Insurance Oversight of the Centers for Medicare and Medicaid Services (CMS) released two checklists containing summaries of certain provisions applicable to grandfathered and non-grandfathered, self-funded, non-federal governmental group health plans.

For a summary of certain provisions applicable to grandfathered plans, click here.
For a summary of certain provisions applicable to non-grandfathered plans, click here.

Overview of health insurance exchanges
The Congressional Research Service released “Overview of Health Insurance Exchanges,” which provides a summary of the various components of the health insurance exchanges. The report includes information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges since 2014.

To read the entire report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS issues the 2017 inflation-adjusted deduction limitations for annual contributions to HSAs
The Internal Revenue Service (IRS) released Revenue Procedure 2016-28, which provides the 2017 inflation-adjusted deduction limitations for annual contributions made to a health savings account (HSA) under section 223. These deduction limitations are updated annually pursuant to section 223(g) to reflect the cost-of-living adjustments.

For more information, click here.

Guide for electronically filing ACA information returns for software developers and transmitters
The IRS released “Publication 5165: Guide for electronically filing Affordable Care Act (ACA) information returns for software developers and transmitters (processing year 2016).” The report outlines the communication procedures, transmission formats, business rules, and validation procedures for returns transmitted electronically through the ACA Information Returns (AIR) system. To develop software for use with the system, software developers, transmitters, and issuers should use the guidelines provided in this publication along with the extensible markup language (XML) schemas published on the IRS website.

To read the entire report, click here.

The CRS publishes employer shared responsibility report
The Patient Protection and Affordable Care Act (ACA) creates shared responsibilities for both employers and individuals with regard to health insurance coverage. The ACA expands federal private health insurance market requirements and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. A new Congressional Research Service (CRS) report examines the new employer responsibilities.

To read the entire report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

CMS finalizes 2017 payment and policy updates for Medicare health and drug plans
The Centers for Medicare and Medicaid Services (CMS) released the final Medicare Advantage and Part D Prescription Drug Program changes for 2017 that seek to provide stable payments to plans, and make improvements to the program for plans that provide high-quality care to the most vulnerable enrollees.

For more information, click here.

RDS program: Change of address for sending an overpayment remittance
The address for sending an overpayment remittance to CMS’s Retiree Drug Subsidy (RDS) Center has changed. Effective immediately, plan sponsors are to remit payment by sending a check or money order, made payable to the Centers for Medicare and Medicaid Services, to the following address:

Retiree Drug Subsidy Center
Attn: Payments – Box 6054
P.O. Box 7247
Philadelphia, PA 19170-6054

For more information, click here.

Guidance on coordinating government contractor fringe benefit requirements with ACA
The U.S. Department of Labor (DOL) issued All Agency Memorandum (AAM) 220 to provide guidance to governmental agencies on how provisions of the Patient Protection and Affordable Care Act (ACA) regarding the employer-shared responsibility provisions interact with the fringe benefit requirements of the McNamara-O’Hara Service Contract Act (SCA) and the Davis-Bacon Act and Davis-Bacon Related Acts (DBRA, together DBA/DBRA).

For more information, click here.

Overview of private health insurance provisions in the ACA
The Congressional Research Service (CRS) issued the report “Overview of private health insurance provisions in the Patient Protection and Affordable Care Act (ACA).” The report provides general perspectives of some of the private health insurance provisions in the ACA and directs readers to more in-depth CRS reports.

To download the entire report, click here.