Tag Archives: IRS

Regulatory roundup

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

Medicare offers more health coverage choices and decreased premiums in 2018
The Centers for Medicare & Medicaid Services (CMS) announced that people with Medicare will have more choices and options for their Medicare coverage in 2018. CMS estimates that the Medicare Advantage average monthly premium will decrease by $1.91 (about 6 percent) in 2018. More than three-fourths (77 percent) of Medicare Advantage enrollees remaining in their current plan will have the same or lower premium for 2018.

For more information, click here.

Fee funding the Patient-Centered Outcomes Research Trust Fund issued
The IRS released Notice 2017-61 which provides the adjusted applicable dollar amount to be multiplied by the average number of covered lives for purposes of the fee imposed by §§ 4375 and 4376 of the Internal Revenue Code for policy years and plan years that end on or after October 1, 2017, and before October 1, 2018.

The fee imposed by §§ 4375 and 4376 helps to fund the Patient-Centered Outcomes Research Trust Fund (PCORTF) and is calculated using the average number of lives covered under the policy or plan and the applicable dollar amount for that policy year or plan year.

The applicable dollar amount that must be used to calculate the fee imposed by §§ 4375 and 4376 for policy years and plan years that end on or after October 1, 2017, and before October 1, 2018, is $2.39. The increase from the prior amount is calculated by multiplying the adjusted applicable dollar amount for policy years and plan years ending in the previous Federal fiscal year, $2.26, by the percentage increase of the projected per capita amount of National Health Expenditures published by HHS on February 14, 2017.

For more information, click here.

Regulatory roundup

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

IRS issues guide on ACA information returns
The Internal Revenue Service (IRS) released Publication 5258, “Affordable Care Act (ACA) Information Returns (AIR) Submission Composition and Reference Guide.” The purpose of this document is to provide guidance to all types of external transmitters about composing and successfully transmitting compliant submissions to the IRS.

To download the guide, click here.

IRS issues guide on electronic filing of ACA information returns
The IRS released Publication 5165, “Guide for Electronically Filing Affordable Care Act (ACA) Information Returns for Software Developers and Transmitters.” The guide outlines the communication procedures, transmission formats, business rules, and validation procedures for information returns transmitted electronically through the AIR system.

To download the guide, click here.

Regulatory roundup

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

Draft ACA substitute Forms 1094 and 1095 published
The Internal Revenue Service (IRS) released a draft of Publication 5223 specifying general rules and specifications for Patient Protection and Affordable Care Act (ACA) Substitute Forms 1095-A, 1094-B, 1095-B, 1094-C, and 1095-C, if you will not be using the official IRS Forms 1095-A, 1094-B, 1095-B, 1094-C, and 1095-C, to furnish statements to recipients.

To download a copy of the draft, click here.

Regulatory roundup

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

New draft Form 1094-1095 information returns published
The Internal Revenue Service (IRS) has released draft 2017 versions of Form 1094/1095 information returns. The draft instructions for the forms have not been released.

Draft Form 1094-B: Transmittal of Health Coverage Information Returns
Draft Form 1095-B: Health Coverage
Draft Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Draft Form 1095-C: Employer-Provided Health Insurance Offer and Coverage

Forms 1094-B and 1095-B are used by coverage providers to report health plan enrollment as required by Code § 6055. Forms 1094-C and 1095-C are used by applicable large employers (ALEs) to report information relevant to Code § 4980H employer shared responsibility penalties as required by Code § 6056.

IRS announces HSA and HDHP adjusted limits for 2018

The Internal Revenue Service (IRS) recently published Revenue Procedure 2017-37, which provides the inflation-adjusted amounts for health savings accounts (HSAs) for calendar year 2018. The updated limits specify the maximum annual contributions to HSAs that may be tax-deductible, as well as the minimum deductibles and the maximum out-of-pocket expenses allowed under qualifying high-deductible health plans (HDHPs).

The table below reflects the 2018 and 2017 values:

The “catch-up” contribution amount of $1,000 for individuals aged 55 or older was set by law and has not changed since 2009.

Annual out-of-pocket expenses include the HDHP’s deductibles, copayments, and coinsurance, but not premiums paid by plan participants.

Employers that sponsor HSAs and HDHPs should review their programs and communications materials and plan for the updated limits for 2018.

For additional information about the 2018 updated HSA and HDHP limits, please contact your Milliman consultant.

Regulatory roundup

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

IRS updates Q&As about ACA information reporting
The Internal Revenue Service (IRS) has updated the following three question and answer (Q&A) documents regarding Patient Protection and Accountable Care Act (ACA) information reporting by employers.

Q&A about Information Reporting by Employers on Form 1094-C and Form 1095-C

Q&A on Reporting of Offers of Health Insurance Coverage by Employers (Section 6056)

Q&A on Employer Shared Responsibility Provisions Under the Affordable Care Act

Employers and coverage providers: 11 facts about healthcare information forms
Under the ACA, businesses that provide health insurance to their employees must submit information returns to the IRS and individuals reporting on health coverage. Taxpayers can use the information on these forms when they file their tax returns to verify the months that they had minimum essential coverage and determine if they satisfied the individual shared responsibility provision of the healthcare law. The IRS will use the information on the statements to verify the months of the individual’s coverage. The IRS’s “Health Care Tax Tip 2016-82” provides some information about these information return forms, the purpose of each, and noteworthy dates.

For more information, click here.