Tag Archives: IRS

Regulatory roundup

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

Health plan choice and premiums in the 2018 federal health insurance exchange
The U.S. Department of Health and Human Services (HHS) has issued a brief that presents information on qualified health plans (QHPs) available on the federal health insurance exchange for states that use the HealthCare.gov platform. National estimates and summary tables are presented in each section of the text. State-specific estimates are in the appendix.

For more information, click here.

ACA AIR submission composition and reference guide published
The Internal Revenue Service (IRS) has published “Affordable Care Act (ACA) Information Returns (AIR) Submission Composition and Reference Guide.” The document provides details on composing and submitting Forms 1094/1095-B and Forms 1094/1095-C by transmitters to the IRS. The scope of the document addresses the application-to-application (A2A) messages exchanged on a Simple Object Access Protocol (SOAP) basis between client and exposed web service endpoints and the user interface (UI)-browser-based web, requiring human initiation.

For more information, click here.

Guidance on the requirements for providing a qualified small employer health reimbursement arrangement released
The IRS published Notice 2017-67 offering guidance on the requirements for providing a qualified small employer health reimbursement arrangement (QSEHRA) under section 9831(d)—which was added to the Internal Revenue Code by the 21st Century Cures Act (Cures Act)—the tax consequences of the arrangement, and the requirements for providing written notice of the arrangement to eligible employees.

For more information, click here.

IRS updates FAQs on employer-shared responsibility payments
The IRS updated its website listing frequently asked questions (FAQs) on employer-shared responsibility provisions under the Patient Protection and Affordable Care Act (ACA), including questions and answers regarding employer-shared responsibility payments.

For more information, click here.

COLAs for retirement, Social Security, and health benefits for 2018

With the release of the September 2017 Consumer Price Index (CPI) by the U.S. Bureau of Labor Statistics, the U.S. Social Security Administration (SSA) and the Internal Revenue Service (IRS) have announced cost-of-living adjustment (COLA) figures for Social Security and retirement plan benefits, respectively, for 2018. The 2018 adjusted figures for high-deductible health plans (HDHPs) and health savings accounts (HSAs) included in this Client Action Bulletin were released by the IRS earlier this year and are provided here for convenience.

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 and 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%) in 2018. More than three-fourths (77%) of Medicare Advantage enrollees remaining in their current plans 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 Internal Revenue Service (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 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 the U.S. Department of Health and Human Services (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.