Tag Archives: Regs and guidance

Regulatory roundup

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

IRS publishes best practices for tax filings related to individual shared-responsibility provision
The IRS released a document offering best practices for practitioners to gather necessary information to use in preparing 2017 tax returns for their clients, including information that may be helpful to demonstrate compliance with the ACA’s health coverage requirements. General requirements on filing a complete and accurate tax return continue to apply. Preparers are expected to resolve conflicting or contradictory statements from their clients during the return preparation process.

Under the individual shared responsibility provision of the ACA, all individuals are required to have qualifying health care coverage (called minimum essential coverage), qualify for an exemption, or make an individual shared responsibility payment, or ISRP, with their Federal income tax returns. An individual is responsible for him or herself, his or her spouse (if filing a joint return), and any individuals who could be claimed as dependents (collectively, the tax household). Under the recently enacted Tax Cuts and Jobs Act, taxpayers must continue to report coverage, qualify for an exemption, or pay the individual shared responsibility payment for tax years 2017 and 2018.

For more information, click here.

Guidance on corrected, incorrect, or voided forms 1095-A
Individuals enrolled in health coverage through a healthcare marketplace must complete a Form 1095-A, Health Insurance Marketplace Statement, early in the year following the year of coverage. They should use the information on the form to claim the premium tax credit, to reconcile advance payments of the premium tax credit, or both, when filing their tax return. Some taxpayers may receive a second Form 1095-A because the information on the initial form was incorrect or incomplete. The IRS has published information related to corrected or voided Forms 1095-A for tax years 2014 through 2017.

For more information, click here.

Regulatory roundup

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

Guide for electronically filing ACA Information Returns for software developers and transmitters
The Internal Revenue Service has published its Guide for Electronically Filing Affordable Care Act (ACA) Information Returns (AIR) for Software Developers and Transmitters (Processing Year [PY] 2018). The guide outlines the communication procedures, transmission formats, business rules, and validation procedures for information returns transmitted electronically through the AIR System.

For more information, click here.

Health insurance provider fee moratoriums released
The Internal Revenue Service have published questions and answers regarding the health insurance provider fees on its website. The posting offers perspective on several issues, including the following

• Under the 2019 moratorium, is there a health insurance provider fee in 2019?
• Must Form 8963 be filed in the 2019 fee year?
• Do the 2017 or 2019 moratoriums affect the 2018 fee year?
• Does the 2019 moratorium apply to fee year 2019 or data ear 2019?

For more information, click here.

Regulatory roundup

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

Proposed rule regarding association health plans
The Department of Labor (DOL) has issued a proposed rule under Title I of ERISA. The rule would broaden the criteria under ERISA section 3(5) for determining when employers may join together in an employer group or association that is treated as the “employer” sponsor of a single multiple-employer “employee welfare benefit plan” and “group health plan” as those terms are defined in Title I of ERISA.

To read the proposed rule, click here.

Regulatory roundup

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

Results of medical loss ratio for 2016
The Centers for Medicare and Medicaid Services (CMS) published a report summarizing the results of the medical loss ratio (MLR) data submitted by health insurance companies to the agency for group and individual market health insurance coverage in 2016.

To learn more, click here.

Actuarial value calculator and methodology for 2019
In a memorandum, the CMS announced the release of its 2019 Actuarial Value Calculator and Methodology.

For more information, click here.

Regulatory roundup

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

Issues and challenges in measuring and improving the quality of healthcare
The Congressional Budget Office (CBO) released a new paper providing an overview of the current state of measuring healthcare quality. The agency uses the Medicare program to illustrate the key issues and challenges that arise in doing so.

To download the paper, click here.

Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) enforcement report published
The Centers for Medicare and Medicaid Services (CMS) has published a new report to increase transparency with respect to enforcement of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Although CMS has taken action to ensure compliance with MHPAEA since its enactment in 2008, this report only includes MHPAEA investigations completed in 2016 and beyond.

To download the report, click here.

 

Regulatory roundup

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

CMS issues revocation notice bulletin
The Centers for Medicare and Medicaid Services (CMS) released a notice by issuer or third-party administrator for employers/plan sponsors of revocation of the accommodation for certain preventive services. The bulletin addresses notice requirements in the recently published interim final rules addressing the religious and moral exemptions from the requirement to provide contraceptive benefits in group health plans and health insurance coverage.

For more information, click here.

Ninety-day delay of applicability date for disability claims procedure amendments
The U.S. Department of Labor (DOL) has announced a 90-day delay of the applicability date for ERISA plans to comply with a final rule amending the claims procedure requirements applicable to disability benefits.

The three-month delay of the applicability date announced today is intended to give interested stakeholders the opportunity to submit, and for the DOL to consider, data and information related to concerns by some insurance industry and employer groups, and some members of Congress, that the claims procedure amendments will drive up disability benefit plan costs, cause an increase in litigation, and, in so doing, impair workers’ access to disability insurance benefits.

The final rule amending the disability benefits claims procedure requirements for ERISA plans was published in the Federal Register on December 19, 2016. The amendments were to become applicable to claims for disability benefits filed on or after January 1, 2018.

For more information, click here.