At Sterling Benefits, we are proactively working with multiple resources to dissect the various facets of the law and to understand the guidelines and timelines it presents to our clients. You can expect that we will provide ongoing communications and information as interpretation and implementation details continue to unfold from the government.

Our priority at Sterling Benefits is to stay focused on delivering value and quality customer service to our customers as we work together with health care reform. Significant changes will take place in 2014. In the meantime, there are some items that will require attention much sooner. We will keep you posted as details and clarifications from the government are made available. We encourage you to review this information and utilize our office as a resource in addressing questions and concerns.

Thursday, July 25, 2013

PCORI Fees & HRA's

Plan sponsors with calendar-year HRA plans must remit PCORI fees applicable for the 2012 plan year by July 31, 2013

For the July 1, 2013 payment deadline the fee is $1.00 per HRA-covered employee (dependents excluded).  Fees for plan years ending before 1/1/2013 are due by 7/31/2013.  If a plan ends after 1/1/2013 and before 10/1/2013, the fee is still $1.00, but not payable until 7/31/2014.

The Regulations indicate that the reporting and payment of PCORI fees cannot be delegated to your HRA TPA. The fees should be reported on Form 720 (Quarterly Federal Exercise Tax Return Form).

Please review the attached Health Care Reform Hot Topic for more information.

Monday, July 8, 2013

U.S. relaxes health law income - Health markets to employ honor system

As reported by the Washington Post:

The Obama administration announced Friday that it would significantly scale back the health law's requirements that new insurance marketplaces verify consumers' income and health insurance status.
Instead, the federal government will rely more heavily on consumers' self-reported information until 2015, when it plans to have stronger verification systems in place.

The delay comes after a Tuesday announcement that the federal government would postpone for one year a requirement that employers with 50 or more full-time workers provide health coverage.

"I think that Health and Human Services is doing the best that it can under the circumstances," said Sara Rosenbaum, a health policy professor at George Washington University.

The verification systems are meant to determine who qualifies for new benefits under the Affordable Care Act. The law includes tax subsidies to purchase health insurance for Americans who earn less than 400 percent of the poverty line, about $45,000 for an individual.

Those earning less than 133 percent of the poverty line - about $15,000 - will qualify for Medicaid coverage in the District and 23 states that have decided to expand the program.

The federal government also needs to know who receives health insurance coverage from an employer. Consumers who receive affordable health insurance from their company under a policy that costs less than 9.5 percent of their income do not qualify for tax credits under the Affordable Care Act.

Wednesday, July 3, 2013

Employer Mandate Delayed Until 2015

Bloomberg: Health-Law Employer Mandate Said to Be Delayed to 2015
Businesses won't be penalized next year if they don't provide workers health insurance after the Obama administration decided to delay a key requirement under its health-care law, two administration officials said. The decision will come in regulatory guidance to be issued later this week. It addresses vehement complaints from employer groups about the administrative burden of reporting requirements, though it may also affect coverage provided to some workers (Dorning and Wayne, 7/2).

The Washington Post: White House Delays Employer Mandate Requirement Until 2015  The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday. Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015 (Kliff, 7/2).

What’s not changing as a result of these delays:
  • The Exchanges/Marketplaces
  • The individual mandate
  • Individuals’ access to premium tax credits
  • Any other PPACA provision
Here is the announcement by the Treasury Department made on 7/2/2013: http://www.treasury.gov/connect/blog/Pages/Continuing-to-Implement-the-ACA-in-a-Careful-Thoughtful-Manner-.aspx.

Please review the attached Health Care Reform Hot Topic for more information.