Special Health Insurance Sign-Up for Tax Filers Owing Fees

Do you have to pay a penalty? 
If you learn as you do your taxes that you owe a fee for not having health insurance last year, avoid having to pay this fee next year. Find out if you are eligible to sign up for health insurance for 2015, even though open enrollment has closed. If you are - you’ll avoid bigger penalties next year, and may receive subsidies that make the insurance premiums more affordable. This special enrollment period runs from March 15 to April 30.

Final 2015 Notice of Benefit and Payment Parameters and Actuarial Value Calculator

On March 6, the Department of Health and Human Services (HHS) provided the 2015 actuarial value calculator and issued final regulations on the 2015 Notice of Benefit and Payment Parameters. While HHS changed a few items from the proposed rule – namely the open enrollment period and cost-sharing limits – many provisions remain the same.

Open Enrollment Period
The 2015 open enrollment period for individual and family plans has been extended by 30 days and will be held November 15, 2014 – February 15, 2015.

2015 Cost-Sharing Limits
The 2015 maximum annual out-of-pocket limits for all non-grandfathered plans will increase by 4.21 percent, lower than originally proposed. The confirmed 2015 amounts are $6,600 for individual coverage and $13,200 for family coverage. The maximum 2015 deductibles for insured non-grandfathered small group plans are $2,050 individual and $4,100 family.

Animation Explains Changes Coming for Americans Under the Affordable Care Act

2014 is coming--are you ready for Obamacare? Join the YouToons as they walk through the basic changes in the way Americans will get health coverage and what it will cost starting in 2014, when major parts of the Affordable Care Act, also known as "Obamacare," go into effect.

Courtesy: The Henry J. Kaiser Family Foundation.

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.

IRS Determines that the PCOR Fees are Deductible Business Expenses

On May 31, 2013, the IRS released an update memorandum that found that fees paid by issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund (PCOR) were ordinary and necessary business expenses, and, thus, deductible business expenses under Section 4375-77 Excise Tax on Certain Insurance Policies.

To view the complete IRS Memo:  http://www.irs.gov/pub/irs-utl/AM2013-002.pdf

Affordable Care Act Rate Shock?

Come January 1 of next year, those with the lowest health insurance risk may be hit the hardest with premium increases as high as 40%.

If you are young, healthy and qualify for non-group coverage, you could face rate hikes forcing you to reconsider how you spend your health care dollars.

And because of new age rating band requirements tied to the ACA, the 18 to 44 age group’s premiums will increase while the over 57 group will decrease.

Full Article:  Affordable Care Act Rate Shock?

HRAs & PCORI Fees

As part of The Patient Protection and Affordable Care Act (PPACA) a new fee was introduced to be paid by health insurers and self-funded plan sponsors to fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI was established by the Act to promote the use of evidence-based medicine by disseminating comparative clinical effectiveness research findings. In mid December, the IRS released final regulations and guidance on the calculation and payment of the PCORI fees. Plans that are subject to the fee are: