Explanation of Guidance on HRAs, Health FSA- Clarification?

It appears that the pre-tax reimbursement of individual premiums under a premium only plan (POP) (under Code Section 125) is directly at odds with the prohibition against any annual limit on the dollar amount of essential health benefits under the Affordable Care Act (Act). 

On Friday, September 13, the Departments of Labor, Treasury and Health and Human Services provided guidance on the application of certain provisions of the Affordable Care Act (Act) on health reimbursement arrangements (HRAs), certain health flexible spending arrangements (Health FSAs) and employee assistance programs (EAPs). It was clear from the initial reading of the guidance that individual premiums could not reimbursed by HRAs. In a further reading of the guidance, there appears to be more serious consequences.
 

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.

New fact sheets answer questions about Health Reimbursement Arrangements

An FAQ issued by the Department of Labor on January 24, 2013 stated that stand-alone HRAs used to buy an individual policy is not considered combined employer-sponsored coverage that follows the annual dollar limit requirement. If employees are offered an HRA and employer-sponsored coverage and turn down the employer-sponsored coverage, the stand-alone HRA will violate the law. The FAQ does allow amounts already in a stand-alone HRA before January 1, 2014 to be drawn on after that time if certain standards are met.

Anthem HRA Fact Sheet

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: