In the fall of 2013, the Department of Health and Human Services (HHS) announced a transitional relief program that allowed state insurance departments to permit early renewal at the end of 2013 of individual and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act (ACA) […]
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Bim Group: A Year in Review
Highlights of the Patient-Centered Outcomes (PCORI) / Comparative Effectiveness Fee
The Patient-Centered Outcomes Research Institute (PCORI) fee initially applied from 2012 to 2019. However, in December 2019, the Further Consolidated Appropriations Act, 2020 extended the fee to 2029. The fee is due based on plan/policy years ending on or after October 1, 2012, and before October 1, 2029. The fee is due by July 31 of the year following the calendar year in which the plan/policy year ended. This means that the first fee was due July 31, 2013, for those on November, December, and […]
Read moreCompliance Recap – December 2019
December was a busy month in the employee benefits world. The U.S. Court of Appeals for the Fifth Circuit held that the Patient Protection and Affordable Care Act’s (ACA’s) individual mandate is unconstitutional. The Internal Revenue Service (IRS) released final instructions and final 1094-B, 1095-B, 1094-C, and 1095-C forms for 2019. The IRS also extended […]
Read moreStatus of Court Case Challenging ACA Constitutionality
On December 18, 2019, the U.S. Court of Appeals for the Fifth Circuit (Appeals Court) held that the Patient Protection and Affordable Care Act’s (ACA’s) individual mandate is unconstitutional. The Appeals Court is remanding the case to the U.S. District for the Northern District of Texas (District Court) for additional analysis on whether the individual […]
Read moreIRS Releases Draft Forms and Instructions for 2019 ACA Reporting
Background Under the Patient Protection and Affordable Care Act (ACA), applicable large employers (ALEs) are required to offer health benefits to their full time employees and individuals are required to have health insurance, although the penalty is $0 for failing to have minimum essential coverage starting in 2019. Reporting is required by employers with 50 […]
Read moreProposed Rules on Coverage and Transparency and Final Rules on Hospital Price Transparency
On November 15, 2019, the Internal Revenue Service (IRS), Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, Departments) released proposed rules on coverage transparency. The proposed rules seek to give an estimate of plan participants’ potential cost-sharing liability for covered items and services they might receive from a particular […]
Read moreSummary of Benefits and Coverage Highlights and Frequently Asked Questions
A Summary of Benefits and Coverage (SBC) is a four-page (double-sided) communication required by the federal government. It must contain specific information, in a specific order and with a minimum size type, about a group health benefit’s coverage and limitations. For fully insured plans, the insurer is responsible for providing the SBC to the plan administrator […]
Read moreWebinar: What Employers Need to Know About IRS Reporting in 2020
Tuesday, December 10, 2019 2:00 p.m. ET / 11:00 a.m. PT Register Now The Patient Protection and Affordable Care Act’s reporting requirements are rapidly approaching for employers with group health plans or with 50 or more full-time or full-time equivalent employees. This webinar will provide an overview of the reporting process, what we learned from […]
Read moreHR Elements: How to Handle Pay-History Inquiries —The Right Way
We’ve all been there. You’ve gotten deep into the job interview process, and then you’re face-to-face with the awkward question: would you share your previous salary? Whether the question rears its head in a digital application or during initial in-persons, none of us like answering it. Many people, especially young people, are less committed to […]
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