Bailey Benefit News
New Disability Claims Procedure
The Department of Labor (DOL) issued a final ruling in January amending its claims and appeal procedures for ERISA-covered plans to provide additional rights for disability claimants. This amendment is applicable to disability claims filed on or after April 1, 2018.
ACA Taxes Addressed in Budget Negotiations
The government shutdown ended with a three week extension of the federal budget. The Republicans were able to sway enough Democrats to vote for this extension by providing funding for the Children's Health Insurance Program (CHIP) for the next six years.
IRS Extends ACA Reporting Deadline
The IRS is extending the due date for providing IRS Form 1095 to the employees. As you will re-call, large employers (i.e. employers with 50 or more full time and full time equivalent employees) plus employers with self-funded health plans have to prepare, distribute and file IRS Form 1094 and IRS Form 1095.
2015 IRS Penalty Notification Letter
The IRS is going to start sending employer mandate penalty notices (formerly known as employer shared responsibility payment) via IRS Form 226J. If your company receives this notice, you only have 30 days to either accept the penalty or contest it.
IRS Limits for 2018
See an outline of the various IRS limits for the 2018 calendar year reflecting the cost-of-living adjustments which were recently announced
CBC The Future of Health Care Featuring Kathleen Crawford
The Affordable Care Act has been receiving a lot of attention in the news lately. Yet, from a practical standpoint, employers and their employees still
have a lot of questions.
Updated List of Required Preventative Services Under the Affordable Care Act
Highlights of the updated list of ACA (non-grandfathered health plans) required services to be provided as preventable in-network benefits at no charge.
New USPSTF Updates for Non-grandfathered ACA plans
All non-grandfathered health plans, under the Affordable Care Act, are required to cover certain in-network preventive care services with no charge to the member.
ACA Affordability Contribution Percentages Will Decrease in 2018
While the House has passed the American Health Care Act, it is now in the Senate being debated and most likely rewritten. With that said, the PPACA is still the law of the land and must be followed.
The American Health Care Act (AHCA) Passes the U.S. House
The House of Representatives passed the American Health Care Act (AHCA). This is the same bill that was pulled before a vote in March.
Premier Health Network hospitals now out of network for UnitedHealthcare employer-sponsored, individual plans
UnitedHealthcare has an important update about their negotiations with Premier Health Network and their
participation in the UnitedHealthcare network. Premier has decided to not renew its participation for employersponsored
and individual plans, which means its hospitals are no longer in-network for commercial health plans as
of April 30, 2017.
American Health Care Act Pulled
Speaker Paul Ryan pulled legislation to repeal and replace the Affordable Care Act on Friday afternoon, March 24, 2017, after GOP leaders and the White House failed to pull together enough support from the conservative and moderate wings of their party.
Release of the American Health Care Act
House Republicans released their initial legislation for repealing and replacing the Affordable Care Act on March 6, 2017.
See our upcoming events. Each 90 minute seminar is certified for 1.5 hours of HRCI and SHRM credit
Anthem Cigna Merger Blocked
On February 8, 2017, a federal judge ruled against Anthem's proposed $54 billion merger with Cigna.
Aetna/Humana Merger Blocked
On January 23, 2017, A federal judge blocked Aetna's proposed $37 billion acquisition of Humana.
Cobra Form Update
The Department of Labor has released new COBRA forms. We realize you may have a COBRA vendor that handles your administration. However, should you ever need these, you now have the most up to date forms.
Phishing Email Disguised as Official OCR Audit
On November 28, 2016, the Department of Health and Human Services issued the following Phishing Alert:
IRS Extends Reporting Due Dates for 1095 Forms Sent to Individuals
On November 18, 2016, the Internal Revenue Service (IRS) announced extended deadlines for 2016 Minimum Essential Coverage (Section 6055) and Large Employer Shared Responsibility (Section 6056) reporting due to individuals in early 2017.
IRS Limits for 2017
Here is an outline of all the various IRS limits for the 2017 calendar year to reflect the cost-of-living adjustments (COLA) and changes in the law:
FSA Limit Increasing for 2017
The IRS announced in Revenue Procedure 2016-55 the annual inflation adjustments for more than 40 tax provisions for 2017, including the tax rate schedules, and other tax changes. This Revenue Procedure provides details about these annual adjustments.
HIPAA Phase 2 Audits
The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has begun to implement Phase 2 of its audit program. It intended to use this audit program to ensure compliance with HIPAA’s Privacy, Security and Breach Notification Rules.
Marketplace Appeals Process
Last week, many employers received notice from the Marketplace indicating one of their employees was qualified for advance premium tax credits. Many are asking what is this notice and how should you deal with it. The following explains what the notice is and what steps an employer should take.
HSA Contribution and Coverage Limits 2017
The IRS Revenue Procedure 2016-28 provides the 2017 cost-of-living contribution and coverage adjustments for HSAs, as required under Code Section 223(g).
HHS and IRS Updates
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have issued the final 2017 Notice of Benefit and Payment Parameters. This affects both the group and individual plan markets.
Side Affects:Disrupting Health Care
Bailey & Company is proud to announce that our affiliate, McGohan Brabender, has just launched its very own podcast.
December 2015, Cadillac Tax Delayed
On Friday, December 18th, Congress passed a two-year delay of the “Cadillac Tax”. The Cadillac Tax is a 40 percent excise tax on high-cost employer-sponsored health plans.Read more
November 2015, ACA Reporting Requirements
As you know, the reporting for the ACA is approaching. Applicable large employers must report whether an individual is covered by minimum essential coverage and that an offer of minimum essential coverage that provides minimum value was made to each full-time employee.Read more
September 2015, Flu Shot Clinics
Many of our clients host in-house flu clinics demonstrating to employees that they are committed to keeping their employees healthy and productive.Read more
August 2015, Compliance Update
Compliance updates from August 2015.Read more
August 2015, Requirements for Companies Filing their own 1095 1094 Forms
Effective January 2015, employers with 50 or more full-time equivalent employees are required to file forms with the IRS so that the IRS can monitor both individuals and employers for the “pay or play” penalties.Read more
July 2015, Compliance Update
Compliance updates from July 2015.Read more
June 2015, Compliance Update
Compliance updates from June 2015.Read more
Supreme Court Declares Same-Sex Marriage Legal
In a 5-4 decision, the Supreme Court held that the U S Constitution requires all states to license and recognize same sex marriages.Read more
ACA 6055 & 6056 reporting requirements webinar
We recently hosted a webinar on the ACA 6055 & 6056 reporting requirements. If you were unable to attend the webinar or would like to view it in its entirety, click view webinar link:View webinar
Newly released 2016 High Deductible Health Plan and Savings Account limits.Read more
Be Careful What You Promise Employees Who Leave Your Employment
Clients sometimes like to ease the transition for employees who are retiring or whom the client would like to encourage to leave.Read more
The Key to Good Health Could Be In the Palm of Your Hand
Scott McGohan, CEO of our affiliate McGohan Brabender, was recently selected to give a TED Talk regarding health and healthcare in America.Read more
2014 W2 Reporting 12,3
A reminder that if you, the employer, issue more than 250 W-2’s, you must report the value of your employee’s health care cost on their W-2.Read more
The IRS announced October 30th that healthcare flexible spending accounts and limited flexible spending accounts maximum limit will increase to $2,550. The new limit will affect plans that begin on January 1, 2015 or later. In addition to the FSA limit, below is an outline of other IRS limits for the 2015 calendar year for defined benefit and defined contribution plans to reflect cost-of-living adjustments (COLA) and changes in the law. Read more
Upcoming Employer requirements
The new reporting will be used by the IRS to determine whether an individual is eligible for a premium subsidy or subject to the individual tax penalty for not having medical coverage. In addition, the IRS will utilize the reporting information to determine whether an applicable large employer (ALE) is subject to a shared responsibility payment. As a reminder, an ALE is one who employed 50 or more full-time or full-time equivalent employees in the previous calendar year. Read more
Minimum Essential Coverage (Individual Mandate) Reporting Instructions
The IRS recently issued draft instructions for the Affordable Care Act forms required for employer shared-responsibility (ESR) and minimum essential coverage (MEC) reporting. It's expected that issuers of health insurance and certain employers will use Form 1094-B and Form 1095-B for MEC reporting, while large employers will use Form 1094-C and Form 1095-C for ESR reporting and, in some cases, MEC reporting. Form 1095-A will be used for Marketplace reporting. Read more
What is a Health Plan Identifier?
A Health Plan Identifier is a unique10-digit code which can also be referred to as a “Health Plan Oversight System ID” or “HPID.” The main intent of the HPID is to create standardization for electronic transactions mandated by HIPAA and create uniformity in how health plans are identified in those transactions. Read more
The Affordable Care Act requires contributions to be paid by both fully-insured and self-funded health plans which will fund the Transitional Reinsurance Program which is in place from 2014 to 2016. The program then pays insurers in the individual market that cover high risk individuals. Read more
Upcoming Employer Reporting Requirements
The new reporting will be used by the IRS to determine whether an individual is eligible for a premium subsidy or subject to the individual tax penalty for not having medical coverage. In addition, the IRS will utilize the reporting information to determine whether an applicable large employer (ALE) is subject to a shared responsibility payment. Read more
On July 24, 2014, the IRS released Revenue Procedure 2014-37 to index the Affordable Care Act's (ACA) affordability percentages for 2015 under the employer mandate. The IRS also adjusted upward the income level under which employees are exempt from the ACA's individual mandate. Read more
Special One Time Rule for COBRA Individuals
COBRA continuation coverage is available to eligible individuals (qualified beneficiaries) who lose group health plan coverage due to certain qualifying events (such as job loss, divorce, employee death, and loss of dependent child status). COBRA coverage is typically expensive and lasts for a limited period of time. On the other hand, qualified health plans available in the Marketplace are generally less expensive due to subsidies and continue for as long as an individual wishes to pay for coverage. Read more
Newly released 2015 High Deductible Health Plan and Savings Account limits.
The government recently released final regulations regarding the reporting requirements
The government recently released final regulations regarding the reporting requirements that begin January 1, 2015 for all employers with 50 or more full-time employees, including full-time equivalents. Read more
Regulations implementing a 90-day limit on waiting periods for health coverage
On February 20, the Departments of Labor, Treasury, and Health and Human Services announced the release of both final and proposed regulations implementing a 90-day limit on waiting periods for health coverage. Read more
2015 Employer Shared Responsibility Requirements
On Monday, February 10, 2014, the IRS released final regulations regarding the employer shared responsibility requirements. Within the 277 pages of regulations, they announced transitional relief for some employers in 2015 as well as important clarification on a number of outstanding issues. Read more