H&W: Recent ACA Guidance Recap

Several government agencies have recently issued clarifying regulations/FAQs and proposed rules. See below for a summary of this information.

Small Business Health Care Tax Credit: The IRS issued proposed regulations which incorporate previous IRS Notices (2010-44 and 2010-82) and provide guidance on the changes to the tax credit beginning in 2014. These include increasing the possible credit to 50% of premium, requiring enrollment in a SHOP health plan, and limiting the credit to two consecutive taxable years. See the IRS web page for more information.

Employer Appeal Provisions: Included with the final regulation to address implementation of the Exchanges were provisions that will allow employers to contest a denial of eligibility to purchase coverage through a SHOP or a determination that the employer does (or does not) offer minimum essential coverage that meets both minimum value and affordability standards.  See the CMS Fact Sheet for more information.

90-Day Waiting Period Limitation: A DOL FAQ clarified that employers may have eligibility requirements specified in the plan’s terms that must be met before the 90-day waiting period begins, as long as they are not designed to avoid compliance with the 90-day waiting period limitation. It also stated that plans can rely on current guidance at least through 2014. To the extent final regulations are more restrictive on plans or issuers than the proposed regulations, they will not be effective prior to January 1, 2015 and plans and issuers will have sufficient time to comply. See the Reference Material for more information.

Reporting Requirements: The IRS released proposed regulations on health care reform’s “reporting of minimum essential coverage” and “reporting by applicable large employers” that requires employers to provide health insurance coverage information to the government. After the final rules are published, employers will be encouraged to voluntarily report information in 2014 (although it will be optional) and required reporting will begin in 2015.

HSAs and Preventive Health Services: Among the requirements for an individual to qualify to make (or for the individual’s employer to make on their behalf) tax-favored contributions to a HSA is that the individual be covered under a High Deductible Health Plan (HDHP) and have no disqualifying health coverage. IRS Notice 2013-57 clarifies that a health plan will not fail to qualify as a high deductible health plan (HDHP) merely because it provides, without a deductible, the preventive health services required under the ACA.

Remember that final guidance is added to your Compliancedashboard where appropriate.