The IRS has released the draft 2018 forms for the Affordable Care Act (ACA) reporting under the 6055 and 6056 Internal Revenue Code. Highlights 1094-C and 1095-C were released on July 11, 2018 will be used by Applicable Large Employers (ALEs) to report under Section 6056. For self-insured plan sponsors they will continue to use combined reporting under Sections 6055 and 6056 1094-B was released on July 3, 2018 and will be used by entities (carriers) under Section 6055. The 2

Starting January 1, 2019 affordability percentages will increase according to the Internal Revenue Service's Revenue Procedure notice. Employer-sponsored group coverages will be required to meet the new percentages in order to be considered affordable as follows: Employer Shared Responsibility – 9.86% Premium Tax Credit Eligibility – 9.86% No longer in effect after 2018 was the third, the Individual Mandate Exemption at 8.3% as a result of Tax Cuts and Jobs Act. *see previo

Under the Affordable Care Act (ACA), there is a provision that limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. That provision is called the Medical Loss Ratio (MLR). MLR requires that insurers of fully-insured small group* and individual plans spend at least 80% of the premium received on health care claims and quality improvement with the remaining profit of 20% allowed to be spent on administration, marketing and p

Moving in a positive direction and receiving a good amount of bipartisan support in congress, the Personal Health Investments Today Act (PHIT), passed yesterday by the US House of Representatives 277-142. This comes shy of two weeks having passed by the House Ways and Means Committee. The Act now moves on to the Senate and if passed would pave the way to allow up to $1,000 per year per individual and up to $2,000 per year per family to cover #exercise related expenses, pre-t

Governor Synder signed legislation to repeal the Michigan Health Insurance Claims Tax (HICA), Senate Bills 992-994 with immediate effect as Public Act 173 of 2018, on June 11, 2018. The HICA was originally passed in 2011 and accessed a one percent tax on all health care claims paid in the State. The law was amended in 2014 to reduce the HICA rate on paid claims from 1% to 0.75% for service beginning July 1, 2014 through December 31, 2016. Another amendment changed the HICA

The Department of Labor (DOL) released a final rule on June 19, 2018 to allow new options for associations to sponsor health plan for their members and broadens the criteria for both businesses and self-employed individuals. The new rule allows them to band together SOLELY to establish health insurance coverage as well as expand access across state lines under the revised commonality-of-interest test. Commonality-of-Interest Test: In the same trade, industry or profession th

The passage of the Tax Cuts and Jobs Act of 2017, on December 22, 2017, included a “repeal” of the individual mandate, that laid wake to concerns related to the stability of the individual market. (Actually, the mandate was not repealed, but rather the penalty was set to $0 for 2019 and future years. For purposes of this Associated Release we will refer to the act as a repeal) As a result of the repeal there is uncertainty as to the material impact on enrollments and premium