Compliance Stuff

In a win for plan sponsors, the recently enacted  Employer Reporting Improvement Act  and the  Paperwork Burden Reduction Act  (the Acts), among other things, introduce several significant changes to the reporting and enforcement rules of the Affordable Care Act (ACA).  The Current Rules Forms 1095-B and 1095-C:   U nder the ACA, plan sponsors, specifically Applicable Large Employers (ALEs), must report information about the health coverage they offer to their employees.  This ACA reporting is done through Forms 1095-B and 1095-C, which must be filed with the IRS and provided to all full-time employees and employees receiving employer-sponsored coverage. (This is the case, even though the ACA’s individual mandate is currently set to $0, and therefore functionally isn’t being enforced.) Key aspects of ACA enforcement also include: A Tight Turnaround to Respond to Proposed Assessments : The IRS may assess employer shared responsibility payments (ES...

  As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health plans generally have their compliance obligations satisfied by the insurer, self-insured health plans usually rely on the employer or the plan's third-party administrator (TPA) to meet the compliance requirements. Below is a brief summary of items that employers should be aware of for their health plans and, as appropriate, we have delineated when such compliance is limited only to self-insured health plans. Capitol Bridge Health Plan: Effective 03/01 - 02/28 TDB Communication, Inc. Health Plan: Effective 07/01 - 06/30 Capitol Bridge Health Services Health Plan: Effective 07/01 - 06/30 Capitol Bridge Puerto Rico: Effective (TO BE DETERMINED) 1. HIPAA Privacy Extends Special Protections to Reproductive Health Care: Employer Action Required by 12/23/24 Earlier...