As has become the norm, the last month has been a flurry of activity and ACA developments. Below is a summary of relevant guidance and updates from Jason Cogdill at ProBenefits.
Developments & New Guidance
10/23/13: Administration announced extension of deadline from Feb. 15 to March 31 for individuals to enroll in Marketplace coverage to avoid individual mandate penalty (CMS issued formal guidance 10/28)
10/24/13: HHS released final regulations on program integrity related to exchanges, SHOP, premium stabilization programs, & market standards.
10/31/13: IRS announced new $500 rollover option for Health Flexible Spending Accounts
11/4/13: CCIIO & CMS issued Q&A discouraging third party payments of Marketplace coverage by hospitals, healthcare providers, & commercial entities
11/8/13: HHS released final rules on mental health parity and substance abuse disorder parity
11/13/13: White House announced “administrative fix” to allow individuals and small groups to maintain current health plans if approved by the state and offered by the carrier. CMS sent this letter to all state insurance commissioners encouraging participation.
11/23 /13: White House announced delay in deadline to enroll in Marketplace coverage for 1/1/14 effective date (now December 23 – see below for more details)
11/26/13: U.S. Supreme Court accepts review of two cases challenging the ACA’s preventive services mandate as it relates to contraceptive coverage
11/27/13: HHS announces changes to SHOP enrollment provisions & deadlines (here is new HHS post from this afternoon)
11/29/13: IRS releasing final rules on the additional Medicare tax and Health Insurance Providers Fee
Still not issued: The final guidance on the employer mandate has not yet been released. I am still anticipating release around the end of December or in early January. That is the most significant item to come for employers. Similarly, final guidance on the Section 105(h) nondiscrimination rule for fully insured plans has not been released. I anticipate that in early 2014, with effective date at first renewal 1/1/15 or later. If the guidance is not released by the Spring, the effective date could be pushed back even farther.
As we reach the Administration's unofficial deadline of 11/30 for full functionality of HealthCare.gov, access has improved but issues remain. The White House and HHS announced a delay in the deadline for individuals to enroll in coverage effective 1/1/14. That deadline is now 12/23, postponed from 12/15. Also announced was that open enrollment for 2015 coverage will begin on November 15 instead of October 15.
Here is a very informative presentation from the Center on Budget and Policy Priorities regarding Marketplace enrollment, subsidy eligibility, & the individual mandate. That may be of value to you and your staff as you dig deeper into 2014 issues.
Here is a very detailed breakdown of subsidy eligibility for various individuals and circumstances.
Among other current hot topics are:
(1) Small group strategies (including “strategic unaffordability” approach for small group plans, such that contribution levels are designed to keep employees who decline group coverage eligible for Marketplace subsidies);
(2) Reimbursement by employers for individual premiums or Marketplace premiums for coverage held by employees;
(3) Minimum essential coverage (“skinny plans”) for 2015 and employer mandate compliance; and
(4) Optional special qualifying event for 1/1/14 for non-calendar Section 125 plans.
These items will be the subject of upcoming discussion, webinar sessions, and otherwise. If you need more information on any topic included above or otherwise, let me know.
The contents of this blog are provided for general benefits and business use. The contents, including any attachments, are not intended as legal advice and do not create or represent an attorney-client relationship between ProBenefits, Inc. or Jason M. Cogdill, Attorney at Law.