Here’s another great update from our friend Jason M. Cogdill, Corporate Counsel & Benefits Attorney at ProBenefits, Inc.
The biggest ACA news of 2014 is not what has happened but what has not happened. Most significantly, the final guidance on the employer mandate has not yet been released (update below). Also, there was speculation about a big announcement before or after last Tuesday’s State of the Union address by President Obama, but none occurred. The State of the Union contained no surprises regarding the ACA. If you did not see or read the President’s comments on topic, you can read them here.
I anticipate that February and March will be important months in terms of guidance and developments, including the final stretch before the end of the Marketplace open enrollment period on March 31. It was recently reported that there are 56 active items of ACA guidance currently in the works between the IRS, DOL, and HHS. 43 of the 56 items are expected to be released during 2014, and several of them – starting with the employer mandate guidance – are needed soon. In addition, Congressional negotiations on the debt ceiling and the federal budget could have ACA implications.
Our continuing challenge is education. Most Americans (62% according to a recent Kaiser Health News poll) do not realize that most significant ACA provisions have taken effect. 2013 was in many ways a year of survival. 2014 will be a year of strategy. We will find a way to address the employer mandate and other considerations.
Recent Developments & Guidance Items
A summary timeline of developments over the last six weeks is below.
- 12/16/13: IRS released Notice 2014-01 regarding Section 125, FSA, & HSA elections and reimbursements for same-sex spouses following US v. Windsor.
- 12/18/13: CMS issued Q&As on SHOP enrollment & minimum participation requirements.
- 12/19/13: CMS issued letter to consumers with cancelled policies & expanded the individual mandate hardship exemption to allow purchase of catastrophic coverage by those whose coverage was cancelled.
- 12/20/13: HHS, DOL, & IRS issued proposed regulations regarding excepted benefits under HIPAA & ACA application to such benefits.
- 12/24/13: IRS issued corrections to final regulations on individual mandate penalties for individuals not maintaining minimum essential coverage in 2014.
- 12/30/13: HHS announced required reinsurance fee for 2015. The new amount will be $3.67 per covered member per month ($44 per year), down from the 2014 amount of $5.25 per month ($63 per year). The reinsurance fee is scheduled to decrease again in 2016 and then expire. HHS also announced a new exemption for self-insured, self-administered plans that will impact certain collectively bargained health plans.
- 1/9/14: IRS released FAQ on OOP limits, expatriate plans, & fixed indemnity policies.
- 1/10/14: In a preview of upcoming employer mandate issues, Treasury posted a letter confirming that hours of certain voluntary firefighters and emergency personnel will not count in determining full-time employee or full-time equivalent status.
- 1/13/14: Marketplace enrollment report released for October 1 through December 31 (summary).
- 1/15/14: U.S. District Court for the DC District upheld the government’s position in Halbig v. Sebelius, a challenge to the award of ACA premium subsidies for coverage not purchased through state exchanges.
- 1/17/14: HHS released additional materials for agents utilizing Marketplace.
- 1/27/14: IRS issued proposed regulations on individual mandate addressing treatment of HRA coverage & wellness incentives.
We will continue to share Jason’s updates in an effort to keep you on the front-edge of the Affordable Care Act rollout in the coming weeks and months. If you haven’t already done so, subscribe to our blog at the top of this screen. And, if you’re thinking about outsourcing cobra administration to free up HR team to focus on health reform, download this outsourcing guide.