Compliance Corner 11/21/14 Edition

Capital Building          compliance corner

In this Issue:

U.S. Supreme Court to Hear Case Challenging Premium Tax Credits Provided Through Federally Facilitated Exchanges

DOL FAQs Emphasize Prohibition on Premium Reimbursement Arrangement

IRS Clarifies Deductibility of Reinsurance Program Contributions for Insurers and Self-insured Plan Sponsers

IRS Clarifies Premium Tax Credit Eligibility for Pregnant Women

DOL Releases Interim Final Rule on Additional Reporting Requirements of Multiple-Employer Plans

DOL Issues Guidance on State Regulation of Stop-loss Insurance

Deadline Extended for 2014 Enrollment Counts for Transitional Reinsurance Program


Compliance Corner 11/4/14 Edition

Capital Building   In this Issue:

IRS: Plans Without Coverage for Hospital or Physician Services Do Not Meet Employer Mandate's Minimum Value Requirement

HPID Requirement Delayed Indefinitely

Online Enrollment in SHOP Marketplace Begins Nov. 15

CMS Provides Additional Reinsurance Contributions Guidance, Deadline Extended to Nov. 17

IRS Issues 2015 Pension Plan Limitations and Cost of Living Adjustments

 IRS Issues Guidance That Encourages Use of Annuities in 401(k) Plans

Compliance Corner 10/23/14 Edition

Capital Building In this issue:

Federal Agencies Issue Guidance Related to Reference-based Pricing

IRS Issues Information Letter Explaining Vanpooling as Tax-free Benefit

IRS Releases 401(k) Plan Checklist

November Compliance Requirements for Self-insured Plans



Health Care Reform

Federal Agencies Issue Guidance Related to Reference-based Pricing

CMS Issues FAQs Relating to Medicare and the Marketplace

On Aug. 1, 2014, CMS published a document containing several FAQs relating to the interaction of Medicare and marketplace coverage. The FAQs do not contain additional requirements for employers, but may be of general interest, particularly for employers with Medicare‑eligible employees and employers that are purchasing coverage through SHOPs.

IRS Regulations Address Health Insurance Premium Tax Credits, Cap Fines for Individuals

On July 24, 2014, the IRS released three separate revenue procedures, proposed regulations, and final and temporary regulations addressing a number of factors affecting premium tax credits available to individuals through the health insurance marketplace.

Within the guidance, the IRS finalized rules regarding the health insurance premium tax credit, effective July 28, 2014, and published in the Federal Register the same day. The guidance also included temporary regulations regarding reconciling the premium tax credit with advance credit payments. The IRS simultaneously issued proposed rules regarding the health insurance premium tax credit, which propose to incorporate both the final and temporary regulations within the section of the tax code (Section 36(b)) pertaining to the individual mandate and eligibility for premium tax credits.

PRESS RELEASE: Forest Capital Management Begins Operations


New SEC Registered Investment Advisor (RIA) to provide unique approach to retirement plans, participants, and individual wealth management clients.

Chicago, IL ‐‐ Forest Capital Management, LLC, (FCM) a newly formed SEC registered investment advisor (RIA), is pleased to announce the launch of its operations. The new firm will advise on retirement plan assets such as 401(k)’s, 403(b)’s, and pensions, as well as provide wealth management solutions for families and individuals.

Click here to review the full press release.

Reinsurance Contribution FAQ

Reinsurance Contribution FAQ Describes Process for Submitting Payment

On May 22, 2014, CMS released an FAQ providing details about the submission process for the collection of reinsurance contributions. The FAQ states that HHS will implement a streamlined process for the collection of reinsurance contributions.

As a reminder, contributing entities responsible for making reinsurance contributions include insurers, employers that sponsor self-insured plans and third-party administrators that pay contributions on behalf of self-insured plans. Self-insured plans that self-administer claims processing or adjudication are exempt from the reinsurance rate for 2015 and 2016. Such entities are required to provide basic company and contact information via a form available at no later than Nov. 15.

FAQs – Employer Mandate, Seasonal Coverage and More

New FAQs Clarify Employer Mandate, Seasonal Worker Coverage and Reimbursing Employees for Individual Policy Premiums

On May 13, 2014, the IRS posted new frequently asked questions (FAQs) addressing various areas affecting employer-sponsored health plans, including the employer mandate, seasonal worker coverage, minimum value and small business tax credits.

CMS Issues FAQs on Small Group Health Plan Market Reform

CMS Issues FAQs on Small Group Health Plan Market Reform Implementation

On May 16, 2014, CMS issued FAQs on market reform implementation in the individual and small group health plan market. The FAQs include guidance on:

  • Essential health benefits (EHB)
  • Actuarial value (AV)
  • Guaranteed availability
  • Minimum essential coverage (MEC)
  • Transitional policy extensions for non-PPACA-compliant health plans

Although the FAQ guidance applies to insurers, it is also relevant for employers with small group plans.

IRS issues Individual Mandate Fact Sheet

June 3, 2014

IRS Issues Individual Mandate Fact Sheet

On May 27, 2014, the IRS posted to its website Publication 5156, entitled “Facts About the Individual Shared Responsibility Provision.” The individual shared responsibility provision, also known as the individual mandate, went into effect Jan. 1, 2014. The fact sheet explains that, unless they qualify for an exemption, U.S. residents must have qualifying health coverage, called “minimum essential coverage,” in 2014. Those individuals who do not comply are subject to a shared responsibility payment when filing their federal income tax return. The fact sheet provides examples of minimum essential coverage and exemptions.