Category: Legislative Updates

The federal agencies have issued FAQ guidance addressing provisions of the Consolidated Appropriations Act, 2021 that prohibit “gag clauses” under group health plan (GHP) agreements. The FAQs provide guidance on the prohibition, including directions for submitting an annually required compliance attestation. The first attestation is due by December 31, 2023. This Update details the guidance from the FAQs and references links to the website to be used for submitting these attestations. Most required attestations will be submitted by a GHP’s insured carrier or a self-insured GHP’s third-party administrator (TPA).

Gag Clause Prohibition
The prohibition applies to agreements between GHPs or insurers and providers, TPAs, or other service providers. A gag clause is a “contractual term that directly or indirectly restricts specific data and information that a plan or issuer can make available to another party.” Gag clauses might be found in agreements between a plan or issuer and (1) a health care provider, (2) a network or association of providers, (3) a TPA, or (4) another service provider offering access to a network of providers. Specifically, this includes:

• Restrictions on the disclosure of provider-specific cost or quality of care information or data to referring providers, the plan sponsor, participants, beneficiaries, or enrollees, or individuals eligible to become participants, beneficiaries, or enrollees of the plan or coverage;

• Restrictions on electronic access to de-identified claims and encounter information or data for each participant, beneficiary, or enrollee upon request (consistent with applicable privacy protections); and

• Restrictions on sharing these types of information or data or directing that such information or data be shared, with a business associate.

For example, if a contract between a TPA and a GHP states that the plan will pay providers at rates designated as “Point of Service Rates,” but the TPA considers those rates to be proprietary and therefore includes language in the contract stating that the plan may not disclose the rates to participants, that language prohibiting disclosure would be considered a prohibited gag clause. As another example, if a contract between a TPA and a GHP provides that the plan sponsor’s access to provider-specific cost and quality of care information is only at the discretion of the TPA, that contractual provision would be considered a prohibited gag clause. GHPs and issuers must ensure that their agreements with health care providers, networks or associations of providers, or other service providers offering access to a network of providers do not contain these or other provisions that violate the prohibition on gag clauses.

Compliance Attestation
GHPs and insurers must annually submit a Gag Clause Prohibition Compliance Attestation (GCPCA) that their plan is in compliance with the gag clause prohibition. The agencies have issued detailed instructions, a user manual, and a reporting template on the GCPCA webpage and are linked in an EBSA bulletin. Attestations are submitted through CMS’s Health Insurance Oversight System (HIOS). The first GCPCA is due no later than December 31, 2023, covering the period from December 27, 2020 (or, if later, the effective date of the plan or insurance coverage) through the date of attestation. Subsequent attestations are due each December 31. This GCPCA requirement applies to health insurers offering group or individual coverage and to insured and self-insured GHPs, including ERISA plans, non-federal governmental plans, and church plans subject to the Code, regardless of whether the plans are grandfathered or grandmothered under the ACA. Attestation is not required for excepted benefits, and the agencies will not enforce the requirement against health reimbursement arrangements (HRAs) or other account-based plans.

Next Steps
GHP sponsors and insurers should review the instructions and technical guidance—and confirm that no prohibited provisions remain in their agreements. Conner Strong & Buckelew will work with the insurers and TPAs on behalf of our clients in preparation for the first GCPCA deadline. Insurers will attest on behalf of a fully insured plan and a self-insured plan may satisfy the requirement to provide a GCPCA by entering into a written agreement under which the plan’s service provider(s) (such as a TPA, including an issuer acting as a TPA) will attest on the plan’s behalf, however the legal requirement technically remains with the GHP.  An insurer that provides administrative services to self-insured plans may submit a single attestation covering the insurer, its fully insured plans, and its self-insured plan clients. The FAQs recommend that the insurer coordinate with each plan to avoid duplication.

Conner Strong & Buckelew will provide alerts and updates as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

The Biden Administration has announced its plan to end the COVID-19 public health emergency (PHE) and National Emergency (NE) on May 11, 2023. The COVID-19 Outbreak Period (OP) ends 60 days after the NE ends, so under this timeline, the OP will end on July 10, 2023. We are aware that there are key questions to be addressed in light of this latest decision. We have provided herein an overview of the items to be aware of when the emergencies end, including health plan coverage rules related to the COVID-19 pandemic. This is as follows:

Public Health Emergency (PHE)

• COVID-19 Diagnostic Testing Without Cost Sharing — During the PHE, health plans must cover COVID-19 tests and related services without imposing any cost sharing (such as deductibles, copayments, or coinsurance) or prior authorization or other medical management requirements, and on January 15, 2022, this coverage requirement extended to at-home COVID-19 diagnostic tests. Health plans will no longer be required to provide this first-dollar coverage when the PHE ends.

• COVID-19 Vaccines — Non-grandfathered group health plans must cover coronavirus preventive services, including recommended COVID-19 immunizations, without cost sharing requirements. During the PHE, covered services may be provided by in-network or out-of-network providers. Once the PHE ends, health plans must continue to cover recommended COVID-19 immunizations without cost sharing but can limit this coverage to in-network providers.

• Standalone Telehealth Benefits — For plan years beginning during the PHE, a large employer (more than 50 employees) may offer standalone telehealth benefits and other remote care services to individuals who are not eligible for coverage under any other group health plan offered by the employer without violating the Affordable Care Act’s market reforms. These types of standalone arrangements will not be permitted after the PHE ends.

• Pre-Deductible Telehealth Coverage Relief Not Linked to Emergencies — The pre-deductible telehealth coverage relief is not linked to the PHE or OP. This relief allows high deductible health plans (HDHPs) compatible with health savings accounts (HSAs) to provide benefits for telehealth or other remote care services before plan deductibles are met without jeopardizing HSA eligibility. Note that since this relief is not linked to the PHE or OP, HDHPs may be designed to waive the deductible for any telehealth services for plan years beginning in 2023 and 2024 without causing participants to lose HSA eligibility.

National Emergency (NE)

• Outbreak Period Deadline Extensions — When the COVID-19 OP ends, health plans can go back to their nonextended deadlines for purposes of HIPAA special enrollment, COBRA, and claims and appeals procedures. The following deadline extensions end when the OP is over or, if earlier, after an individual has been eligible for a specific deadline extension for one year.

• • Claims and Appeals Deadlines—The deadlines to file a benefit claim, file an appeal of an adverse benefit determination or request an external review of a claim under the plan’s claims and appeals procedures.

• • COBRA Notice and Premium Payment Deadlines—The 60-day period to elect COBRA; the date for making COBRA premium payments (generally at least 45 days after the day of the initial COBRA election, with a grace period of at least 30 days for subsequent premium payments); and the date for individuals to notify the plan of a qualifying event or disability determination (generally 60 days from the date of the event, loss of coverage or disability determination).

• • • Example 1: COBRA qualified beneficiary (QB) enrolls in COBRA and makes several payments but fails to make the COBRA payment for November 2022 coverage by the normal grace period of 11/30/22. The payment deadline is tolled as of 11/30/22. The one-year tolling period would end 11/30/23 (if the NE continued), and the payment deadline would be 11/30/23. But if the NE ends on 5/11/23, the OP will end on 7/10/23 and the 30-day payment period would start 7/10/23 and end 8/9/23.

• • • Example 2: COBRA QB offered COBRA and election period started 11/1/22. The election deadline is tolled as of 11/1/22. The one-year tolling period would end 10/31/23 (if the NE continued), so the 60-day election period would start 11/1/23 and end 12/30/23. But if the NE ends on 5/11/23, the OP will end on 7/10/23 and the 60-day election period would start 7/10/23 and end 9/8/23.

• • • Example 3: COBRA QB offered COBRA and election period started 7/10/23. The election deadline is not tolled. The 60-day election period would start 7/10/23 and end 9/8/23.

• • HIPAA Special Enrollment — The 30-day period (or 60-day period, if applicable) to request special enrollment. HIPAA special enrollment events are a subset of the Section 125 permitted election change events that provide special rights. A member qualifies for HIPAA special enrollment under a health plan for certain limited events like loss of eligibility for coverage and acquisition of a new spouse or dependent by marriage, birth, adoption, or placement for adoption.

• • • Example 4: Employee has baby on 11/1/22. The election deadline is tolled as of 11/1/22. The normal 30-day timeline to notify the employer is by 12/1/22. The one-year tolling period would end 10/31/23 (if the NE continued), so the normal 30-day election period (for coverage retroactive to the date of birth) would start 11/1/23. But if the NE ends on 5/11/23, the OP will end on 7/10/23 and the 30-day election period would start 7/10/23 and end 8/9/23.

• • • Example 5: Employee has baby on 7/10/23. The election deadline is not tolled. The normal 30-day timeline to notify the employer would start 7/10/23 and end 8/9/23.

We do expect that the agencies will issue more guidance prior to May 11^th on the ending of the PHE and NE emergencies, and we certainly expect that the various carriers and TPAs will also be providing information on their next steps in response. COBRA vendors and carriers/TPAs will need to adopt the necessary measures to comply with and administer the new changes and plan sponsors will need to consider how and when to communicate the new health plan coverage rules and revised deadlines for elections, payments, and losses of coverage.

Conner Strong & Buckelew will provide updates and additional guidance as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

The U.S. Department of Health & Human Services (HHS), Labor and Treasury have proposed a rule to strengthen access to birth control coverage under the Affordable Care Act (ACA).  For more information on the proposed rule, consult this HHS fact sheet. Under the ACA, most group health plans (GHPs) are required to offer coverage of birth control with no out-of-pocket cost. For those few plans that do not offer such coverage due to a religious objection, the proposed rule seeks to ensure broader access by allowing enrollees to make their own choices to access contraceptive services at no cost. The rule is subject to a comment period and it will be months before the proposed rule might ultimately be finalized. Potentially impacted GHP sponsors should stay tuned for updates from Conner Strong & Buckelew, but otherwise operate as usual.

Biden Administration’s Continued Efforts to Protect Reproductive Health Care
The issuance of the proposed rule is the latest effort by the Biden Administration to bolster access to birth control at no cost. The U.S. Supreme Court’s decision in Dobbs has placed a heightened importance on access to contraceptive services nationwide. HHS released a report in August on actions taken to ensure access to reproductive health care, including contraception, following the Supreme Court’s ruling, with further details on future actions and commitments. In addition, HHS also recently released a report which outlines the actions HHS has taken in the face of the health crisis precipitated by the Dobbs decision.

Next Steps if Rule is Finalized
If this proposed rule is finalized, individuals in GHPs that would otherwise be subject to the ACA preventive services requirements but do not cover contraceptive services because of a moral or religious objection, would now have access. The proposed rule would leave in place the existing religious exemption for entities with objections, as well as the optional accommodation for contraception, but it would create an independent pathway for individuals enrolled in plans arranged or offered by objecting entities to make their own choice to access contraceptive services directly through a willing contraceptive provider without any costs. This would allow women and covered dependents to navigate their own care and obtain birth control if their plan or insurer has a religious objection. The individual contraceptive arrangement would not require any involvement on the part of an objecting entity.

We will provide alerts and updates as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

Group health plan (GHP) sponsors that offer prescription drug (Rx) coverage must, at least annually, notify Medicare Part D eligible individuals and the Centers for Medicare & Medicaid Services (CMS) of their plan’s creditable coverage status. Both disclosures (to Medicare Part D eligible individuals and to CMS) must meet specific form, content and timing requirements as prescribed by CMS. This update addresses the required disclosure to CMS and reminds plan sponsors that online disclosure should be completed annually no later than 60 days from the beginning of the plan year. This means that an employer with a calendar year plan that began January 1, 2023, must complete the CMS online reporting no later than March 1, 2023, and an employer with a plan year that begins July 1, 2023 must complete the reporting no later than August 29, 2023. (For more information on the Medicare Part D disclosure requirement for individuals, please see our update Medicare Part D Notices Due Before October 15th).

Medicare Part D Notice to CMS Rules
Medicare Part D rules generally require that GHPs with an Rx benefit must disclose to CMS whether the Rx coverage offered is “creditable” or “non-creditable.” “Creditable” Rx coverage generally means the actuarial value of Rx coverage under the GHP is equal to (pays out as much) or better than the Rx benefits offered under Medicare Part D. “Non-creditable” Rx coverage is coverage that is actuarially less in value (expected to pay out less) than the coverage offered under Medicare Part D. This disclosure is required whether the entity’s coverage is primary or secondary to Medicare. An Rx plan must use the online CMS Disclosure Form to report its “creditable” or “non-creditable” Rx status at the times noted below. Guidance and instructions are provided to assist Rx plan sponsors with completing the form.

Disclosure Timing
The CMS disclosure must be made annually and whenever any change occurs that affects whether the Rx plan’s coverage is creditable. CMS should receive a creditable coverage disclosure:

• Within 60 days of the beginning of the plan year for which the disclosure is being reported.
• Within 30 days of a change in creditable coverage status.
• Within 30 days of the Rx plan’s termination.

A GHP is not required to submit the online disclosure form to CMS for any plan year where the plan does not offer Rx benefits to any Medicare Part D eligible individuals as of the beginning of the plan year. Also, plan sponsors approved for the retiree drug subsidy are exempt from filing the CMS disclosure notice with respect to those qualified covered retirees for whom the sponsor is claiming the subsidy. Note that this creditable coverage reporting is in addition to the mandatory CMS Medicare Secondary Payer (MSP) reporting typically handled by an insurer or third-party administrator for a GHP (see the CMS site on Mandatory MSP Reporting for more information).

Should you have questions about this or any aspect of GHP requirements, please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

Congress recently passed and President Biden signed into law a $1.7 trillion governmental funding package (the 2023 CAA) that includes a provision to again temporarily allow plan sponsors that offer high deductible health plans (“HDHPs”) to provide first-dollar telehealth and other remote care services (waive the deductible) for plan years beginning after 12/31/22 and before 1/1/25, without causing participants to lose health savings account (“HSA”) eligibility. This Update is of interest to plan sponsors with HDHPs who may want to take advantage of this optional relief. The details are herein.

Telehealth HSA/HDHP – General Rule
For an individual to be eligible to make or receive contributions to an HSA, the individual must be covered by an HSA-qualified HDHP. Typically, this type of HDHP cannot pay for covered services, except for specified preventive care, until the participant meets the plan’s deductible. Coverage provided under the HDHP before the minimum deductible is satisfied would make plan participants ineligible to make or receive HSA contributions, and failure to follow the rules could result in a portion of an employees’ HSA contributions being subject to income taxes and penalties. Therefore, under the general rules, a telehealth program is not compatible with an HSA unless the HDHP charges a fair market value (FMV) fee each time a participant uses the telehealth service until the minimum deductible required for the qualifying HDHP is met.

Temporary Relief Granted
Temporary relief from this requirement was provided in 2021 through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and then extended through 12/31/22 in the 2022 Consolidated Appropriations Act (CAA). Now the 2023 CAA has further extended this temporary relief permitting employees with HSAs to participate in a calendar year telehealth plan with no cost-sharing and remain HSA eligible for the 2023 and 2024 calendar plan years. For non-calendar year plans, there will be a gap in the relief starting 1/1/23 as the new relief in CAA 2023 does not begin until the start of the 2023 plan year. Below is a history of the relief granted over the last few years:

• The 2020 CARES Act added an exception permitting sponsors of HDHPs to offer telehealth services at no cost to participants, regardless of the plan’s annual deductible, without impacting participant HSA eligibility, for the period from 1/1/20 through the last day of the plan year beginning in 2021 (e.g., 12/31/21 for calendar year plans; 6/30/22 for a plan year that began 7/1/21).

• The 2022 CAA extended the CARES Act provision starting 4/1/22 and through 12/31/22. For plan sponsors adopting this optional extension, this left as much as a three-month gap from 1/1/22-3/31/22 in which the standard deductible would still apply. So, for example:

• • Calendar year HDHPs had a three-month gap from 1/1/22-3/31/22, so these plans should have ended the deductible waiver for telehealth services as of 12/31/21 and could start the deductible waiver for telehealth services received on or after 4/1/22 and through 12/31/22.

• • Non-calendar year HDHPs whose 2021 plan year ended before 3/31/22 (e.g., 3/1/21-2/28/22 plan year) had a gap through 3/31/22, so these plans should have ended the deductible waiver for telehealth services occurring after the end of the 2021 plan year. They could again start the deductible waiver for telehealth services received on or after 4/1/22 and through 12/31/22.

• • Non-calendar year HDHPs whose 2021 plan year ended on or after 3/31/22 (e.g., 5/1/21-4/30/22 plan year) had no gap from 1/1/22-3/31/22 because the original CARES Act waiver of the deductible for telehealth services continued until no later than 12/31/22.

• The 2023 CAA has now further extended this temporary relief as follows:

• • Calendar year HDHPs have no gap because the 2022 CAA waiver of the deductible for telehealth services continued until 12/31/22, so employees with HSAs can participate in a calendar year telehealth plan with no cost-sharing and remain HSA eligible for the 2023 and 2024 calendar plan years.

• • Non-calendar year HDHPs will have a gap in the relief starting 1/1/23 as the 2022 CAA telehealth/HSA relief ended as of 12/31/22, but the 2023 CAA does not begin until the start of the 2023 plan year. So, from 1/1/23 until the start of the 2023 plan year, employees must either be excluded from the telehealth program or must pay a FMV fee each time they use the telehealth service until they have incurred medical expenses at least equal to the minimum required HDHP deductible. Then from the start of the 2023 non-calendar year plan, employees can once again participate in the telehealth program and/or the FMV fees may be discontinued for the 2023 and 2024 non-calendar year plan year.

Next Steps
The relief provisions are optional, so it is left to each plan sponsor with an HDHP to determine whether to adopt the deductible waiver for telehealth (fully insured carriers will make the determination and self-insured plan sponsors must coordinate with their TPA/stop-loss provider in order to implement the plan design changes as deemed appropriate). Note too that if the IRS fails to issue guidance closing the non-calendar year plan gap, employers may also want to consider charging FMV fees on their telehealth programs for the 2023 gap period.

Conner Strong & Buckelew will provide alerts and updates as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

On Friday, December 23rd various federal agencies issued a “last-minute” update related to the new federal requirements for group health plans’ Rx reporting. By way of reminder, the 2021 Consolidated Appropriations Act established new transparency requirements for reporting specific information about prescription drugs and health care spending to the federal government. This data submission is called the “RxDC” report. The Rx stands for prescription drug and the DC stands for data collection. The first RxDC report is due by December 27, 2022 and covers data for both the 2020 and 2021 “reference years.” Plans must then submit data for the 2022 reference year by June 1, 2023, and by June 1 annually thereafter. For plans that are fully insured, most of the reporting will be handled by insurers. For plans that are self-funded, more is required. See our Conner Strong & Buckelew legislative update for more details on this requirement.

For more than a year, Conner Strong & Buckelew has been working directly with health insurance carriers, TPAs, PBMs and others to monitor guidance and confirm vendor approaches to assist our clients in remaining compliant with these RxDC requirements. We anticipated additional guidance given the significant operational challenges plans and issuers have encountered in complying with these reporting requirements. So in the spirit of giving, on December 23rd, the agencies issued much-anticipated FAQ enforcement action guidance and information on clarifications and flexibilities related to the RxDC reporting rules:

“For the 2020 and 2021 data submissions that are due by December 27, 2022, the Departments will not take enforcement action with respect to any plan or issuer that uses a good faith, reasonable interpretation of the regulations and the Prescription Drug Data Collection (RxDC) Reporting Instructions in making its submission. The Departments are also providing a submission grace period through January 31, 2023, and will not consider a plan or issuer to be out of compliance with these requirements provided that a good faith submission of 2020 and 2021 data is made on or before that date. In addition, to facilitate the submission process, the Departments are providing … clarifications and flexibilities with respect to reporting requirements (including operational requirements within the Health Insurance Oversight System (HIOS) reporting system) for the 2020 and 2021 data”.

The updated guidance is welcome news and makes clear that employers and plan sponsors making a good faith effort to comply will not be subject to penalty in the event there are issues in the early stages of the new requirements. The extension for initial submissions to January 31, 2023 is also welcome news. Regardless of the latest guidance, employers and plan sponsors are advised to continue to fully comply with the new requirements. We anticipate additional guidance and updates to the reporting instructions in advance of the next reporting due date in June 2023.

We will provide alerts and updates as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

Pursuant to the Affordable Care Act (“ACA”), applicable large employers (ALEs) — those with 50 or more full-time or equivalent employees — must adhere to the ACA’s annual reporting rules to remain compliant regarding group health plan offerings. Also, an employer that sponsors self-insured health insurance coverage, no matter their size and whether or not the employer is an ALE, has information reporting responsibilities as a provider of minimum essential coverage (MEC). Employers report their health plan information to the IRS retroactively, so companies will file their ACA forms regarding their 2022 health plans in spring 2023.

Since these rules are complex and reporting is upon us, this update provides details on these ACA reporting requirements.

ACA Health Coverage Information Reporting
Under the ACA employer shared responsibility (ESR) provisions, applicable large employers or ALEs must either offer MEC that is “affordable” and that provides “minimum value” to their full-time employees (and their dependents), or potentially owe an ESR penalty payment to the IRS. The ESR provisions are sometimes referred to as “the employer mandate” or “the pay or play provisions.” The same employers that are subject to the ESR provisions (that is, ALEs) also have information reporting responsibilities regarding MEC offered to employees. These responsibilities require employers to send reports to employees and to the IRS. An employer that sponsors self-insured health insurance coverage – whether or not the employer is an ALE – has information reporting responsibilities as a provider of MEC.

ACA Information Reporting Forms
The IRS released the final 2022 forms needed for this ACA reporting. No major substantive changes were made to the forms for 2022 reporting, however additional information regarding these forms may become available once the IRS finalizes the instructions for the forms.

• Form 1095-B; Form 1094-B; Draft B Form Instructions
• Form 1095-C; Form 1094-C; Draft C Form Instructions

Reporting to Employees and Other Covered Individuals
Here’s a quick summary of the employee and individual Form 1095-B/C information reporting requirements:

• Insurance carriers must send Form 1095-B to individuals covered under a fully insured plan.
• ALEs must send Form 1095-C to full-time employees showing information on the employee coverage offer, and must also send Form 1095-C (with Part III completed) to individuals covered under a self-insured plan (individuals will not receive Form 1095-B).
• Non-ALEs must send Form 1095-B to individuals covered under a self-insured plan (individuals will not receive Form 1095-C).

Insurers, self-insuring employers, other coverage providers, and ALEs have until March 2, 2023, to provide Forms 1095-B/C to employees and individuals. This reflects a 30-day extension for providing Forms 1095-B/C to individuals which is automatic for 2023 (employers and providers don’t have to request the extension). The IRS will not grant an additional 30-day extension beyond this deadline.

Filing Forms with IRS
Employers/coverage providers must also send the IRS copies of the Forms 1095-B/C information using Forms 1094-B/C. The due dates for filing Forms 1094-B and 1094-C with the IRS are not extended. Employers filing by paper must submit their Forms to the IRS by February 28, 2023. Those filing electronically have until March 31, 2023. Extensions of these filing deadlines are available by filing Form 8809. Employers and coverage providers who are filing more than 250 of these reporting forms are required to file electronically.

Note on State Employer Reporting Requirements
Note that insurers and employers in certain states (e.g., California, Massachusetts, New Jersey, Rhode Island, Vermont, and the District of Columbia) that have enacted individual mandates may have reporting requirements similar to the ACA federal requirements. See, for example, the New Jersey website for more information on that state’s employer reporting requirement. In some cases, the federal ACA forms can be used to satisfy these state requirements. We recommend that clients touch base with their ACA reporting vendors to ask whether they will assist with satisfying any relevant state reporting requirements on the client’s behalf.

IRS Resources and Penalty Assessments
Employers and plan sponsors should take note of the filing and timing requirements and review the information reporting requirements through IRS resources available at the IRS Applicable Large Employer Information Center. The webpage can be used to understand the Forms 1094/5, to determine ALE status, and as a means to finding additional resources on these complicated filing rules. Employers should also continue to be on the lookout for IRS penalty letters or notices related to past ACA filings and should immediately present any materials received to their ACA reporting vendors, legal counsel, and qualified tax advisers. We note that the IRS continues to assess ACA employer penalties (see Letter 226-J) for previous reporting years and also note that good faith relief from penalties for certain errors on the ACA forms no longer applies. It is important for employers to fully understand their ACA reporting obligations as it is expected the IRS will continue to be less lenient with basic reporting errors.

We will continue to monitor developments under the ACA including the ongoing legislative efforts to develop a common-sense reporting solution to ease what has become an enormously expensive compliance burden for employers. We will provide details on any new or revised employer obligations as they take shape over time.

Should you have questions about this or any aspect of federal health insurance reform, contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.