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7/15 Final ACA Preventive Care Regs Address Contraceptives and Other Rules
On July 14, IRS and DOL published ACA final regulations on the requirements for certain preventive services without cost sharing, including guidance that a religious employer or organization must provide an “alternative means” of coverage of all FDA-approved contraceptive devices. The final regs also finalize provisions on noncontraceptive preventive care and other prior rulemaking actions.
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7/13 ACA Doubles Employer Penalties, Introduces Electronic Filing
The penalties associated with failures for adequate reporting of Minimum Essential Coverage and Applicable Large Employers ("Pay or Play") have been increased significantly, and the IRS has updated its website with additional information about the electronic submission of Forms 1094 and 1095. Read our Alert for summaries of these two developments.
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6/30 SCOTUS Decision Has Implications for Employer-Sponsored Health Plans
On June 26, 2015, the United States Supreme Court held in Obergefell v. Hodges that states cannot refuse to issue same-sex marriage licenses or refuse to recognize same-sex marriages performed in another state.  The court’s decision means that states must now extend marriage to same-sex couples on the same terms as opposite-sex couples. This decision will have an impact on employee benefit plans, especially self-funded plans that do not currently cover same sex spouses. Read our Alert for more details.
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6/25 King v. Burwell: Subsidies Are Available in FFEs
The Supreme Court issued their decision in King v. Burwell, a case that addresses whether subsidies to purchase health insurance coverage are available in states that have federally-facilitated exchanges (FFEs) rather than state-established exchanges. Thirty four states have FFEs, in which over 80% of the enrollees receive subsidies to purchase health insurance coverage.
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6/23 Clarification on ACA Reporting
The IRS recently issued additional guidance on ACA reporting and electronic filings of ACA returns. Both employers that will oversee third party vendors providing ACA reporting services and employers planning to do their own reporting should take special note of this latest guidance. An employer that outsources ACA reporting remains liable for the content of their ACA reports. Read our latest alert for an overview of the recent guidance.
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6/17 Final SBC Regulations Effective Fall 2015
The ACA requires group health plans to provide a Summary of Benefits and Coverage (SBC) to participants and beneficiaries. An SBC is a brief and simple statement of the benefits and cost sharing under the plan. Final regulations were released in June which modify the February 2012 regulations, and adopt many provisions from the 2014 proposed regulations. Read our alert for highlights from the June 2015 final regulations.
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6/2 Making Sense of ACA's Out-of-Pocket Limits
The Affordable Care Act (ACA) limits the cost sharing a non-grandfathered group health plan can impose on plan participants (out-of-pocket or OOP limits). Cost sharing includes co-payments, coinsurance, deductibles and similar charges for essential health benefits. The application of cost-sharing limits is a new concept for HDHPs. This Alert clarifies some of challenges in administering OOP limits on HDHPs.
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