The IRS will need detailed information from employers to enforce three Affordable Care Act (ACA) tax provisions. The IRS must determine whether: (1) an employer owes a pay or play penalty for failing to offer affordable, minimum value health coverage to its full-time employees; (2) employees and/or their family members are entitled to tax credits (subsidies) for the purchase of health insurance in the public exchanges; and (3) employees and/or their family members owe penalties for failing to maintain health coverage.
The federal Family and Medical Leave Act (FMLA) provides eligible employees of covered employers with unpaid, job-protected leave for specified family, medical, and military family reasons. On February 25, 2015, the Department of Labor (DOL) issued a Final Rule that revises the FMLA’s regulatory definition of “spouse.”
Starting in 2015, a large employer will be subject to pay or play penalties if it fails to offer affordable health coverage that provides at least minimum value to its full-time employees. A health plan provides “minimum value” if it is designed to pay at least 60% of the total cost of medical services for a standard population. This is generally equivalent to a bronze level plan sold in the public health insurance Exchange.
The Centers for Medicare and Medicaid Services (CMS) had set November 5, 2014 as the deadline for all but the smallest self-insured health plans to obtain a health plan identification number (HPID). On October 31, 2014 – less than a week before that deadline (and three days after publishing new FAQs on the process) – CMS announced an indefinite delay in the requirement that health plans get HPIDs.
Although the Internal Revenue Service (IRS) and the Department of Labor (DOL) have agreed on standards for wellness programs, and Congress seemed to have blessed those standards when it authorized higher levels of incentives in wellness programs as part of the Affordable Care Act (ACA), the Equal Employment Opportunity Commission (EEOC) has long expressed concerns about those standards.
Effective January 1, 2015, Ohio’s minimum wage will increase to $8.10 an hour for non-tipped employees, and $4.05 for tipped employees. The increase applies to employers with more than $297,000 in annual gross receipts.
In a unanimous decision that was a surprise to most in the benefits community, the Supreme Court, in Fifth Third Bancorp v. Dudenhoeffer, rejected the commonly accepted rule that fiduciaries of employee stock ownership plans (ESOPs) are entitled to a “presumption of prudence” in connection with their decision to buy or hold employer stock.
The employer pay or play penalties were originally scheduled to apply in 2014 but the IRS gave employers a one-year reprieve. Final regulations and FAQs published February 10, 2014 explain how the penalties will work in 2015 and provide several helpful transitional rules.
Summary: ACA mandates don’t apply to health plans classified as “excepted benefits.” The government has proposed regulations expanding the definition of excepted benefits to include self-insured dental and vision coverage even if that coverage is provided without employee contributions.
New final regulations under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) apply to group health plans in plan years beginning on or after July 1, 2014 (January 1, 2015 for calendar year plans). The regulations generally incorporate the 2010 interim final regulations and subsequent FAQs, with some notable clarifications.
The IRS and DOL issued new guidance prohibiting the application of pre-tax funds to the payment of individual health insurance premiums and imposing new conditions on health flexible spending accounts and health reimbursement arrangements.
On September 23, 2013 the IRS issued Notice 2013-61. The Notice sets forth streamlined refund procedures for overpayments of federal employment taxes paid by employers and employees relating to health benefits provided to legally married same-sex spouses. The Notice addresses health benefits provided both in 2013, and prior open years. The IRS had previously released Revenue Ruling 2013-17 setting forth its position that same-sex partners legally married under the laws of any state would be considered married for federal tax purposes regardless of where the couple resides. Under this state of celebration standard, the laws of the state where the marriage was celebrated (rather than the state of domicile) governs marital status for federal income tax purposes.
Jolie Havens authored a column for the Houston Business Journal outling 7 possible strategies that large Texas employers can consider to comply with the Affordable Care Act’s employer cost-sharing mandate.