IRS Releases Proposed Regulations For Health Insurance Provider Fees
Section 9010 of the Affordable Care Act surrounds Health Insurance Provider Fees and the IRS has released some new proposed regulations for reporting information among other changes. See IRS REG-123829-16 and REG–134438–15. The changes include those reflected upon covered organizations netting more than $25 million in premiums written following December 31, 2017.
For these and other covered entities, a filing of Form 8963 (Report Of Health Insurance Provider Information) is required with a mandate to electronic filing of the form for those with over $25 million in net premiums written. This includes corrected forms as well. Those with less than $25 million in net premiums written are not required to file electronically. Should the mandated electronic filings not occur, they will be regarded as a “no file” of Form 8963 by the applicable entity.
Further, the IRS’s proposed regulations, which apply to any fee due on or after September 30, 2018, add specific language to the definition of “net premiums written” to clarify that net premiums written include risk adjustment payments received and are reduced for risk adjustment charges paid.
If a covered entity did not include risk adjustment payments received as direct premiums written on its Supplemental Health Care Exhibit (SHCE) or did not file an SHCE, these amounts are still part of net premiums written and must be reported as such on Form 8963. For this purpose, risk adjustment payments received and charges paid are computed on an accrual basis.
These proposed regulations prove once again that the IRS moving into 2017 is particularly focused on correct form filing and clarity of terms and definitions as they pertain to healthcare.
For more free resources with ACA compliance and reporting, click on one of these resources below:
5 Common ACA Compliance Mistakes
New Instructions for Forms 1094-C and 1095-C
Potential Penalties for 2016 Reporting
To learn more about ACA compliance in 2021, click here.
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