The Internal Revenue Service has identified additional issues under Code Section 4980I, commonly known as the “Cadillac Plan” excise tax, and is proposing new regulations to deal with them. The …
2016 Presidential Election
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A Wyoming Indian tribe lost a legal bid to be exempted from the employer mandate of the Affordable Care Act, and must provide health insurance to all of its employees. …
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EditorialsLegislation
ACA Reporting Update: New Forms, Higher Penalties
by Robert Sheenby Robert SheenACA Reporting Update: New Forms, Higher Penalties By Damian A. Myers Damian Myers is an Associate in the Employee Benefits, Executive Compensation and ERISA Litigation Practice Center in the Washington, …
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Affordable Care ActLegislationMedicaid/Medicare
Medicare and Medicaid Popular After 50 Years
by Robert Sheenby Robert SheenWhen Medicare and Medicaid were signed into law on July 30th 50 years ago, opponents attacked the programs as wasteful, intrusive and a precursor to socialism or communism. Today both …
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The IRS issued a reminder that individuals who received advance payments of the Premium Tax Credit (PTC) in 2014, for insurance they purchased through a marketplace or exchange, should file …
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LegislationRegulationsUncategorized
IRS on Employer Shared Responsibility Provisions
by Robert Sheenby Robert SheenThe Internal Revenue Service has issued a reminder to employers about specific “shared responsibility” provisions of the Affordable Care Act that may affect them. The size and structure of a …
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New reporting requirements mandated by the Affordable Care Act are posing challenges to large and small companies, and most employers have made little progress on deciding on or implementing a …
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LegislationRegulations
California Health Insurance Rates To Rise By 4%
by Robert Sheenby Robert SheenCalifornia’s Affordable Care Act exchange, known as Covered California, has negotiated an average 4% increase in premiums for the 1.3 million residents of the state who buy individual insurance through …
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An increasing amount of medical care is being delivered by nurse practitioners, physician assistants and other non-physician providers, making care more widely available and helping hold down costs, according to …
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The Internal Revenue Service (IRS) issued a reminder that all employers that provide self-insured health coverage, must file an annual return reporting certain information for each employee they cover. If …
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After two years of debate and months of closed-door negotiations, Utah’s Republican governor and state legislature have agreed on a deal to expand Medicaid in that state, covering about 126,000 …
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Affordable Care ActLegislationRegulations
ACA Offers Help For Informal Caregivers
by Robert Sheenby Robert SheenMillions of Americans who provide unpaid care for ill, disabled or aged family members or friends can now get help through the Affordable Care Act for their own physical and …
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Affordable Care ActIRS
IRS Offers ACA Webinars for Employers and Insurers
by Robert Sheenby Robert SheenThe Internal Revenue Service is offering a series of three webinars designed to help employers and insurance providers understand provisions of the Affordable Care Act. The webinars will be held …
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Affordable Care ActHealth Care CoverageMedicaid
Alaska’s Governor Acts to Expand Medicaid
by Robert Sheenby Robert SheenAlaska’s Gov. Bill Walker moved to expand Medicaid, saying he will ask the administration to offer Medicaid coverage to all qualifying residents of the state. Noting that Alaska’s legislature had …
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Despite a few glitches, the Internal Revenue Service says, the agency’s staff did a “commendable” job implementing provisions of the Affordable Care Act. The most significant new challenge the IRS …
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LegislationRegulations
New Rules on Religious Objections to Birth Control
by Robert Sheenby Robert SheenThe Obama administration has unveiled new rules aiming to address religious objections by to providing birth control to female employees as required by the Act.
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EditorialsLegislationRegulations
Impact of ‘King’ on Applicable Large Employers
by Robert Sheenby Robert SheenImpact of ‘King’ on Applicable Large Employers The Supreme Court’s decision in ‘King v. Burwell’ had ramifications for “applicable large employers” that went beyond approving payment of insurance subsidies in …
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Time’s Up on Premium Reimbursement The IRS has taken a hard position on employer payment plans under the ACA, and now the time is up for small employers to comply. …
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Affordable Care ActHealth Care Coverage
Enrollments Alone Don’t Lead to Better Health
by Robert Sheenby Robert SheenDespite the Affordable Care Act’s success in getting 16 million more Americans enrolled in health insurance programs, major hurdles still keep consumers from understanding their coverage, finding a doctor and …
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Penalties in sections of the Internal Revenue Code relating to the failure to timely file correct and complete information in a return as well as the failure to timely distribute …
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RegulationsUncategorized
College’s Objection to Contraception Coverage Is Denied
by Robert Sheenby Robert SheenThe US Court of Appeals has denied a religious college’s request to bar the government from enforcing the Affordable Care Act’s requirement that insurance plans cover the cost of all …
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The Affordable Care Act’s requirement that insurers offer coverage to everyone, including those with serious pre-existing medical expenses, has not resulted in a surge of hight-cost claims. The federal agency …
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Information is now available online for 11.4 million financial transactions paid by drug and medical device suppliers to 600,000 physicians and 1,100 teaching hospitals. The payments total $6.49 billion. The …
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LegislationRegulations
After ‘King’ Ruling, States Look at Medicaid Expansion
by Robert Sheenby Robert SheenNow that the Supreme Court has ruled in favor of the administration’s position in the ‘King v. Burwell’ case, supporting the legality of Affordable Care Act subsidies in all states, …
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The changes to America’s health care delivery system introduced by the Affordable Care Act are causing some of the nation’s largest health insurance companies to explore merger talks with competitors. …
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Affordable Care ActLegislation
Supreme Court Rules ACA Subsidies Are Legal
by Robert Sheenby Robert SheenIn a 6-3 decision, the Supreme Court ruled on June 25th that it is legal for government subsidies under the Affordable Care Act to be available to all Americans, as …
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The federal agencies that regulate the Act issued a set Frequently Asked Questions (FAQ) to clarify the limits on cost-sharing under the ACA. For plan years beginning in 2016, the …
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The Internal Revenue Service issued revised regulations regarding the Summary of Benefits and Coverage (SBC) that must be provided to those covered by health insurance plans. The SBC is intended …
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American Health Care Act (AHCA)Regulations
Americans Say Prescription Drug Costs Unreasonable
by Robert Sheenby Robert SheenNearly three-quarters of the public (73%) think prescription drugs costs are unreasonable, and place the blame on pharmaceutical companies rather than health insurance companies, aKaiser Foundation poll found. Asked for …
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By a margin of 55% to 38%, Americans believe the Supreme Court should not block federal subsidies in the states that do not operate their own health insurance exchange, an …
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A Republican Congressman has introduced to help individuals who would lose their insurance subsidies if the Supreme Court rules in favour of the plaintiffs in the “King v. Burwell” case. …
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The decision by 22 states not to expand Medicaid under the will ACA will result in 5,200 avoidable deaths each year, according to a White House Report, along with hundreds …
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The House Ways and Means Committee approved H.R. 160, which would repeal the 2.3% excise tax on medical device manufacturers imposed under the Affordable Care Act and intended to help …
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Officials from at least 16 states met in early May for a confidential, unannounced meeting to discuss options available to their states if the Supreme Court rules against the Obama …
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Affordable Care ActApplicable Large Employer (ALE)IRS
IRS Explains Definition of ‘Large Employer’
by Robert Sheenby Robert SheenThe IRS has issued an explanation of how companies can determine if they are an ”applicable large employer” or ALE, and how that affects their obligations under the Affordable Care …
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PenaltiesUncategorized
Most Consumers Satisfied With Marketplace Plans
by Robert Sheenby Robert SheenMost people who purchased their own health insurance plans through an Affordable Care Act marketplace say they are satisfied with their plan’s coverage and features, according to a Kaiser Family …
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Some employers choose to reimburse employees for the cost of individual health insurance coverage rather than establishing a group medical plan. But these plan don’t comply with the Affordable Care …
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Affordable Care ActPharmaceutical
Rules on Contraception Coverage Tightened
by Robert Sheenby Robert SheenThe Obama administration issued tighter rules on contraception offered by insurance companies, requiring insurers to pay for at least one form of birth control. The guidance, issued as a set …
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LegislationMinimum Essential CoverageRegulations
Article: Reporting 2015 Coverage of “MV-lite” Plans
by Robert Sheenby Robert SheenSome employers have used “MV-lite” plans that offer very limited hospital and doctor benefits, yet technically satisfy the “minimum value” calculations of the government’s online calculator. These plans have been …
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Affordable Care ActLegislation
Appeals Court Bars Challenge to ACA Mandates
by Robert Sheenby Robert SheenThe Fifth Circuit Court of Appeals rejected a challenge to the individual and employer mandates of the Affordable Care Act. The court ruled that the taxpayer who filed the lawsuit …
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A reference tool to help understand what is required for them to comply with the Affordable Care Act, and the timeline for compliance, has been prepared by the law firm …
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Montana’s Democratic Gov. Steve Bullock signed into law a Medicaid expansion bill that had been drafted by a Republican member of the state legislature. Under the new law, Montana will …
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Robert S. Sheen, Editor-in-Chief The ACA Times and President Trusaic, Inc., will speak about the Affordable Care Act at the 2015 NNAHU Expo, May 13 in Reno, Nevada. The conference, …
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The nation’s individual insurance market grew 46% to 15.5 million people in the first year that plans could be purchased through Affordable Care Act marketplaces, according to a study by …
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Researchers at UCLA found that about 59% primary care and specialty physicians in California support the Affordable Care Act, and 61% believe the law will either help their practice or …
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California Insurance Commissioner Dave Jones said Anthem Blue Cross failed to justify premium increases averaging 8.7% on individual health insurance policies grandfathered under Affordable Care Act rules. According to the …
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Because of the Affordable Care Act, employers may face a 40% excise that tax on health insurance plans that provide “excess” benefits – commonly known as “Cadillac” plans. Employers should …
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Equal Employment Opportunity Commission (EEOC)
Many Employers Are Covering Part-Time Workers
by Robert Sheenby Robert SheenMany large and mid-size companies are extending health insurance coverage beyond their full-time workers to include part-timers in their plans, according to a study by the ADP Research Institute. About …
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A poll tracking Americans’ views the Affordable Care Act shows public opinion holding steady and closely divided, with 43% expressing a favorable view and 42% with an unfavorable view. The …
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who include wellness programs as their will get guidance the privacy rights participating employees in new rules proposed by the US Equal Employment Opportunities Commission (EEOC). The proposed rules, published …