Summer is upon us and with it a number of annoyances. Mosquitos. Road construction. And those pesky Affordable Care Act (ACA) compliance responsibilities that tend to slip during summer months …
IRC Section 4980H Penalties
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ACA Full-Time: What is it and Why Does it Matter? What constitutes a full-time employee under the ACA? The answer is not as simple as it seems. And getting your …
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ACA DeadlineAffordable Care Act
March 31 is the Deadline for E-Filing ACA Returns With the IRS
by Robert Sheenby Robert SheenToday, March 31, 2021, is the e-filing deadline for submitting ACA Forms 1094-C and 1095-C to the IRS for the 2022 tax year, as required by the ACA’s Employer Mandate. …
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ACA Compliance
AIRs Portal Downtime Could Prove Problematic for Employers
by Robert Sheenby Robert SheenOn December 5, the IRS closed production of the Affordable Care Act’s Information Returns (AIRs) portal to prepare for 2021 reporting year electronic filing submissions. The agency says that the …
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On December 9, 2021, the IRS published the final ACA reporting instructions for the 2021 tax year, including the final 1094-C and 1095-C forms. As expected, the forms and instructions …
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ACA ComplianceAffordable Care Act
Data Quality Management Is Key to ACA Compliance
by Robert Sheenby Robert SheenMany of the challenges posed by the Affordable Care Act’s Employer Mandate are inherently data problems. Data quality management is not just an issue for larger employers with multiple HR …
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ACA Compliance
3 Resources To Assist Employers With 2021 ACA Reporting
by Robert Sheenby Robert SheenThe end of the 2021 tax year and the subsequent tax season are approaching rapidly. What precautions is your organization taking to ensure a smooth ACA reporting experience this year? …
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Affordable Care Act
ACA Reporting to Grow in Complexity Due to State Individual Mandates
by Robert Sheenby Robert SheenACA reporting is complex and the process has only grown more challenging as states continue to enact additional state-level ACA reporting requirements as a function of their Individual Mandates. But …
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ACA ReportingAffordable Care Act
Understanding ACA Forms 1094-C/1095-C
by Robert Sheenby Robert SheenEmployers required to comply with the ACA’s Employer Mandate must report their full-time employee’s healthcare information to the IRS annually via forms 1094-C and 1095-C, but what exactly are these …
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The IRS announced that there is no statute of limitations for ACA penalties. What does that mean exactly? Simply put, it means that the ACA non-compliance penalties for any reporting …
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Affordable Care Act
Recapping on Biden’s ACA Reforms, What Employers Need to Know
by Robert Sheenby Robert Sheen3 minute read: Since Biden took office on January 20, 2021, several advancements to the Affordable Care Act followed, so we thought it best to recap on the ACA reforms …
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3 minute read: In December 2020, the Departments of Labor, Health and Human Services, and Treasury (including the IRS) issued a final rule regarding ACA grandfathered health plans. Grandfathered health …
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Affordable Care Act
March 31 is the Deadline for E-Filing ACA Returns With the IRS
by Robert Sheenby Robert SheenToday, March 31, 2022, is the e-filing deadline for submitting ACA Forms 1094-C and 1095-C to the IRS for the 2022 tax year, as required by the ACA’s Employer Mandate. …
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Affordable Care ActHealth Care Coverage
ACA to Aid Millions in Obtaining Healthcare, KFF Report Finds
by Robert Sheenby Robert Sheen2 minute read: The data is in: at least 27 million Americans have lost employer-sponsored health coverage as a result of COVID-19. The Kaiser Family Foundation issued a report in …
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3 minute read: In yet another triumphant win for the Affordable Care Act, the state of Missouri approved and passed the expansion of Medicaid. The expansion comes after nearly 53% …
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2 minute read: The convergence of insurance regulation at the federal and state levels keeps getting more complex. In July, the DC Circuit Court of Appeals upheld the Trump administration …
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Affordable Care Act
Gig-Economy Worker Benefits Will Affect ACA Compliance
by Robert Sheenby Robert Sheen3 minute read: It’s no mystery that both companies and consumers benefit from the gig-economy, but what about the workers? Sure, it provides a means to an end, but workers …
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ACA ComplianceAffordable Care Act
Employee Misclassification Laws Add Headache to Employer ACA Compliance
3 minute read: In the past year three states have implemented laws that broaden the definition of “employee” and include penalties or additional liability exposure for employers who misclassify their …
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Affordable Care Act
More ACA Complexity: California Releases Draft Instructions Diverge From ACA Employer Reporting
by Robert Sheenby Robert Sheen2 minute read: With the zeroing out of the ACA’s “Individual Mandate,” which required individuals to have minimum essential health coverage through the enactment of the Tax Cuts and Jobs …
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2 minute read: House of Representative Democrats have unveiled a bill that would enhance many of the ACA’s components while reversing much of the Trump administration’s onslaught to the healthcare …
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2 minute read: On July 8, 2020 the Supreme Court handed down its decision in Little Sisters of the Poor v. Pennsylvania, upholding the new Trump Administration rule regarding contraceptive …
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Affordable Care Act
ACA’s Expansion of Medicaid Takes Hold in Oklahoma
by Robert Sheenby Robert Sheen3 minute read: In late June, Oklahoma joined 37 other states and the District of Columbia in expanding Medicaid under the ACA. Better late than never and in good timing …
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Affordable Care Act
Proposed Rules allow for More Flexibility to Grandfathered Group Health Plans
by Robert Sheenby Robert Sheen2 minute read: The Treasury, the Internal Revenue Service, the Department of Labor and the Department of Health and Human Services have jointly released a notice of proposed rulemaking to …
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Affordable Care Act
Californians Beware, The Individual ACA Penalty Has Increased
by Robert Sheenby Robert Sheen2 minute read: California residents that fail to obtain qualified health coverage this year will receive a penalty from the state for an amount larger than first projected. Per California’s …
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2 minute read: Virginia has decided to get into the worker misclassification game with the passage and implementation of HB 984 on July 1, 2020. Unlike states such as California …
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Affordable Care Act
Protect App-Based Drivers Act Would Create Further Employee Classification and ACA Reporting Issues
3 minute read: As part of their campaign against the requirements of California Assembly Bill 5 (AB5), which went into effect January 2020 and requires employers to treat contract workers …
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Affordable Care Act
Proposed IRS Regs Will Not Affect How Individuals Receive PTCs
by Robert Sheenby Robert Sheen2 minute read: The IRS recently issued proposed regulations on how the personal tax exemption reduction to “0” will affect qualifications for recipients of Premium Tax Credits (PTCs). Regulation 124810-19, …
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Affordable Care Act
Why CMS’s 2021 Payment Notice May Lead to More PTC Allocations
by Robert Sheenby Robert Sheen2 minute read: Back in March, the Centers for Medicare and Medicaid Services (CMS) issued the Notice of Benefit and Payment Parameters for 2021 (2021 Payment Notice). The rule includes …
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Affordable Care Act
Employers May See More ACA Penalties As a Result of COVID-19
by Robert Sheenby Robert Sheen2 minute read: A new data analysis report from the Kaiser Family Foundation (KFF) finds the vast majority of Americans who lost their job amid COVID-19will be eligible for government …
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ACA ComplianceAffordable Care Act
Uber and Lyft sued by California for Misclassifying Gig Workers. How Misclassification can Impact ACA Compliance
by Robert Sheenby Robert Sheen3 minute read: Gig Economy giants Uber and Lyft are being sued by the state of California for allegedly failing to meet the requirements of California Assembly Bill 5 (AB …
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ACA ComplianceACA ReportingAffordable Care Act
ACA Penalties to Continue with the IRS Returning to Work
by Robert Sheenby Robert Sheen2 minute read: As states begin to lift their shelter-in-place orders and begin plans to re-open, employers should take note of recent IRSactivity, as the agency is expediting its efforts …
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ACA ComplianceAffordable Care Act
Supreme Court Rules in Favor of ACA Risk Corridors
by Robert Sheenby Robert Sheen2 minute read: The Affordable Care Act chalked up a win in late April when the Supreme Court ordered the federal government to pay insurance companies funding it’s been entitled …
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Affordable Care Act
Potential ACA Relief for Employers Facing COVID-19 Hardship
by Robert Sheenby Robert Sheen2 minute read: As the COVID-19 global health pandemic continues to affect businesses large and small, employers must still comply with the requirements of the ACA’s Employer Mandate. As a …
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2 minute read: While Trump Administration shot down the idea of a special ACA enrollment period to help individuals who have lost their coverage due to the COVID-19 Pandemic, states …
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13 minute read: Compliance with the various employer provisions of the Affordable Care Act (ACA) can be complicated under normal employment conditions. As employers face the incredibly difficult business climate …
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2 minute read: The IRS has been busy issuing penalties to employers that failed to comply with the ACA’s Employer Mandate for the last several tax years. Employers should note …
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5 minute read: As businesses across the country are shutting their doors to comply with various state or local Stay at Home orders to combat the spread of the COVID-19 …
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Affordable Care ActHealth Care Coverage
Federal Special Enrollment Period on the Horizon
by Robert Sheenby Robert Sheen2 minute read: The Trump Administration is doing the unexpected and considering a special ACA enrollment period in light of the COVID-19 Pandemic. The special enrollment period will provide uninsured …
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2 minutes read: Due to the enormous challenges the coronavirus crisis is imposing on our healthcare system, the state of California has extended its Special Enrollment period. Effective immediately, the …
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ACA ComplianceAffordable Care Act
The Trucking Industry Faces Challenges with AB5
by Robert Sheenby Robert Sheen3 minute read: California’s AB5 has changed the landscape on how independent contractors and employers work together. The trucking industry in particular faces unique challenges in adjusting to the new …
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2 minute read: The Supreme Court has agreed to rule on the constitutionality of the Affordable Care Act, for a second time. This unusual turn of events comes after the …
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Affordable Care Act
ACA Changes Continue to Stabilize the Marketplace
by Robert Sheenby Robert Sheen3 minute read: According to research by the Kaiser Family Foundation (KFF), there will be an average of 4.5 insurers per state this year, up from 4.0 in 2019 and …
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3 minute read: The passage and implementation of Assembly Bill 5 (“AB5”) in California has become a reckoning for employers who engage with large numbers of independent contractors and has …
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Affordable Care Act
California Health Exchange Welcomes New Enrollees Thanks to Individual Mandate
by Robert Sheenby Robert Sheen2 minute read: As California finalizes its initial open enrollment results, the data shows the state’s Individual Mandate played a part in the higher turnout. According to Covered California, the …
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Affordable Care Act
ACA Paper Filing Submissions are Due to the IRS Today
by Robert Sheenby Robert Sheen2 minute read: Today is the IRS deadline for employers to provide paper filings of forms 1094-C and 1095-C to the IRS for the 2019 tax year as required by …
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ACA ComplianceAffordable Care Act
Why Monthly ACA Compliance is Critical for Avoiding IRS Penalties
by Robert Sheenby Robert Sheen2 minute read: With the IRS expected to continue to ramp up enforcement of the ACA’s Employer Mandate this year, employers should recognize the importance of a monthly ACA compliance …
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Affordable Care ActPremium Tax Credit
Proposed CMS Rule Could Reduce Number of Premium Tax Credits
by Robert Sheenby Robert Sheen2 minute read: The Centers for Medicare and Medicaid (CMS) has proposed a rule that would ensure that the agency doesn’t wrongfully provide health insurance subsidies, or Premium Tax Credits …
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3 minute read: Several states and the District of Columbia are taking pains to make sure the Individual Mandate under the Patient and Protection and Affordable Care Act (“ACA”) is …
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2 minute read: The 2020 open enrollment results for individuals enrolling through the Healthcare.gov platform are in, and the results indicate a strong and stabilizing health care system. A report …
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2 minute read: Now that it is 2020, several state-wide Individual Mandates have gone into effect, including California’s. As of January 1, California residents, including domestic partners and their dependents, …