ACA open enrollment for the 2023 plan year is just over a month away, and this time, individuals may have more options and a better experience than years prior. We …
Premium Tax Credits (PTCs)
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Affordable Care Act
ACA Open Enrollment Reaches Record-Breaking 14.5 Million
by Robert Sheenby Robert SheenOver 14.5 million Americans elected to receive health coverage through one of the ACA’s insurance marketplaces during the 2022 open enrollment period. The record-breaking participation is 21% higher than the …
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ACA ComplianceACA Reform
How Build Back Back Better Would Reshape U.S. Healthcare
by Robert Sheenby Robert SheenWith the Infrastructure Bill now officially signed into law, Congress will now shift its focus onto the $1.75 trillion Build Back Better proposal. In its current version, the plan could …
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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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Affordable Care Act
New Stimulus Plan Expands PTC Eligibility, Employer Penalties
by Robert Sheenby Robert Sheen3 minute read: President Joe Biden recently signed into law the American Rescue Plan (ARP) and it includes provisions that make ACA healthcare coverage more accessible to Americans. The $1.9 …
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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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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
TIGTA Reports 27.4% of Premium Tax Credits Are Improper Payments
by Robert Sheenby Robert Sheen2 minute read: On April 30, 2020, the Treasury Inspector General for Tax Administration (TIGTA) issued a new report entitled, “Improper Payment Reporting Has Improved; However, There Have Been No …
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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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ACA ReportingAffordable Care Act
The IRS Is Intensifying ACA Enforcement Efforts
by Robert Sheenby Robert Sheen3 minute read: Originally published on August 7, 2019, in Accounting Today. Accountants may see some of their business clients getting caught up this summer in IRS activities to enforce …
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3 minute read: We hosted an ACA webinar in July with HR.com, and were asked several questions relating to the ACA’s Employer Mandate. The answers are now available on our …
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3 minute read: I frequently meet with insurance brokers, CPAs and business owners who are interested in the latest on the IRS’s efforts to enforce the Affordable Care Act. In …
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ACA ComplianceAffordable Care Act
Expect Greater Scrutiny and Audits from IRS Staff on ACA Compliance
by Robert Sheenby Robert Sheen4 minute read: The IRS staff is preparing a new round of IRC 4980H penalty assessments to be issued to employers for failing to comply with the requirements of the …
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ACA ComplianceAffordable Care Act
Employers Must Correct IRS Errors to Avoid ACA Penalties
by Robert Sheenby Robert Sheen3 minute read: We are all human, including the people who work at the IRS. And like all of us, sometimes they make mistakes. The only difference is that errors …
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ACA ReportingAffordable Care Act
ACA Reporting Requirements [UPDATE]
by Robert Sheenby Robert Sheen7 minute read: It’s always interesting to look back and see how regulation develops. The Affordable Care Act (ACA) is no exception. I wrote a five-part series about the ACA …
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Affordable Care Act
More States Move Forward with Reinsurance Programs
by Robert Sheenby Robert Sheen3 minute read: The Trump administration has made repealing and replacing the Affordable Care Act a top priority. What’s interesting, however, is that as the White House continues to undermine …
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Affordable Care ActHealth Care Coverage
More Americans Paying for ACA Health Plans
by Robert Sheenby Robert Sheen2 minute read: It’s no secret that replacing the law is a top priority for President Trump and a majority of Republicans in Congress. Recent data from the Centers for …
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Affordable Care ActHealth Insurance Marketplace
2018 Looks Promising for Health Insurers Offering Marketplace Plans [Update]
by Robert Sheenby Robert SheenThe Affordable Care Act’s (ACA) Health Insurance Marketplace has evolved over the years as a necessary evil for some healthcare providers. Some have withdrawn from it, citing profit losses and …
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Affordable Care ActHealthcare
Individual Healthcare Mandate Being Considered in Maryland [UPDATE]
by Robert Sheenby Robert SheenSenate Republicans added repeal of the ACA’s individual mandate to the Senate’s tax reform bill to save nearly $340 billion in federal funds during the next decade to mitigate increases …
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Affordable Care ActHealth Care Coverage
The Affordable Care Act Has Helped Millions, But There’s More Work To Do
by Robert Sheenby Robert SheenIn 2010, former President Barack Obama introduced the Affordable Care Act (ACA) in an effort to provide more Americans with health coverage. Over the course of its now-nearly eight-year run, …
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ACA ComplianceTax Reform
ACA Individual Mandate is Set to be Gone, but Desire for Health Insurance Remains
by Robert Sheenby Robert SheenAs part of tax reform legislation passed by Congress, the individual mandate provision in the ACA requiring every American citizen to obtain health insurance or pay an annual financial penalty …
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Affordable Care ActTax Reform
Tax Reform Bills Keep ACA Employer Mandate Intact
by Robert Sheenby Robert SheenThrowback Thursday Feature from Wednesday, December 6, 2017. When the U.S. House and Senate Republicans meet in conference to discuss how they will reconcile their two different tax reform legislations, among …
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Affordable Care ActHealth Care Coverage
ACA Enrollment Continues at Faster Pace From Previous Year
by Robert Sheenby Robert SheenThey say that you don’t know what you’ve got till it’s gone, a theory that may be true for the Affordable Care Act (ACA). It was just months ago when …
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Affordable Care ActHealth Insurance Marketplace
The Healthcare Marketplace is Stabilizing Around the ACA
by Robert Sheenby Robert SheenWe are well into open enrollment period for the Affordable Care Act (ACA). Despite significant increases in premium rates for 2018, enrollment for healthcare coverage on HealthCare.gov is higher than …
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Affordable Care ActHealth Care Reform
U.S. Senate Committee Continues Healthcare Hearings Today After Hearing From Governors Last Week
by Robert Sheenby Robert SheenThe U.S. Senate Committee on Health, Education, Labor and Pensions continues its hearings on healthcare policy today. The committee will hear testimony today on providing states greater flexibility in managing …
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ACA CompliancePremium Tax Credit
Incorrect PTC Calculations Show that Technology Is A Gift and a Curse
by Robert Sheenby Robert SheenOver the last two years, the IRS has made some strides in ensuring that certain ACA-mandated processes are as seamless as possible for taxpayers and employers, from streamlining electronic form …
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Affordable Care ActHealth Care Coverage
Congressional Budget Office Expects Health Insurance Premiums to Increase
by Robert Sheenby Robert SheenGross premiums for silver-level health insurance plans purchased through the healthcare marketplace would be 20 percent higher in 2018 and 25 percent higher by 2020 if cost-sharing reductions (CSRs) payments …
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Affordable Care ActAmerican Health Care Act (AHCA)Health Care Coverage
Would American Health Care Act Dis-incentivize Employers From Offering Healthcare?
by Robert Sheenby Robert SheenOp-Ed Published on LA Biz Journal on March 21, 2017 Starting in the 1940’s, the Internal Revenue Service (IRS) made employer-based healthcare tax free. Employers were not required to offer …