Spencer’s Benefits Reports NetNews – August 1, 2014


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Spencer’s Benefits Reports NetNews™

July 28, 2014 – August 1, 2014

Featured This Week

New Reports

  • Analysis: Determining Full-Time Status, Waiting Periods Under ACA, 7/14 (550.1.-1)

(Read Intelliconnect) »

  • Analysis: Premium Stabilization Programs, 78/14 (542.-1)


(Read Intelliconnect) »

  • Court Case: Insurers May Deny Death Benefits For Felonies, Intoxication, 7/14 (341.33.-5)


(Read Intelliconnect) »

  • Analysis: Essential Health Benefits Under ACA, 7/14 (541.-1)


(Read Intelliconnect) »


August 1, 2014

Warner Asks Administration To Again Delay ACA Employer Mandate

Sen. Mark R. Warner (D-Va.) has asked the Obama administration to either delay or minimize the Code Secs. 498OH, 6055 and 6056 reporting requirements for employers under the Patient Protection and Affordable Care Act (ACA). In a letter dated July 23 to Treasury Secretary Jack Lew, Warner said he has concerns over the ability of employers to comply with the ACA reporting requirements in time for their general start date on Jan. 1, 2015…

(Read Intelliconnect) »

Lack Of Statehood Gets Territories Off The Hook For Some ACA Provisions

Five U.S. territories are not required to comply with certain provisions of the Patient Protection and Affordable Care Act (ACA), the Department of Health and Human Services (HHS) clarified in a letter to the territories on July 16. Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam and the Northern Mariana Islands were told that, after a “careful review of this situation and the relevant statutory language,” HHS has determined that the new provisions of the Public Health Service Act (PHSA), enacted in Title I are governed by the definition of “state,” and therefore the new provisions do not apply to the U.S. territories…

(Read Intelliconnect) »

July 31, 2014

CMS, White House Trumpet $9 Billion Savings From 80/20 Rule

Since 2011, consumers have saved around $9 billion on premium costs, a windfall that’s primarily attributable to the Patient Protection and Affordable Care Act’s (ACA) medical loss ratio (MLR), or 80/20 rule, according to a recent report from the Centers for Medicare and Medicaid Services’ Center for Consumer Information and Insurance Oversight (CCIIO). The 80/20 rule says that, if a health insurance company in the individual or small group market does not spend at least 80 percent of the premium dollars it collects on medical care or activities to improve health care quality (85 percent for the large group market), it must refund the difference to its customers. Companies report their premiums and spending by market for each state in which they operate…

(Read Intelliconnect) »

2014 Monthly National Average Premium Provided

In Rev. Proc. 2014-46, the IRS has issued guidance providing the 2014 monthly national average premium for qualified health plans that have a bronze level of coverage for taxpayers to use in determining their maximum individual shared responsibility payment under Code Sec. 5000A(c)(1)(B). An explanation of the methodology used to determine the monthly national average premium amount also is provided…

(Read Intelliconnect) »

IRS Provides Guidance For Health Insurance Costs For Self-Employed Individuals And For Taxpayers Entitled to Premium Tax Credit

In Rev. Proc. 2014-41, the Internal Revenue Service has issued guidance for taxpayers to compute the deduction under Code Sec. 162(l) for health insurance costs for self-employed individuals and for the premium tax credit allowed under Code Sec. 36B. This guidance is intended to provide taxpayers with calculation methods that resolve the circular relationship between the Code Sec. 162(l) deduction and the Code Sec. 36B tax credit. The use of the calculations provided is optional; a taxpayer may determine the amounts of the deduction and the tax credit using any method that satisfies the requirements of the applicable tax law, including Code Sec. 36B, Code Sec. 162(l), and the regulations issued under those code sections…

(Read Intelliconnect) »

July 30, 2014

Text: IRS, Final And Temporary Regs, Rules Regarding the Health Insurance Premium Tax Credit

(Read Intelliconnect) »

Text: IRS, NPRM, Rules Regarding the Health Insurance Premium Tax Credit

(Read Intelliconnect) »

Draft Forms For Reporting Employee Health Coverage Released By IRS

Draft forms that employers will soon have to use to report on health coverage they offer to their employees were released by the Internal Revenue Service on July 24, 2014. The draft forms are not to be used for reporting, and they do not, as of yet, include draft instructions, which the IRS expects to issue in August. The forms and instructions, suitable for filing, will be finalized by the IRS later this year. The IRS provided the draft forms to help employers prepare for new reporting provisions. The IRS also is seeking comments on the forms, at the Comment on Tax Forms and Publications page on IRS.gov…

(Read Intelliconnect) »

IRS Issues Final And Proposed Regulations For Claiming The Premium Tax Credit

The Internal Revenue Service has issued temporary and proposed regulations, effective for tax years beginning after Dec. 31, 2013, and expiring July 24, 2017. These regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges and claim the premium tax credit, and Exchanges that make qualified health plans available to individuals. The regulations were published in the July 28 Federal Register

(Read Intelliconnect) »

IRS Updates Required Contribution Percentages To Determine Affordable Minimum Essential Coverage For 2015

In Rev. Proc. 2104-37, the Internal Revenue Service has updated the applicable percentage table used to calculate an individual’s premium tax credit for tax years beginning after Dec. 31, 2014, as well as the required contribution percentage in Code Sec. 36B(c)(2)(C)(i)(II), which is used to determine whether an individual is eligible for affordable employer-sponsored minimum essential coverage under Code Sec. 36B for plan years beginning after Dec. 31, 2014. In addition, the guidance cross-references the required contribution percentage under Code Sec. 5000A(e)(1)(A), which is used to determine whether an individual is eligible for an exemption from the individual shared responsibility payment because of a lack of affordable minimum essential coverage…

(Read Intelliconnect) »

July 29, 2014

Employers Brighten Smiles With Extended Dental Coverage

Some young adults are enjoying extended dental coverage under the health care policies of their parents whose employers are voluntarily expanding such coverage in conjunction with expanded medical coverage under the Patient Protection and Affordable Care Act (ACA). That’s according to a report published in Medical Care, a journal of the American Public Health Association. Although the ACA allows parents to keep their children on their medical plans up to age 26, there is no similar requirement for dental coverage…

(Read Intelliconnect) »

Company Stock Plans Influence 86 Percent Of Employees Thinking Of Changing Jobs

An increasing number of workers are considering the availability of a company stock plan when evaluating a new job opportunity, according to a new survey of 2,116 stock plan participants by Fidelity Investments. When asked about the importance of company stock plans as part of their compensation and benefits package, 86 percent of respondents under the age of 40 said they would want their new employer to offer a company stock plan if they changed jobs. In addition, 40 percent of overall respondents consider a company stock plan as a “must have” when making a decision to change employers, and 37 percent indicated that giving up their company stock plan would make it harder for them to leave their current job…

(Read Intelliconnect) »

July 28, 2014

Halbig, King Decisions Overturning Subsidies May Hinder ACA Implementation

The ultimate outcomes of Halbig v Burwell and King v Burwell, remain to be seen. However, the overturn of 26 USC Sec. 36B that may result is predicted to “broadly undermine the implementation” of the Patient Protection and Affordable Care Act (ACA), according to a report by the Urban Institute and the Robert Wood Johnson Foundation. Consequences of the possible overturn of Sec. 36B, which provides premium subsidies for plans on the federally facilitated Marketplaces (FFMs), are likely to include increases in premiums and uninsured rates…

(Read Intelliconnect) »

House Passes Highway Bill With Pension Funding Provisions

The House has passed the Highway and Transportation Funding Bill of 2014 (H.R. 5021), legislation that would temporarily provide financing for the Highway Trust Fund, funded in part by provisions that would modify the method of determining the interest rates used generally for calculating pension plan liabilities…

(Read Intelliconnect) »

ERISA Advisory Council To Meet August 19-21

The Advisory Council on Employee Welfare and Pension Benefit Plans, also known as the ERISA Advisory Council, will hold a meeting on August 19-21, in Washington, D.C., at the U.S. Department of Labor, 200 Constitution Avenue NW. The notice of the meeting was published in the July 24 Federal Register

(Read Intelliconnect) »

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