Anti-assignment clauses in ERISA plans are enforceable

Plan provisions that bar insureds from assigning their claims to a third party—even to the healthcare provider that rendered the service—are generally enforceable in health plans governed by the Employee Retirement Income Security Act, the U.S. Court of Appeals for the Third Circuit held. ERISA does not clearly prohibit anti-assignment clauses, and every other federal […]

Dems press for new analysis on proposed short-term, limited-duration health insurance rule

Democratic Senators Patty Murray (D-Wash.) and Ron Wyden (D-Or.), along with Representatives Frank Pallone Jr. (D-N.J.), Richard Neal (D-Mass.), and Bobby Scott (D-Va.), are urging the top officials at the Departments of Health and Human Services, Labor, Treasury, and the Office of Management & Budget to hold off on finalizing the proposed rule on short-term […]

Employer groups call for suspension of ACA tax penalties, repeal of employer mandate

The assessment of tax penalties under the Affordable Care Act’s employer mandate should be suspended until the mandate is repealed given the ongoing cost, complexity and confusion surrounding compliance with the recordkeeping and reporting requirements. That’s according to the ERISA Industry Committee (ERIC) and a number of employer trade associations that submitted a letter to […]

Proposed regulations modify electronic filing requirement for information returns

The IRS has proposed regulations that would change the rules for determining whether a person must file information returns electronically. Under the new rules, all information returns, regardless of type, must be taken into account to determine whether a person meets the 250-return threshold for the electronic filing requirement. Further, electronic filing of corrected information […]

Self-insured group health plans covered approximately 34 million participants, DOL annual report finds

The Department of Labor (DOL) has released to Congress its eighth annual report on self-insured group health plans with data from Form 5500, Annual Return/Report of Employee Benefit Plan, as well as data from certain financial filings of self-insured employers. Approximately 54,500 health plans filed a Form 5500 for 2015 (the most recent complete data […]

Biggest chunk of the health care dollar goes to prescription drugs

The greatest percentage of the health care dollar goes to prescription drugs, at 23.2 cents, according to research from America’s Health Insurance Plans (AHIP) and Milliman. The survey examined commercial health plan data from 2014 to 2016. The analysis found: 23.2 cents goes to pay for prescription drugs; 22.2 cents goes to pay for doctors; […]

Standard mileage rates updated to reflect elimination of miscellaneous itemized deductions

In Notice 2018-42, the IRS has updated Notice 2018-3, to reflect changes to the tax law made by the Tax Cuts and Jobs Act (TCJA; P.L. 115-97). Changes impacting Notice 2018-3 include: the suspension of the deduction for un-reimbursed employee expenses; the suspension of the deduction for move related expenses; and the increase of depreciation […]

IRS provides guidance on various Letters 227

The IRS has provided guidance on the various Letters 227, which are acknowledgement letters sent to employers regarding the employer shared responsibility payment (ESRP). There are five different 227 letters. ESRP. The ESRP rules apply only to applicable large employers (ALEs), which are generally employers that had an average of 50 or more full-time employees […]

States’ motion to intervene granted in case challenging the ACA’s constitutionality

The District Court of the Northern District of Texas granted the motion of seventeen states to intervene as defendants in a challenge to the constitutionality of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) brought by nineteen states and three individuals. The plaintiffs, led by the state of Texas, seek a declaratory judgment […]

IRS updates premium tax credit table, required contribution percentage

The IRS has updated the applicable percentage table used to calculate an individual’s premium tax credit and required contribution percentage for plan years beginning after 2019. The percentage is used to determine whether an individual is eligible for affordable employer-sponsored minimum essential coverage; the percentage is used to determine whether an individual is eligible for […]