Changes have been made regarding the ages associated with preventive (no cost) mammogram screenings effective 4/1/17. This change is in compliance with ACA preventive screening requirements.
Additional Changes as of 1/1/17
The U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) has extended the effective date of its model Health Insurance Exchange Notices through April 30, 2017. Previously, these model notices were set to expire on March 31, 2017. No other changes have been made to these notices.
Click here to access the model notices with the new expiration date. Please note that there are two separate notices--one for employers that offer a health plan to some or all employees, and another for employers that do not offer a health plan.
These model notices are the most current versions provided by the EBSA. For further guidance regarding these notices, please contact the EBSA directly at 1-866-444-3272.
Late Friday, March 24, 2017, the U.S. House of Representatives canceled a vote on the proposed Affordable Care Act (ACA) replacement plan, called the American Health Care Act (AHCA). According to House leadership, the Republicans didn’t have enough votes to pass the House, and so House Speaker Paul Ryan (R-WI), after discussing with President Trump, canceled the vote. Following the cancellation, both Ryan and Trump stated that the ACA repeal and replace efforts will be on the back burner for now, as Congress will move forward with other initiatives, including tax reform.
The AHCA Plan
The AHCA would have repealed penalties associated with the ACA’s individual and employer mandates, repealed the health insurance tax on insurers and the health FSA contribution employee contribution limits, and allowed reimbursements from HSAs, FSAs and HRAs for over-the-counter (non-prescription) medication. For HSAs, it would have increased contribution limits and loosened reimbursement rules. Lastly, the AHCA would have delayed the Cadillac tax until 2025 and created new refundable tax credits (based on age) as a replacement for the ACA’s premium tax credit system.
The AHCA faced an uphill battle from its introduction, as Republican factions were never fully on board. Specifically, the House Freedom Caucus, a conservative group within the House led by Rep. Mark Meadows (R-NC), wanted the AHCA to include a wider repeal of the ACA, including repeal of the ACA’s prohibition on lifetime and annual limits, and essential health benefits requirements. Ultimately, despite their determination, House leadership could not both appease the Freedom Caucus and maintain support from other, more moderate House Republicans.
Looking forward, it’s unclear how Congressional Republicans and President Trump will proceed with their ACA repeal and replace efforts. Rep. Ryan stated that the ACA is the ”law of the land” for the foreseeable future, and Trump said he’ll let the ACA “explode.” Both hinted at revisiting the issue later down the road, though. But those comments, coupled with Trump’s inauguration day executive order on ACA non-enforcement, leave uncertainty around the future of the ACA and any repeal-and-replace efforts. That leaves us with several possibilities to consider:
The vote cancellation means the status quo remains — the ACA is the law of the land, so employers should plan to continue their compliance efforts. Among other things, this means continued compliance with the employer mandate and the associated reporting. Employers should continue those efforts through tracking of hours, including any measurement periods used for variable hour or seasonal workforces. Employers should also plan to comply with other ACA requirements, including PCOR and reinsurance fee payments, covering preventive services at zero cost-sharing, covering dependents to age 26 and observing pre-existing condition exclusion prohibitions.
The federal government has issued a new format for the Summary of Benefits and Coverage (SBC) document effective April 1, 2017.
While the change has been made to improve readability for consumers, the new format may cause some confusion for readers. Given that, here are a few points of clarification.
One of the most significant changes to the format is the way deductibles are referenced in the cost-sharing chart. The cost-sharing chart shows copayments and coinsurance after the deductible has been met. For example, if labs go toward the deductible and then there are no charges, because the chart is showing cost after the deductible, the “What You Will Pay” column states “no charge.”
A new statement appears at the top of the chart noting that all copayments and coinsurance are after the deductible has been met, if a deductible applies (see chart below). Please note that while this wording appears at the top of the chart, it does not also appear within the chart for specific benefits on our deductible plan SBCs, nor is it repeated on the top of every page.
Decision Reverses Previously Announced Policy
Pursuant to a recent executive order, the Internal Revenue Service (IRS) will continue to accept for processing tax returns in instances where a taxpayer does not indicate his or her health coverage status.
The Affordable Care Act requires individual taxpayers to indicate on their IRS Form 1040 whether they had minimum essential coverage for each month, qualify for an exemption, or must make an individual shared responsibility payment. Previously, the IRS announced its intention to begin rejecting tax returns during processing in instances where the taxpayer did not provide that information on his or her Form 1040.
Recent Policy Change
A recent executive order directed federal agencies to exercise all authority and discretion available to them to minimize the economic burden of the ACA. Consistent with that order, the IRS will continue to allow electronic and paper returns to be accepted for processing in instances where a taxpayer does not indicate his or her health coverage status. Though these returns will not be systematically rejected by the IRS at the time of filing, taxpayers remain required to follow the law, and may receive follow-up questions and correspondence from the IRS after the filing process is completed.
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Source: HR 360, Inc.
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