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The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010, bringing many changes for employers and health plans. The law continues to evolve as regulations are released. This monthly alert brings you information on the major provisions and regulations coming from Washington, connects you to valuable tools in understanding and complying with the law, and keeps you informed of Michigan legislation enacted in response to PPACA.
On Friday, January 20, 2017, President Trump signed his first Executive Order, titled "Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal."
The Executive Order instructs the Secretary of the Department of Health and Human Services (HHS) and the heads of all other executive departments and agencies with authority, or responsibility, under the Patient Protection and Affordable Care Act (ACA) to exercise all authority and discretion to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the ACA that would impose a fiscal burden on any state, or cost a fee, tax, penalty, or regulatory burden on individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products, or medications.
44North recommends that employers wait for confirmation from various federal agencies that regulations they are in the process of complying with (notably, ACA-related reporting) are on hold for the time being. Without confirmed Cabinet members for the Secretary of HHS, the Secretary of the Treasury, and the Secretary of Labor, there will likely be a lag in information directly from any one agency. President Trump's Chief of Staff also sent out a memo that essentially put a regulatory freeze on all agencies until presidential appointments are confirmed. We are, unfortunately, in a "wait and see" period.
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 PPACA REMAINS LAW |
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Republicans Withdraw Health Care Bill
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On Friday, March 24, House GOP leaders, with support from President Donald Trump, withdrew the American Health Care Act (AHCA) from further consideration
. The Patient Protection and Affordable Care Act (PPACA) remains in place; however, it may see change through future regulatory and/or regulatory action.
It is unclear at this time how the regulating agencies will handle postponed rule-making or whether another Congressional attempt
at "repeal and replace" will occur.
44North will continue to keep you apprised of any new developments.
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| SBCS AND SECTION 1557 |
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SBC Template and Required Addendums for Covered Entities under PPACA Section 1557
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A Summary of Benefits and Coverage (SBC) is the communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations. If an employer providing an SBC is a covered entity under the Section 1557 of the Patient Protection and Affordable Care Act (ACA), additional requirements apply.
The SBC is to be used by all health plans, including individual, small group, and large group; insured and self-insured; grandfathered, transitional, and ACA compliant. The new SBC must be used for plan years with open enrollment periods beginning after April 1, 2017. It will not be used for marketplace plans for the 2017 coverage year.
For fully insured plans, the insurer is responsible for providing the SBC to the plan administrator (usually this is the employer). The plan administrator and the insurer are both responsible for providing the SBC to participants, although only one of them actually has to do this.
For self-funded plans, the plan administrator is responsible for providing the SBC to participants. Assistance may be available from the plan administrator's TPA, advisor, etc., but the plan administrator is ultimately responsible. The plan administrator is generally the employer, not the claims administrator.
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| QUALIFIED SMALL EMPLOYER HRAS |
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IRS Delays Initial Notice Requirements for QSE HRAs
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Under the 21st Century Cures Act, small employers that want to reimburse individual health coverage premiums through HRAs called "Qualified Small Employer Health Reimbursement Arrangements" (QSE HRAs) must provide annual written notice to all eligible employees no later than 90 days before the beginning of the benefit year.
On February 27, 2017, the Internal Revenue Service (IRS) issued Notice 2017-20 that delays the initial written notice deadline. The Department of the Treasury and the IRS intend to issue guidance to provide employers with additional time to furnish the initial notice to employees; the extended deadline will be no earlier than 90 days following the issuance of future guidance. Further, no penalties will be imposed for failure to provide the initial notice before the extended deadline
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| COMPLIANCE RECAP |
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February 2017
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February had relatively little activity in the employee benefits world because a new Secretary of the Department of Health and Humans (HHS) was recently confirmed and HHS started its rulemaking under the new administration.
On February 10, 2017, the U.S. Senate confirmed Rep. Tom Price as the new Secretary of HHS, who has a budget of more than $1 trillion, the largest budget of any Cabinet secretary. HHS administers the Patient Protection and Affordable Care Act (ACA), Medicare, and Medicaid, and oversees other programs and agencies.
HHS issued its Annual Civil Monetary Penalties Inflation Adjustment to reflect required inflation-related increases to the civil monetary penalties in its regulations. The IRS released a letter that discusses retroactive Medicare coverage's effect on HSA contributions. Also, the IRS announced that it will not automatically reject individual tax returns when the taxpayer failed to indicate continuous coverage, failed to claim an exemption from the individual mandate, or failed to pay the penalty
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CMS Allows States to Extend Life of "Grandmothered" or Transitional Health Insurance Policies
On February 23, 2017, the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets.
States may permit issuers that have renewed policies under the transitional policy continually since 2014 to renew such coverage for a policy year starting on or before October 1, 2018; however, any policies renewed under this transitional policy must not extend past December 31, 2018.
If permitted by applicable state authorities, health insurance issuers may choose to continue certain coverage that would otherwise be cancelled, and affected individuals and small businesses may choose to re-enroll in such coverage.
CMS' Proposed Rule on ACA Market Stabilization
On February 17, 2017, the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to stabilize the health insurance market and address risks to the individual and small group markets. CMS proposes changes to guaranteed availability of coverage, network adequacy, essential community providers, open enrollment periods, special enrollment periods, continuous coverage, and standards for the Exchanges.
The proposed changes primarily affect the individual market. However, to the extent that employers have fully-insured plans, some of the proposed changes will affect those employers' plans because the changes affect standards that apply to issuers.
Public comments are due by March 7, 2017
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Table of Contents
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| HR CORNER |
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USCIS Publishes Updated Guidance on Completing New I-9 Form
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On January 22, 2017, it became mandatory for employers to use the revised version of
Form I-9, the Employment Eligibility Verification Form. U.S. Citizenship and Immigration Services (USCIS) has published the updated M-274,
Handbook for Employers: Guidance for Completing Form I-9, which offers detailed guidance for employers completing Form I-9.
This updated Handbook for Employers additionally:
- Captures policy and regulatory changes since 2013
- Is written in plain language, so that it is easier to understand
- Includes a streamlined questions and answers section
- Features updated tables, new figures, and more current sample documents
- Explains guidance regarding automatic extensions for certain Employment Authorization Documents
I-9s are required for all newly hired and re-hired employees. Employers who violate the law are subject to civil fines, criminal penalties, and debarment from government contracts. Failing to comply with verification requirements carries penalties of up to $2,156 per form.
Changes and updates to Form I-9 include:
- The ability to complete the I-9 electronically
- Instructions on providing email addresses (new to the form)
- Requirements when using a designee to complete the form
- Examples of how to use the "Additional Information" Section
- An extensive new section on Automatic Extensions of Employment (EAD)
- Use of Native American Tribal documents
- Employer responsibilities when providing practical training to STEM OPT students
- Rules on reverification
- How to correct errors
In addition to the Handbook for Employers, the
Table of Changes for Revised M-274
is a quick reference table that highlights all changes to the new form and verification process.
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Office Closure
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All 44North offices will be closing at noon on Friday, April 14th. For emergency assistance, please call 855-306-1099 and a service representative will be happy to assist.
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The information in this newsletter is based on 44North's review of the national healthcare reform legislation and is not intended to impart legal advice. Interpretations of the reform legislation vary, and efforts will be made to present and update accurate information. This overview is intended as an educational tool only and does not replace a more rigorous review of the law's applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. Analysis is ongoing and additional guidance is also anticipated from the Department of Health and Human Services.
Questions or comments? Please email us at
[email protected] .
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Does Your Plan Renew This Month?
DON'T FORGET!
- Due 7 months after the plan year ends.
- SAR, if applicable, is due 2 months later.
Health Plan Related Notices and Disclosures
:
- SPD
- SMM
- SBC
- For full list click here.
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