Chat with us, powered by LiveChat

Monthly Archives: April, 2017

  • Reminder: Certain Small Employer HRAs Now Exempt From ACA’s Market Reforms

    QSEHRAs Must Satisfy Certain Requirements

    As a reminder, a recent law allows certain small employers to offer new “qualified small employer health reimbursement arrangements” (QSEHRAs) to reimburse employees for qualified medical expenses, including individual health insurance premiums.

    Background
    Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits) and HRAs used to purchase coverage on the individual market were considered group health plans that did not comply with certain market reforms of the Affordable Care Act (ACA). As a result, these HRAs were subject to a $100 per day excise tax per applicable employee under the federal tax code.

    The 21st Century Cures Act, which was signed into law in December 2016, exempts so-called QSEHRAs from the ACA’s market reforms.

    QSEHRA Requirements
    To qualify as a QSEHRA, an arrangement generally must:

    • Be funded solely by an eligible employer without salary reduction contributions;
    • Provide, after an eligible employee provides proof of coverage, payment or reimbursement of qualified medical expenses (which generally includes individual health insurance premiums) incurred by the employee or his or her family members;
    • Limit annual payments and reimbursements to $4,950 per employee or $10,000 per family (which are prorated where coverage is less than the entire year); and
    • Be provided on the same terms to all eligible employees.

    Under the law, the term ‘eligible employer’ means an employer that has fewer than 50 full-time equivalent employees and does not offer a group health plan to any of its employees. Therefore, large employers and employers who offer a group health plan must still comply with the prior agency guidance.

    The law defines an ‘eligible employee’ as any employee of an eligible employer. Employers may, however, exclude employees from QSEHRA eligibility who:

    • Have not completed 90 days of service;
    • Have not attained age 25;
    • Are part-time or seasonal;
    • Are covered by certain collective bargaining agreements; or
    • Are nonresident aliens that receive no earned income from sources within the U.S.

    Employer Notice & Reporting Requirements
    While the 21st Century Cures Act requires an employer funding a QSEHRA for any year to provide an initial written notice to each eligible employee that includes certain information about the QSEHRA, the IRS recently announced its intention to issue additional guidance concerning the contents of the notice. Until the issuance of such guidance, employers that provide QSEHRAs for years beginning in 2017 are not required to furnish an initial written notice to eligible employees, and no penalties will be imposed for failure to provide the notice.

    Note that the law also requires an employee’s total permitted benefit for the year to be reported on his or her Form W-2.

    Click here for more information on QSEHRAs from the U.S. Department of Labor.

    Our Health Reimbursement Arrangements section offers additional information about HRAs.

    Health Care Reform Updates provided by:

    Team Nash
    2005 E 2700 St, Suite 140, Salt Lake City, UT, 84109
    385-234-6754

    Please Note: The information and materials herein are provided for general information purposes only and are not intended to constitute legal or other advice or opinions on any specific matters and are not intended to replace the advice of a qualified attorney, plan provider or other professional advisor. This information has been taken from sources which we believe to be reliable, but there is no guarantee as to its accuracy. In accordance with IRS Circular 230, this communication is not intended or written to be used, and cannot be used as or considered a ‘covered opinion’ or other written tax advice and should not be relied upon for any purpose other than its intended purpose.

    The information provided herein is intended solely for the use of our clients and members. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher. Kindly read our Terms of Use and respect our Copyright.

    © 2017 HR 360, Inc. – All rights reserved

    Read more
  • Health Plans for Non-Profits in Utah

    Are you looking for Health Plan options for your Non-Profit? We can help! As a Boutique Insurance Agency, we will find the right plan that fits your organizations needs. Contact us today at https://www.nashinsurance.com/contact/

    Read more
  • ACA’s ‘Essential Health Benefits’ Explained

    Requirements Generally Apply to Plans Offered in Individual and Small Group Markets

    Under the Affordable Care Act (ACA) and its corresponding regulations, non-grandfathered health plans offered in the individual and small group health insurance markets are generally required to cover a core package of items and services known as “essential health benefits.” (This requirement does not apply to self-insured plans or plans offered in the large group market.)

    Essential health benefits must include items and services in the following ten benefit categories:

    1.    Ambulatory patient services;
    2.    Emergency services;
    3.    Hospitalization;
    4.    Maternity and newborn care;
    5.    Mental health and substance use disorder services, including behavioral health treatment;
    6.    Prescription drugs;
    7.    Rehabilitative and habilitative services and devices;
    8.    Laboratory services;
    9.    Preventive and wellness services and chronic disease management; and
    10.  Pediatric services, including oral and vision care.

    The essential health benefits must be equal in scope to benefits offered by a “typical employer health plan.” A final rule issued by the U.S. Department of Health and Human Services defines essential health benefits based on state-specific essential health benefits benchmark plans, and provides that all plans subject to the essential health benefits requirements offer benefits substantially equal to the benefits offered by the benchmark plan. For more information on EHB-benchmark plans for each of the 50 states and D.C., click here.

    Note: If allowed by a particular state and insurance company, a small business may be able to renew its current group plan through December 31, 2018, even though the coverage does not comply with the requirement to cover essential health benefits.

    Click here for more information on essential health benefits.

    Visit our ACA by Year & Company Size section for an overview of other ACA requirements.

    Health Care Reform Updates provided by:

    Team Nash
    2005 E 2700 St, Suite 140, Salt Lake City, UT, 84109
    385-234-6754

    Please Note: The information and materials herein are provided for general information purposes only and are not intended to constitute legal or other advice or opinions on any specific matters and are not intended to replace the advice of a qualified attorney, plan provider or other professional advisor. This information has been taken from sources which we believe to be reliable, but there is no guarantee as to its accuracy. In accordance with IRS Circular 230, this communication is not intended or written to be used, and cannot be used as or considered a ‘covered opinion’ or other written tax advice and should not be relied upon for any purpose other than its intended purpose.

    The information provided herein is intended solely for the use of our clients and members. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher. Kindly read our Terms of Use and respect our Copyright.

    © 2017 HR 360, Inc. – All rights reserved

    Read more
  • Spring is in Salt Lake City

    New flowers, sunshine, and great opportunities for business growth are here. If you’d like to find the perfect insurance fit for your employees, we can help! Get in touch for a free quote by calling 800-653-6129 today.

    Read more