ACA News and Publications

A complete archive of our ACA news and publications.

2013

ACA Pathways: IRS Issues Proposed Rules on Employer Reporting of Health Plan Coverage

September 11, 2013 - On September 5, 2013, the Internal Revenue Service (IRS) released two proposed rules on the Affordable Care Act (ACA)'s requirements for certain employers to provide information to the IRS and to covered individuals about the health plan coverage they offer (or do not offer) to their employees. These reporting requirements, found in Internal Revenue Code sections 6055 and 6056, are intended to provide the IRS with information to administer other ACA requirements - in particular, the employer and individual mandates. Read more

ACA Pathways: IRS Issues Final Rules on Individual Mandate Penalties

September 4, 2013 - Beginning in 2014, the Affordable Care Act (ACA) requires most individuals to obtain acceptable health insurance coverage for themselves and their family members or pay a penalty. This rule is often referred to as the "individual mandate." Individuals may be eligible for an exemption from the penalty in certain circumstances. Read more

ACA Pathways: Agencies Issue Final Regulations on Contraceptive Coverage and Religious Organizations

July 11, 2013 - The Department of Health and Human Services, Department of Labor and Department of U.S. Treasury (collectively, the "Agencies") recently published final rules regarding the requirement under the Patient Protection and Affordable Care Act ("Affordable Care Act") to cover certain contraceptive services. Read more

ACA Pathways: IRS Issues Transitional Relief for 2014 for Employer Reporting of Health Plan Coverage and Employer Shared Responsibility Provisions of The Affordable Care Act

July 10, 2013 - On July 2, 2013, the Treasury Department announced that it will delay enforcement of the Affordable Care Act (ACA)'s employer shared responsibility (play or pay) provisions, as well as provide large employers with an additional year to comply with the health plan reporting requirements under Internal Revenue Code (Code) Sections 6055 and 6056. Read more

Employer Mandate Penalties Delayed Until 2015

July 3, 2013 - The Obama Administration has postponed the Affordable Care Act (ACA) employer mandate penalties for one year, until 2015. The Department of the Treasury announced the delay on July 2, 2013, along with a similar delay for information reporting by employers, health insurance issuers and self-funded plan sponsors. Read more

Health Care Reform Update - Covered California Announces Health Plan Offerings for 2014

May 30, 2013 - On May 23, 2013, the State of California health insurance marketplace, known as Covered California, announced its 2014 health care plan offerings and preliminary rates for the individual market.   Read more

Health Care Reform Update: DOL Issues Model Exchange Notice and Updates Cobra Election Notice

May 2013 - Beginning Jan. 1, 2014, individuals and employees of small businesses will have access to insurance coverage through the Affordable Care Act's (ACA) health insurance exchanges (Exchanges). Open enrollment under the Exchanges will begin on Oct. 1, 2013. ACA requires employers to provide all new hires and current employees with a written notice about ACA's Exchanges. Read more

IRS Proposed Regulations: More Guidance to Determine Minimum Value and Affordability Requirements for Wellness Programs, and HRA and HSA Contributions

May 2013 - Proposed regulations by the Department of the Treasury were published on May 3, 2013 that included additional guidance to assist employers in determining whether the health coverage they offer their employees provides "minimum value." Read more

The Pay-or-Play Provisions and Financial Analysis

April 2013 - The "pay-or-play" provisions under Section 4980H of the Internal Revenue Code – as added by the Affordable Care Act (ACA), the law that introduces sweeping health care reform for the nation – become effective as early as January 1, 2014. Read more

Health Care Reform - Exchange Notice Requirements Delayed

January 2013 - The Affordable Care Act (ACA) requires employers to provide all new hires and current employees with a written notice about ACA's health insurance exchanges (Exchanges), effective March 1, 2013. Read more

Summary of Benefits and Coverage (SBC) Questions and Answers

January 2013 - The Summary of Benefits and Coverage (SBC) provision of the Patient Protection and Affordable Care Act is one of the health care reform mandates taking effect in 2013. Here, Burnham Benefits answers critical questions about the provision and gives guidance on SBC compliance, including specific information for California empoyers. For more information, contact your Burnham Benefits representative. Read more


2012

Proposed Reinsurance Fees Will Cost Group Health Plans

December 2012 - The Affordable Care Act (ACA) established three risk‐spreading programs to provide payments to health insurance issuers that cover higher‐risk populations and to more evenly spread the financial risk carried by issuers. These programs, which will be effective in 2014, are a transitional reinsurance program, a temporary risk corridor program and a permanent risk adjustment program. Read more

Understanding the 3.8% Tax

November 2012 - You might expect the kind of information in this Pathways document to be communicated to you by your tax advisor, but as your valued advisor we wanted to be certain that you were made aware of the existence of the new 3.8% tax on particular investment incomes, as well as the 0.9% increase on Medicare tax imposed on high income individuals and households. Read more

Burnham's Guide to Post‐Election Health Care Reform

November 2012 - The polls have closed and the results are in.... Like it or not, health care reform is here to stay. Following the conclusion of the election, many of our clients have approached us and asked "what's next?" or "what do we need to do now to be in compliance?" If you have embraced the wait‐and‐see approach in regard to your health care reform planning, you are not alone. But now, it's time to act. Read more

IRS Issues New Guidance on Employer Penalties

October 2012 - Beginning in 2014, large employers may face penalties if they do not offer any health coverage to full‐time employees, or if they offer health coverage that is unaffordable or does not provide minimum value. The penalty is known as a "shared responsibility payment," and is triggered if one of the employer's full‐time employees receives a premium tax credit or cost sharing reduction for coverage obtained through a health insurance exchange. Read more

Health Care Reform – Important Guidance for Medical Loss Ratio Rebates

August 2012 - The Affordable Care Act's medical loss ratio (MLR) rules mandate that health insurance carriers report how they spend their premium revenue to the Department of Health and Human Services (HHS). In addition, carriers that do not spend at least 80 percent (small group) or 85 percent (large group) of their premium revenue on reimbursement for clinical services and health care quality improvement must provide rebates to consumers beginning in 2012. Read more

Health Care Reform – U.S. Supreme Court Upholds Constitutionality of Entire Act

June 2012 - As we review today’s U.S. Supreme Court’s landmark decision upholding the constitutionality of the Patient Protection and Affordable Care Act (PPACA) (aka Health Care Reform), that statement from Benjamin Franklin describes the Court’s ruling in a nutshell. On the biggest issue, the constitutionality of the individual mandate, the Court, in upholding the mandate, said that the penalty for not carrying insurance is a tax and therefore falls within Congress’ taxing power. Read more

Health Care Reform: Important Guidance for Non-Calendar Year Health FSA Plans

June 2012 - The Affordable Care Act (ACA) imposes a $2,500 limit on salary reduction contributions to a health flexible spending account (FSA) offered under a cafeteria plan. This limit is applicable to grandfathered and non-grandfathered health FSAs. ACA provides that this change is effective for taxable years beginning after Dec. 31, 2012. The $2,500 limit will be indexed for cost-of-living adjustments for 2014 and later years. Read more

Health Care Reform: Comparative Effectiveness Research Fees

May 2012 - The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (Institute) to help patients, clinicians, payers and the public make informed health decisions by advancing comparative effectiveness research. The Institute’s research is to be funded, in part, by fees paid by health insurance issuers and sponsors of self-insured health plans. Read more

Health Care Reform: Final Guidance on Summary of Benefits and Coverage (SBC)

February 2012 - The Patient Protection and Affordable Care Act (PPACA) requires health plans and health insurance issuers to provide a summary of benefits and coverage (SBC) to applicants and enrollees. Both non‐grandfathered and grandfathered plans will need to provide the SBC. Read more


2011

Health Care Reform: Preventive Care Guidelines for Women

August 2011 - The Patient Protection and Affordable Care Act (PPACA) requires non-grandfathered health plans to cover preventive health services without imposing cost-sharing requirements for the services. PPACA’s preventive care mandate is generally effective for plan years beginning on or after Sept. 23, 2010. Read more

Cafeteria Plan Amendment – OTC Drugs and Medicines

June 2011 - As previously reported, beginning January 1, 2011, expenses incurred for medicines or drugs may be reimbursed from a health care flexible spending arrangement (FSA), health savings account (HSA), Archer medical savings account (Archer MSA) or health reimbursement arrangement (HRA) only if the medicine or drug requires a prescription, the drug is available over-the-counter but the individual obtains a prescription, or the drug is insulin. Read more

Health Care Reform: Form W‐2 Reporting Requirements Published

April 2011 - The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of employer‐ sponsored group health plan coverage on their employees’ Forms W‐2. The purpose of the reporting requirement is to provide information to employees regarding how much their health coverage costs. Read more

California State Tax Issue – Up to Age 26 Coverage

April 2011 - On April 7, 2011, California Governor Brown signed Assembly Bill (AB 36) which conforms California state law with federal law to allow tax exclusions or deductions for employers providing health care coverage to dependents under age 27. The bill offers relief from imputing state income back to March 30, 2010, which is the date on which federal tax laws changed to waive dependency requirements for children up to age 26. Please see the attached reprint of our November 19, 2010 HCR Pathways which discussed this issue in greater detail. Read more

California State Tax Issue – Up to Age 26 Coverage Will It Stay or Will It Go?

March 2011 - On November 19, 2010, Burnham Benefits addressed the California taxation issue in an HCR Pathways document. As we sit here today, the issue still exists. However, California Assembly Bill 36 (AB36), which will bring state income taxes into line with federal changes under the PPACA, is currently pending and moving through the California legislature at a rapid pace. Read more

Important Health Care Reform Legislative Update - House of Representatives Passes Legislation to Repeal PPACA

January 2011 - On January 19, 2011, members of the House of Representatives passed a bill by a vote of 245‐189 to repeal the health care reform legislation, also known as the Patient Protection and Affordable Care Act (PPACA). Three Democrats joined the House’s 242 Republicans in unanimously supporting the bill. Read more


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