Bulletins

    Employers must follow guidelines when issuing 2022 MLR rebates

    Area insurers (carriers) are beginning to issue 2022 plan year medical loss ratio (MLR) rebates. The Affordable Care Act requires insurers to meet MLR requirements each year. If an insurer doesn’t meet the minimum MLR (spend 80 to 85 percent of its premium dollars on health care or activities that...

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    IRS lowers 2024 ACA affordability rate to 8.39%

    The IRS recently issued Revenue Procedure 2023-29, lowering the affordability threshold for the 2024 calendar year to 8.39% of annual household income from the 2023 threshold of 9.12%. The threshold is the lowest in the history of the Affordable Care Act (ACA).

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    Federal judge strikes down some ACA preventive care requirements

    Since the 2010 passage of the Affordable Care Act (ACA), non-grandfathered health plans and health insurers have been required to provide most preventive care services with no cost sharing. Last Thursday a Texas federal judge ruled that employers cannot be required to provide specific preventive...

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    Medicaid eligibility review will cause millions to lose coverage

    The Families First Coronavirus Response Act (FFCRA), adopted in March 2020, provided a package of relief programs to help individuals and families affected by the COVID-19 public health emergency.

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    IRS to require e-filing for most employers

    Starting in January 2024, a new IRS final rule will require information returns of 10 or more be filed electronically, eliminating the option for most smaller organizations to submit returns by mail. For decades, and through the end of the 2023 calendar year, the threshold requiring an entity to...

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    Employers have option to amend cafeteria plan allowing mid-year plan change for employees eligible for premium tax credits

    In concert with the recently released IRS final rule, allowing more families to receive premium tax credits (PTCs) through Healthcare.gov, the IRS released Notice 2022-41. The notice allows employers to modify cafeteria plan rules to allow mid-year plan changes when an employee’s household is...

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    IRS addresses family glitch affecting premium tax credit eligibility

    Since our August update on a proposed IRS rule, a final rule was released that eliminates the long- criticized “family glitch” in the Affordable Care Act (ACA). Prior to the new rule, family eligibility for premium tax credits (PTCs) through Healthcare.gov was based on the cost of coverage for an...

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    IRS lowers ACA affordability rate for 2023

    The IRS recently issued Revenue Procedure 2022-34, lowering the affordability threshold for the 2023 calendar year to 9.12% of annual household income from the 2022 threshold of 9.61%. This percentage is used to determine an individual’s eligibility for a premium tax credit (PTC) through...

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    IRS to lower 2022 ACA affordability rate

    The IRS recently issued Revenue Procedure 2021-36, lowering the affordability threshold for the 2022 calendar year to 9.61% of household income from the 2021 threshold of 9.83%. This percentage is used to determine an individual’s eligibility for a premium tax credit and the affordability of...

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    Annual CMS Notice due October 15

    Employers have an annual obligation to issue a creditable or non-creditable coverage notice to all plan participants who are Medicare eligible, including dependents and retirees. The notice, due October 15, informs Medicare-eligible participants whether their prescription drug coverage is at least...

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