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Workplace Wellness Programs

February 9, 2015

The ACA creates new incentives to promote employer wellness programs and encourage employers to take more opportunities to support healthier workplaces. Health-contingent wellness programs generally require individuals to meet a specific standard related to their health to obtain a reward, such as programs that provide a reward to employees who don’t use, or decrease their […]

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90-Day Maximum Waiting Period

February 9, 2015

As of January 1, 2014, individuals who are eligible for health coverage will not have to wait more than 90 days to begin coverage. HHS, IRS, and the Department of Labor have issued final rules on how employers should apply the 90-day rule.

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Medicare Assessment on Net Investment Income

February 9, 2015

As of January 2013, a 3.8% tax will be assessed on net investment income such as taxable capital gains, dividends, rents, royalties, and interest for taxpayers with Modified Adjusted Gross Income (MAGI) over $200,000 for single filers and $250,000 for married joint filers. Common types of income that are not investment income are wages, unemployment […]

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Additional Medicare Withholding on Wages

February 9, 2015

As of January 2013, ACA increased the employee portion of the Medicare Part A Hospital Insurance (HI) withholdings by .9% (from 1.45% to 2.35%) on employees with incomes of over $200,000 for single filers and $250,000 for married joint filers. It is the employer’s obligation to withhold this additional tax, which applies only to wages […]

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Limits on Flexible Spending Account Contributions

February 9, 2015

As of January 2013, the maximum amount an employee may elect to contribute to health care flexible spending arrangements (health FSAs) for any year will be capped at $2500, subject to cost-of-living adjustments. Note that the limit only applies to elective employee contributions and does not extend to employer contributions. To learn more about FSA […]

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W-2 Reporting of Aggregate Health Care Costs

February 9, 2015

As of January 2013, most employers must report the aggregate annual cost of employer-provided coverage for each employee on the Form W-2. The W-2 reporting requirement is informational only and it does not require taxation on any health plan coverage. Reporting is required for most employer-sponsored health coverage, including group medical coverage. Small Employer Exception: […]

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Medical Loss Ratio Rebates

February 9, 2015

Under ACA, insurance companies must spend at least 80% of premium dollars on medical care rather than administrative costs. Insurers who do not meet this ratio are required to provide rebates to their policyholders, which is typically an employer who provides a group health plan. Employers who receive these premium rebates must determine whether the […]

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Summary of Benefits and Coverage (SBCs) Disclosure Rules

February 9, 2015

Employers are required by the ACA to provide employees with a standard Summary of Benefits and Coverage form explaining what their plan covers and what it costs. The purpose of the SBC form is to help employees better understand and evaluate their health insurance options. Penalties may be imposed for non-compliance. The Department of Labor […]

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Employer Notification of the New Health Insurance Marketplace

February 9, 2015

All employers covered by the Fair Labor Standards Act (generally, those firms that have at least one employee and at least $500,000 in annual dollar volume of business), must provide notification to their employees about the new health insurance Marketplace. This notice must have been given to all current employees by October 1st 2013, and […]

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New Health Insurance Coverage Reporting Requirements

February 9, 2015

Effective in 2015, the ACA requires that employers with 50 or more full-time (or full-time equivalent) employees submit informational reports to the IRS regarding the health coverage they offer to their full-time employees (known as Section 6056 rules). New information reporting by issuers, self-insuring employers, and other parties that provide health coverage also took effect […]

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