Tag Archives: mandate

IRS Releases Official PPACA Delay Regulations

hazen desk

From the desk of Alex Renfro.

 

The IRS very recently released IRS Notice 2013-45. This notice does not quantify, but instead puts in formalized fashion the delay of the IRC Sec. 4980H(a) penalties, otherwise known as the employer mandates. This notice does not add much more than the IRS’ original blog post from July 2. There is no legal justification for how the federal government may enact this delay, and there is no authority that they call on other than assuming that they can enact this delay by fiat. While interesting from a Constitutional perspective, more to the point, the title of this notice is “Transition Relief for 2014,” and that is very key.

There have been other transitional relief provisions released by the IRS with regards to the Affordable Care Act for 2014. With the title of this one being “Transition Relief for 2014,” it seems to be the case that the prior transitional relief statutes and regulations are no longer in effect – they have been supplanted by this notice. That means that while there have been some employers who did not have to comply on January 1 because they were going to change their plans on their insurance renewal date, they will not be able to do that anymore. Instead, by January 1, 2015, all employers must comply.

Also, I have noticed in these regulations an assumption by the IRS: Employers will continue to plan as normal in 2014. It is a bit subtle, but what the IRS states is that the purpose of this delay is not to cease having a health plan in 2014 for newly eligible employees. The purpose is to create that health plan, but do so without worry that the plan you are creating may not have minimum essential coverage or that the plan may not be qualified and affordable. Employers have some freedom from the excise taxes, but they are still expected to be in compliance. If an employer is not in compliance, further consequences of failing to have a plan in 2014 will ensue, and the government is not going to be sympathetic to your realization of those consequences. Your delay is resulting in your consequences, by their logic.

With that said, the government is expecting employers to continue looking for health care options to offer their employees in 2014, and I think that is very important to note as their official stance. They are not expecting employers to take a year off, they are not expecting them to not have plans in place by 2014; the only thing they are expecting to occur is the employers find a plan in 2014, but not perform self-reporting on their non-compliance until 2015, which is very different than what a lot of employers may be thinking. The government does not intend these delays to also mean a delay in offering coverage.

Now, that is the official line in these regulations. Of course, if employers do delay in creating plans, that means more people will enroll in state exchanges, which is very good for the health of such exchanges. More people enrolled means a higher spread of risk, or a greater risk diversification, which benefits the exchanges. It is thus somewhat debatable whether the federal government actually believes people will delay in creating a plan or not, but they do stand to benefit by employers delaying. Employers do not benefit by delaying because of a number of other issues we will touch on in future blog posts. Information is also available through our webinars, brochures and proposals as to what could be the danger in delaying in 2014.

IRS Releases Official PPACA Delay Regulations

hazen desk

From the desk of Alex Renfro

The IRS very recently released IRS Notice 2013-45. This notice does not quantify, but instead puts in formalized fashion the delay of the IRC Sec. 4980H(a) penalties, otherwise known as the employer mandates. This notice does not add much more than the IRS’ original blog post from July 2. There is no legal justification for how the federal government may enact this delay, and there is no authority that they call on other than assuming that they can enact this delay by fiat. While interesting from a Constitutional perspective, more to the point, the title of this notice is “Transition Relief for 2014,” and that is very key.

There have been other transitional relief provisions released by the IRS with regards to the Affordable Care Act for 2014. With the title of this one being “Transition Relief for 2014,” it seems to be the case that the prior transitional relief statutes and regulations are no longer in effect – they have been supplanted by this notice. That means that while there have been some employers who did not have to comply on January 1 because they were going to change their plans on their insurance renewal date, they will not be able to do that anymore. Instead, by January 1, 2015, all employers must comply.

Also, I have noticed in these regulations an assumption by the IRS: Employers will continue to plan as normal in 2014. It is a bit subtle, but what the IRS states is that the purpose of this delay is not to cease having a health plan in 2014 for newly eligible employees. The purpose is to create that health plan, but do so without worry that the plan you are creating may not have minimum essential coverage or that the plan may not be qualified and affordable. Employers have some freedom from the excise taxes, but they are still expected to be in compliance. If an employer is not in compliance, further consequences of failing to have a plan in 2014 will ensue, and the government is not going to be sympathetic to your realization of those consequences. Your delay is resulting in your consequences, by their logic.

With that said, the government is expecting employers to continue looking for health care options to offer their employees in 2014, and I think that is very important to note as their official stance. They are not expecting employers to take a year off, they are not expecting them to not have plans in place by 2014; the only thing they are expecting to occur is the employers find a plan in 2014, but not perform self-reporting on their non-compliance until 2015, which is very different than what a lot of employers may be thinking. The government does not intend these delays to also mean a delay in offering coverage.

Now, that is the official line in these regulations. Of course, if employers do delay in creating plans, that means more people will enroll in state exchanges, which is very good for the health of such exchanges. More people enrolled means a higher spread of risk, or a greater risk diversification, which benefits the exchanges. It is thus somewhat debatable whether the federal government actually believes people will delay in creating a plan or not, but they do stand to benefit by employers delaying. Employers do not benefit by delaying because of a number of other issues we will touch on in future blog posts. Information is also available through our webinars, brochures and proposals as to what could be the danger in delaying in 2014.

ENROLLMENT FIRST, INC. & RATLIFF LAW FIRM PARTNER TO BRING WELLMEC, THE SEAMLESS COMPLIANCE SOLUTION TO HEALTH CARE REFORM & THE AFFORDABLE CARE ACT, TO THE MARKETPLACE

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Knoxville, Tennessee (PRWEB) July 26, 2013

WellMEC, the new solution to the Affordable Care Act, is now available to employers in all fifty states.Enrollment First, Inc. and Ratliff Law Firm ERISA and tax attorneys, Eric Ratliff and Alex Renfro, together have created the exclusive solution to health care reform that eliminates compliance challenges created by the Affordable Care Act.

The Affordable Care Act continues to be in a state of flux, spawning a multitude of new rules and regulations that enterprises must comply with or face significant financial penalties. “We are excited to be able to pick up the pieces and exclusively bring the solution to the marketplace for business owners and corporations alike,” said Enrollment First Founder and President Hazen Mirts. “It’s been a long time coming, but after much evaluation and brainstorming between my team and the ERISA and tax attorneys, our solution is ready now and it eliminates the challenges of complying with the ACA now, in 2014, and beyond.”

WellMEC, officially available in July 2013, is a minimum essential coverage, self-insurance plan with reinsurance and covers all wellness and preventive services. The plan provides audit protection through automatic enrollment for new employees and includes a PPO Network. Employees can also elect to participate in WellMEC+, the minimum value plan that satisfies the unaffordable plan penalty, as well as a hospital indemnity plan.

WellMEC eliminates the challenges created by the ACA by providing employers with complete visibility and control over their health benefits while also managing the entire process for them, making it a total turn-key solution all under one roof. One of the most urgent challenges employers are facing is the fast-approaching October 1, 2013 deadline that requires by law written communication and education of their health plan and the existence of an exchange to all full time employees prior to October 1, 2013! The WellMEC compliance system manages exchange communications for employers, creating and delivering communications privately labeled to their business to all employees, all the while certifying plan documents to be compliant and taking care of benefit plan development, billing, eligibility, and enrollments.

“Employees can call and get answers to their health care questions from trained agents that are right here in the US,” said Mirts. “Not only that, but we also assist employees in filling out applications to the exchange to make sure they are completed properly – and to protect employers from steep excise taxes that are not tax deductible they would otherwise pay due to employees qualifying for subsidies.”

The penalties Mirts mentioned are steep, indeed. If an employer is subject to the penalty and fails to offer any full-time employee health coverage, and if any full-time employee enrolls in the exchange and receives a tax subsidy to purchase coverage, the employer is subject to a penalty equal to the number of the business’ full-time employees, minus 30, times $2,000 per year. If an employer offers its employees health insurance, but that coverage does not provide a “minimum value” as required by the law, or if the employee’s contribution for self-only coverage is greater than 9.5% of the employee’s household income, the employee is eligible to receive a tax subsidy to purchase coverage through the exchange. The employer must pay a penalty tax of $3,000 per year for each of these employees.

“These regulations have not been employer-friendly,” said Renfro.

In addition to paying a steep price for employees that qualify for a subsidy, those employees automatically become whistle-blowers under OSHA protection. This means that if employers treat them any differently, they could face a class-action lawsuit. What’s worse is that employers won’t find out which employees qualify for subsidies until January 1, 2015.

“These taxes and mandates have been the driving force behind the creation of WellMEC,” said Mirts. “Renfro is right; none of these regulations have been beneficial for employers and ultimately our economy. Thankfully, we’ve built a solution that helps employers attract, retain and motivate employees to stay, and stay healthy.”

For more information on WellMEC or Enrollment First, Inc., visit http://www.wellmec.net or http://www.enroll1st.com.

WellMEC is protected by patent pending. ID 16202001.