Embedded Individual Out of Pocket Limits

in Affordable Care Act, Health Benefits

The Departments confirmed yesterday what we had suspected all along - that recently issued HHS guidance regarding the application of the self-only maximum annual out of pocket limitation to those who enroll under family coverage also applies to self-insured plans. Click here for the DOL Guidance.  Plan sponsors should confirm that, starting for plan years beginning in 2016, that the individual out of pocket limitation applies individually to each person enrolled in family coverage (or...Continue Reading

IRS Issues Additional Reporting Guidance

in Health Benefits, Tax Issues

The IRS has recently released questions (and answers) with respect to some thorny 6055/6056 reporting issues.

The IRS updated some of its FAQs relating to an employer’s reporting requirements under Code Section 6056.  Click here for 6056 Reporting FAQs.  Although the reporting rules are complex, employers struggling to master the details will be relieved to hear that the IRS will not impose penalties for incomplete or incorrect forms provided to employees in 2016, provided that the...Continue Reading

New Preventive Care FAQs Contain Some Surprises

in Affordable Care Act, Health Benefits

New Affordable Care Act FAQs (Part XXVI, for those keeping track) were issued on May 11, 2015, addressing preventive care coverage.  Employers may be particularly interested in the guidance provided for coverage of contraceptives.

In particular, the FDA has identified 18 specific methods of contraception, and at least one type within each of these 18 methods that must be covered with no cost-sharing.  For example, simply providing coverage for one type of hormonal contraception at no cost...Continue Reading