Posted on October 9, 2014
Guidance issued by the Centers for Medicare and Medicaid Services (CMS) advises states that that their capitated payment rates for Medicaid managed care plans should cover the costs of the Affordable Care Act’s (ACA) health insurance tax, as it is considered a “reasonable business cost.” The tax starts at $8 billion in 2014 and increases every year, up to $14.3 billion in 2018. Starting in 2019, the amount of the tax will increase annually based on premium trends. CMS contends that this fee is not unlike other taxes and fees that actuaries must take into account when developing capitation rates.
Posted on September 19, 2014
The Internal Revenue Service (IRS) finalized a half-million-dollar cap on deductions that the biggest insurance companies can take for executive pay. This final rule will affect certain health insurance providers giving remuneration that exceeds the deduction limitation. According to a recent analysis, the little-known Affordable Care Act (ACA) provision amounted to about $1.3 million per executive for the largest insurers in 2013. The rule details what companies and employees are subject to the limit and how it should be applied.
Posted on August 29, 2014
The Internal Revenue Service (IRS) posted a set of draft instructions to accompany the employer mandate and exchange filing forms released last month. The instructions are directed at marketplaces that have to report enrollees in qualified health plans, as well as employers and others that provide minimum essential coverage or are subject to the employer mandate.
Posted on May 1, 2014
A report issued by S&P Capital IQ found that if publicly traded companies drop employer-sponsored insurance (ESI) benefits by 2020, they could save more than $700 billion by 2025. The report, released earlier today, said that these companies would save substantially by paying the Affordable Care Act’s (ACA’s) penalty rather than paying premium contributions and other costs associated with offering ESI. The authors postulate that once several notable companies elect to no longer offer ESI, many others will follow suit, leading to potentially 90% of major corporation employees receiving ACA Marketplace coverage by 2020.
Posted on March 6, 2014
A final rule released by the Internal Revenue Service (IRS) addresses the reporting requirements for large employers under the Affordable Care Act (ACA). Beginning in 2015, employers with more than 50 full-time employees are required to offer quality and affordable insurance to their employees. The new rule provides a methodology designed to simplify and reduce the costs associated with the employer reporting requirements mandated under the ACA. Another final rule issued by the IRS describes how issuers of minimum essential coverage are expected to report information to the IRS on the type and duration of coverage.
Posted on February 11, 2014
A new rule issued by the Internal Revenue Service (IRS) addresses several components of the employer shared responsibility provisions within the Affordable Care Act (ACA). The rule further delays the employer shared responsibility payment for medium-sized businesses (50-100 employees) until 2016. Large employers will be able to phase in the percentage of full-time employees to whom they must provide health insurance, starting with 70% in 2015 and moving to 95% by 2016. IRS also released a fact sheet to accompany this rule. Additionally, this rule stated that teachers cannot be considered part-time employees because many do not work a full summer schedule.
Posted on January 27, 2014
The US Department of Health and Human Services (HHS) updated the federal poverty level (FPL) guidelines for 2014. The guidelines, which are slightly higher than the 2013 levels, will not impact the eligibility thresholds used to determine subsidy eligibility for health insurance enrollment for 2014. For an individual, the the FPL is now set at $11,670, which represents a 1.6% increase from 2013.
Update: Proposed IRS Procedures for Tax-Exempt Hospitals to Correct and Disclose Failures to Meet Their Community Benefit Obligations Under the Internal Revenue Code
Posted on January 13, 2014
In order to be exempt from federal income taxes, nonprofit hospitals seeking such a designation under the Internal Revenue Code must provide a community benefit, a policy that has been in place since 1969 but that has gone essentially unenforced since its creation by the Nixon Administration. Government estimates of the value of nonprofit hospital tax-exemption placed the total national value at more than $12 billion in 2002, a figure that undoubtedly has grown over the past decade and that reflects both federal tax losses and losses resulting from the fact that most states and localities use federal law to determine exemption from state and local property, sales, and income taxes…
Posted on December 31, 2013
A new rule released by the Internal Revenue Service (IRS) states that nonprofit hospitals failing to satisfy many of the new standards under the Affordable Care Act (ACA) will not lose their tax-exempt status, as long as the shortcomings were not “willful” or “egregious.” Under the ACA, nonprofit hospitals are expected to perform Community Health Needs Assessments, and then work towards implementing these findings in their communities. This proposed rule permits a nonprofit hospital failing to meet these and other standards to discuss the situation with the IRS and therefore not immediately lose tax-exempt status.
Posted on December 30, 2013
A draft rule released by the Internal Revenue Service (IRS) states that not-for-profit hospitals are no longer permitted to count local community benefit services funded by grant revenue when reporting these activities for tax exemptions. In order for non-federal hospitals to receive tax exemptions, these hospitals are required to perform and document their community benefit efforts, such as health-education or free healthcare services, on their Schedule H form. Proponents of the rule state that this change will increase transparency in how community benefit activities are funded, as well as level the playing field for teaching and non-teaching hospitals, who sometimes receive disparate amounts of grant funding.