The Patient Protection and Affordable Care Act added Section 18B to the Fair Labor Standards Act, which requires employers to provide all new hires and current employees with a notice explaining the existence of Exchanges, as well as the potential consequences if an employee purchases a qualified health plan through an Exchange instead of electing […]

On December 5, 2012, the Internal Revenue Service (“IRS”) issued final regulations implementing the annual fee imposed by the Patient Protection and Affordable Care Act of 2010 (“PPACA”) to fund the Patient—Centered Outcomes Research Trust Fund (the “PCORI” fee). In our September 2012 issue, we discussed the proposed regulations on this topic, explained which plans […]

Last month, Trucker Huss reported on the transitional reinsurance program established under the Patient Protection and Affordable Care Act (“PPACA”). This is a temporary reinsurance program for the individual market that will be in operation for years 2014 through 2016. The goal of the transitional reinsurance program is to help stabilize premium coverage in the […]

On November 20, 2012, the Departments of Treasury, Labor and Health and Human Services, released proposed regulations on incentives for nondiscriminatory wellness programs in group health plans as provided for under the Patient Protection and Affordable Care Act of 2010 (“PPACA”). These proposed regulations would apply to both grandfathered and non-grandfathered group health plans for […]

The Patient Protection and Affordable Care Act (“PPACA”) requires that a public health insurance exchange (“Exchange”) be available in every state by January 1, 2014. These Exchanges will offer health coverage to individuals starting in 2014—and no individual can be precluded from enrolling in coverage due to a preexisting condition. Given that individuals are required […]

On November 20, 2012, the Department of Health and Human Services (“HHS”) issued the first major post-election guidance under the Patient Protection and Affordable Care Act (“PPACA”). The proposed regulations address two important issues facing employers that sponsor group health plans: Essential Health Benefits (“EHB”); and Minimum Value ESSENTIAL HEALTH BENEFITS General Rule First, an […]

The Additional Medicare Tax under section 9015 of the Patient Protection and Affordable Care Act takes effect January 1, 2013. Individuals will have to pay this 0.9 percent tax on any amounts that are both currently subject to the Medicare Tax and exceed certain thresholds. Employers, though not themselves responsible for paying the tax, must, […]

In August, the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (the “Departments”), issued guidance on how to determine full-time employee status for purposes of the employer shared responsibility provisions (sometimes referred to as the “pay or play” provisions) of the Patient Protection and Affordable Care Act […]

On April 17, 2012, the Internal Revenue Service issued proposed regulations implementing the annual fee imposed by the Patient Protection and Affordable Care Act of 2010 (“PPACA”) on health insurance issuers and plan sponsors to fund the Patient-Centered Outcomes Research Trust Fund(the “PCOR Fund”). According to the proposed regulations, health insurance issuers and sponsors of […]

What are Medical Loss Ratios? The Patient Protection and Affordable Care Act added a new Section 2718 to the Public Health Service Act that requires health insurance issuers to report how they spend premium dollars, and requires that insurers spend a minimum percentage of premiums on health care services and quality improvement activities. Insurers in […]

This article provides a list of issues that employers should consider when preparing for compliance with the various provisions of the Patient Protection and Affordable Care Act (“PPACA”). This article is not a technical explanation of the provisions; rather it lists some interesting issues that should be noted by employers, which may not be obvious […]

On June 28, 2012, the United States Supreme Court issued its long awaited and intensely debated decision on the constitutionality of the Patient Protection and Affordable Care Act (the “Affordable Care Act” or “Act”). Given the extensive media coverage, most are likely aware that, with the exception of a portion of the Medicaid expansion provisions, […]

On March 19, 2012, the Departments of Labor, Treasury, and Health and Human Services (the “Departments”) issued a new set of FAQs (the FAQs about Affordable Care Act Implementation, Part VIII) providing guidance on the requirement to furnish Summaries of Benefits and Coverage (“SBC”). These FAQs help address questions that were raised following the issuance […]

Over a period of three days, from March 26 through March 28, 2012, the United States Supreme Court heard a historic series of oral arguments addressing the constitutionality of the Patient Protection and Affordable Care Act (the “Act”). The Court addressed the following issues which are discussed briefly below: Does the Court have jurisdiction to […]

Final Regulations Issued for the Summary of Benefits and Coverage, Uniform Glossary and Notice of Modification Required Under the Patient Protection and Affordable Care Act On February 14, 2012, the Departments of Labor, Health and Human Services (“HHS”), and the Treasury (the “Agencies”) published final regulations related to Public Health Service Act section 2715(d) (4) […]