Tiffany N. Santos

Final HRA Regulations Issued – Key Highlights

TIFFANY N. SANTOS, July, 2019    On June 13, 2019, the Departments of Labor, Health and Human Services and the Treasury (the “Departments”) released final regulations that will permit employers and other plan sponsors to offer employees two new types of health reimbursement arrangements or “HRAs” (see here for “FAQs”): (1) an Individual Coverage HRA (“ICHRA”)  […]

Due Date for Providing ACA Coverage Forms to Employees/Participants Extended from January 31, 2018 to March 2, 2018

TIFFANY N. SANTOS, December, 2017   Just before the start of the new year, the IRS issued Notice 2018-06, automatically extending to March 2, 2018 the due date for applicable large employers (generally those with 50 or more full-time employees) to furnish the Form 1095-C to full-time employees (pursuant to Section 6056 of the Internal Revenue […]

2018 Annual Open Enrollment Is Here – Are Your Health and Welfare Plans Ready?

TIFFANY N. SANTOS, August 2017   It’s that time of year again for employers and plan sponsors with calendar-year plans — time for annual open enrollment. Here are some items plan sponsors and plan administrators may wish to consider as they prepare amendments and enrollment materials to comply with applicable legal or regulatory requirements for the […]

DOL Finalizes Disability Benefit Plan Claims Regulations

TIFFANY N. SANTOS, December 2016   On December 19, 2016, the Department of Labor finalized the regulations governing disability benefit claims (see https://www.gpo.gov/fdsys/pkg/FR-2016-12-19/pdf/2016-30070.pdf). Intended “to promote fairness and accuracy in the claims review process and protect participants and beneficiaries in ERISA-covered disability plans,” the regulations for the most part adopt the rules proposed in November […]

IRS Delays the Deadline to Furnish the ACA Forms 1095-C and 1095-B to March 2, 2017 and Extends the Good Faith Transition Relief from Reporting Penalties

TIFFANY N. SANTOS and SHANNON OLIVER, November 2016 In a welcome surprise, the Internal Revenue Service (the “IRS”) on November 18, 2016, released Notice 2016-70 which delays the deadline from January 31, 2017 to March 2, 2017 for employers to furnish the Form 1095-C to full-time employees and for providers of health coverage (such as […]

A Grab Bag of Recent Health Plan Guidance

TIFFANY N. SANTOS and SHANNON OLIVER, July 2016 — IRS Issues Early Affordable Care Act (“ACA”) Draft Forms 1094 and 1095-C for 2016 Coverage and New Proposed Rules for Section 6055 Reporting by Providers of Coverage In early July 2016, the IRS issued early drafts of the forms that applicable large employers must provide to […]

At Last!  IRS Issues Final ACA Reporting Instructions and Forms for Employers and Providers of “Minimum Essential Coverage”

TIFFANY N. SANTOS, September 2015 — On September 16, 2015, after several draft iterations, the IRS issued the long awaited:  Final 2015 Forms 1094-C and 1095-C (and related instructions) for “applicable large employers” to report coverage offered to their full-time employees to allow the IRS to determine whether the employer owes a payment under the […]

Plan Year Changes for Group Health Plans for Year-End 2015 and 2016

TIFFANY N. SANTOS, August 2015 — As the end of the 2015 calendar plan year and the next open enrollment period for the 2016 calendar year group health plan fast approach, employers and other plan sponsors of self-insured health plans must implement and administer a number of changes to comply with the Affordable Care Act […]

New ACA Guidance on Requirement to Cover Preventive Health Services

TIFFANY N. SANTOS, July 2015 — On July 14, 2015, the Internal Revenue Service, Department of Labor and Department of Health and Human Services (the “Departments”) jointly finalized interim final regulations issued in July 2010 regarding the Affordable Care Act’s (“ACA”) requirement to cover certain preventive health services without cost-sharing by non-grandfathered plans. They also […]

ACA Compliance Remains “Business as Usual” for Employers Following King v. Burwell

TIFFANY N. SANTOS and MARSHAL HODA, July 2015 In its much-anticipated June 25, 2015 decision in King v. Burwell, the United States Supreme Court upheld nationwide federal health care subsidies under the Affordable Care Act (“ACA”). King affirmed that the premium tax credit under Section 36B of the Internal Revenue Code (the “Code”) is available […]

Amendments to Excepted Benefits Regarding Dental Plans, Vision Plans and EAPs Finalized

TIFFANY N. SANTOS, September 2014 On September 26, 2014, 1 the Department of the Treasury, Department of Labor and Department of Health and Human Services jointly finalized the amendments to the “excepted benefit” regulations regarding dental and vision plans and employee assistance programs (“EAPs”). While the amended regulations adopt the original proposed regulation language eliminating […]

New Mid-Year Section 125 Permitted Election Changes Help Facilitate ACA Marketplace Enrollment

TIFFANY N. SANTOS, September 2014 — On September 18, 2014, the Internal Revenue Service (“IRS”) issued Notice 2014-55, which allows an employee to revoke an election for employer-sponsored health plan coverage under a Section 125 cafeteria plan (but not a health flexible spending account (“FSA”)) on a prospective basis in the following circumstances: Following a […]

IRS Issues Draft Forms for the Reporting of Coverage under the Affordable Care Act

TIFFANY N. SANTOS, July 2014 — On July 24, 2014, the Internal Revenue Service (“IRS”) released draft forms for review and comment implementing the reporting requirements under Sections 6055 and 6056 of the Internal Revenue Code (the “Code”) (Please see our May 2013 and March 2014 articles for detailed discussions of these reporting requirements). Section […]

Determination of Employer “Pay or Play” Assessment Under Affordable Care Act Cast into Doubt Following Recent Court Split

TIFFANY N. SANTOS, July 2014 — As employers prepare to comply with the Affordable Care Act’s employer shared responsibility provision (or “Pay or Play” requirement) under Section 4980H of the Internal Revenue Code (the “Code”), two recent conflicting Court of Appeals decisions regarding the availability of the premium tax credit to purchase Marketplace/Exchange coverage could […]

Final 90-Day Health Plan Waiting Period Rules Issued

TIFFANY N. SANTOS, March 2014 — On February 24, 2014, the Internal Revenue Service (the “IRS”), Department of Labor and Department of Health and Human Services jointly issued the final regulations implementing the 90-day waiting period limitation under the Affordable Care Act (the “ACA”) and related proposed regulations, clarifying the extent to which an employer […]