Q.- We have a COBRA continuant who is thinking about enrolling in individual coverage through the health care exchange. If she doesn’t like the coverage, do we have to let her re-enroll in our coverage?
The open enrollment period to elect coverage under an individual plan in the Health Care Exchange Marketplace runs from November 1, 2017 through December 15, 2017. Coverage selected during the open enrollment period becomes effective January 1, 2018. After December 15, 2017, an individual can enroll in Marketplace coverage only if the individual experiences a special enrollment life event.
The Internal Revenue Service released the annual inflation adjustments that will apply to certain benefit plan tax provisions in 2018. Revenue Procedure 2017-58, which can be accessed by clicking here, identifies inflation-adjusted items for different provisions of the tax code. From an employee benefits standpoint, the following limits may be of interest to employers:
Q- Under our plan, an individual on COBRA coverage must pay by the first of the month for that month of coverage. Do we have to accept late payments?
President Trump issued an Executive Order on October 12, 2017 entitled Promoting Healthcare Choice and Competition Across the United States. The Order addresses three topics, but employers may be most interested in the potential changes to Health Reimbursement Accounts.
The individual mandate provisions of the Affordable Care Act require every taxpayer to (a) have qualifying health coverage; (b) qualify for an exemption from having health coverage; or (c) pay a tax penalty. Individuals use their 1040 tax returns to identify their individual mandate health coverage status to the government. All individuals must check a box on the 1040 to indicate compliance with the indivdiual mandate.
Employers must distribute Medicare Part D Creditable Coverage Notices to Medicare-eligible individuals by October 15.
With calendar-year plan open enrollment season approaching, employers should consider how they treat payments made for opting out of health coverage.
Q.- An employee on leave wants to cancel her health coverage. Is this a COBRA event?
Q.- An employee is sending his daughter to ballet classes after school. He wants to know if the cost of the classes can be reimbursed from his health FSA. Can they?
As we are getting into the fall months, employers with calendar year plans begin to prepare for the annual open enrollment period. Part of these preparations should include gathering the notices that are required to be distributed each year. While each employer’s specific notice distribution obligations vary depending on factors such as size, types of plans offered and funding, required notices may include the following:
The Affordable Care Act requires applicable large employers (ALEs) to offer health coverage to full time employees and their dependents. A “full-time employee” is defined as an employee who, in any month, works at least 30 hours per week. 130 hours of service in a calendar month is considered the equivalent of 30 hours per week. In fact, for both the look-back and monthly measurement methods, an employer must use 130 hours per month for determining whether an employee is full-time or not full time.