Health Reform Changes Are A Hot Topic, But No Action Items Yet

Health Reform Changes Are A Hot Topic, But No Action Items Yet

While there is lots of talk in Washington, D.C. these days about potential repeal, replacement, and/or rebuilding of the health reform law, so far there has been no action that would actually change any current requirements for employer group benefit plans. In fact, employer plans need to be very mindful of some key looming compliance deadlines.

ACA Reporting Deadline Approaches

Information reporting forms 1094-B or C and forms 1095-B or C must be submitted by employers to the IRS by February 28, 2017, or by March 31, 2017 if the employer submits them electronically. Forms 1095-B or C must be provided to employees and enrollees by March 2, 2017. NOTE: Not all employers are required to report. 

What employers are required to report?

  1. Forms 1094-B and 1095-B are used by entities reporting under Section 6055, including self-insured plan sponsors that are not applicable large employers (ALEs).  NOTE: An ALE is an employer who averaged 50 or more full-time employees including full-time equivalents during the preceding calendar year. Final 2016 versions of these forms and final instructions were released on Sept. 26, 2016.

If an employer is not an ALE, and they sponsor a fully-insured health plan, they are not required to report. Only non-ALEs that sponsor self-insured health plans (i.e. Aetna Funding Advantage, UHC All Savers, Cigna Level-Funding etc.), are required to report.

  1. Forms 1094-C and 1095-C are used by ALEs to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans. Final 2016 versions of these forms and final instructions were released on Sept. 30, 2016.

Creditable Coverage Disclosure to CMS

For any calendar-year plan (January 1 renewal date) that offers prescription drug benefits to Medicare-eligible enrollees (either employees, retirees or dependents), March 1 is the deadline to report to CMS if the employer-plan drug benefit is “creditable,” meaning that it is expected to cover, on average, as much as the standard Medicare Part D prescription drug plan. The deadline for this disclosure to CMS is no later than 60 days after the beginning of each plan year, so for non-calendar year plans this due date will vary. Kistler Tiffany will be glad to walk you through this quick online disclosure process with CMS if need be, so contact your benefit consultant if you need assistance.