ACA Information Reporting Penalties Increased for Returns Filed in 2025 IRS Revenue Procedure 2023-34 includes updated penalty amounts that may apply to reporting entities that fail to comply with the Affordable Care Act’s (ACA) requirements under Internal Revenue Code Sections 6055 and 6056. The increased amounts apply to 2024 information returns and individual statements [...]
Electronic Filing of ACA Returns Beginning in 2024, employers that file at least 10 returns during the calendar year must file their ACA returns electronically. Employers that have not requested an extension or an electronic filing waiver, and that are subject to the ACA reporting rules should be exploring options for filing electronically to [...]
Medicare Part D Disclosures due by Feb.29, 2024 for Calendar Year Plans Group health plan sponsors are required to complete an online disclosure form with the Centers for Medicare & Medicaid Services (CMS) on an annual basis and at other select times, indicating whether the plan's prescription drug coverage is creditable or non-creditable. This [...]
IRS Releases ACA Pay-or-Play Penalties for 2025 On Feb. 12, 2024, the IRS released updated penalty amounts for 2025 related to the employer shared responsibility (pay-or-play) rules under the Affordable Care Act (ACA). For calendar year 2025, the adjusted $2,000 penalty amount is $2,900 ,and the adjusted $3,000 penalty amount is $4,350. This is [...]
Summary of Benefits and Coverage The Affordable Care Act (ACA) added a disclosure requirement for group health plans and health insurance issuers called the “summary of benefits and coverage” (SBC). The SBC is a short document providing simple and consistent information about a health plan’s benefits and coverage. It must be provided free of charge [...]
On July 28, 2022, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) jointly issued a new set of frequently asked questions (FAQs) regarding the contraceptive coverage mandate under the Affordable Care Act (ACA). Background The ACA requires non-grandfathered health plans to cover certain women’s preventive health services without cost [...]
On July 25, 2022, the Department of Health and Human Services (HHS) issued a proposed rule that would revise existing regulations for the Section 1557 nondiscrimination protections under the Affordable Care Act (ACA). The proposed rule is intended to solidify protections against discrimination on the basis of sex, including sexual orientation and gender identity. ACA [...]
On Aug. 1, 2022, the IRS issued Revenue Procedure (Rev. Proc.) 2022-34 to index the contribution percentages in 2023 for determining the affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2023, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not [...]
The Internal Revenue Service (IRS) released draft 2022 forms for reporting under Internal Revenue Code (Code) Sections 6055 and 6056. Draft instructions for these forms have not yet been released. 2022 draft Forms 1094-B and 1095-B are draft versions of forms that will be used by providers of minimum essential coverage (MEC), including self-insured plan [...]
On Aug. 30, 2021, the IRS issued Revenue Procedure 2021-36 to index the contribution percentages in 2022 for determining affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2022, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed: 9.61% of [...]
