US House Narrowly Passes American Health Care Act

In Healthcare Reform by Coolidge Wall

On May 4, the House of Representatives passed the controversial American Health Care Act (HR 1628) by a 217-213 margin. The AHCA is touted by President Trump and House GOP leadership as the bill that will repeal and replace the Affordable Care Act, which was enacted in March 2010. The AHCA now moves to the Senate where its future is uncertain. Introduced March 6, the original bill faced opposition from conservative and moderate House Republicans in addition to the Democrat caucus, the AMA, AARP, and other interest groups. Although amended in Committee to address some GOP concerns, Speaker Ryan pulled …

The 21st Century Cures Act Allows Small Employer Standalone HRAs

In Healthcare Reform by Coolidge Wall

On December 13, 2016, President Obama signed the 21st Century Cures Act. Title XVIII of the Act overturns a portion of ACA regulations (IRS Notice 2013-54) that prohibits employers from offering employees standalone health reimbursement arrangements (i.e., HRAs that are not integrated with a group health plan). This change will allow eligible small employers the opportunity to contribute money to HRA accounts of their employees that can be used to pay health insurance premiums as well as deductibles, copayments, and other out-of-pocket medical expenses. The prohibition on standalone HRAs is lifted somewhat, but only as to small employers who employ …

Navigating the Affordable Care Act Minefield

In Healthcare Reform by Coolidge Wall

Are you an employer trying to sort through all the changes to the Affordable Care Act? If so, join Coolidge Wall Labor & Employment attorney R. Brent Gambill on July 27th in Columbus, OH, at the Sterling Education Services Affordable Care Act Seminar. This in-depth seminar has been approved for CLE credits for both the legal industry and HR industry and will address the following topics: Separating fact from myth in dealing with ACA The goal of health care reform Records and reporting requirements The impact of recent cases and court rulings The cost of noncompliance

Can Employee Hours Be Reduced to Avoid Providing Health Insurance?

In Healthcare Reform by Coolidge Wall

Once the Affordable Care Act was passed, employers began reviewing their options about providing health insurance coverage to employees. One option continually referenced in the news was how employers were considering reducing employee hours to avoid providing health insurance coverage. One employer is now the subject of a class action law suit that claims the employer violated ERISA when it reduced employee hours to avoid providing health insurance coverage. Marin v. Dave & Buster’s, Inc., S.D.N.Y. No. 1:15-cv-036081. Marin alleges on behalf of the affected employees that Dave & Buster’s reduced their hours as part of a company-wide plan to …

IRS Extends the ACA’s Form 1094 and Form 1095 Filing Deadlines

In Healthcare Reform by Coolidge Wall

The IRS has unexpectedly extended the deadlines by which insurers and self-funded employers must provide health plan enrollment and coverage information to employees and the IRS under the Affordable Care Act. This is the information required to be reported on Forms 1094 and 1095. Notice 2016-4 issued December 28 extends the due dates: For providing to full-time employees the 2015 Form 1095-B and the 2015 Form 1095-C from February 1, 2016 to March 31, 2016; and For filing with the IRS the 2015 Form 1094-B, the 2015 Form 1095-B, the 2015 Form 1094-C, and the 2015 Form 1095-C from February …

Effective Date of the ACA’s “Cadillac” Tax Postponed by the Appropriations Act

In Healthcare Reform by Coolidge Wall

The monolithic Consolidated Appropriations Act of 2016, which became law December 18, changes the effective date of the Affordable Care Act’s so-called “Cadillac” tax. A key funding mechanism of the ACA is a 40 percent excise tax imposed on the cost of employer sponsored health coverage furnished to an employee that exceeds a statutory limit. Under the ACA, this tax becomes effective in 2018. However, after an intensive lobbying effort led by business and organized labor, Congress included a provision in the Appropriations Act that delays the effective date of the excise tax to 2020. The Appropriations Act also changes …

Supreme Court Upholds Affordable Care Act Tax Credits

In Healthcare Reform by Coolidge Wall

On June 25th the Supreme Court ruled that premium tax credits provided by the Affordable Care Act (ACA) to help individuals of low or moderate income to buy health insurance either on state- or federally-managed marketplaces are lawful. This means that people in all states, including the 34 states with federally-facilitated marketplaces, will continue to have access to the tax credits. Because of the Court’s 6 to 3 ruling in King v. Burwell, ACA will remain unchanged, and individuals, employers, and health insurers must continue to comply with the law’s individual and employer coverage mandates. Backdrop ACA requires most Americans …

EEOC Challenges Wellness Programs

In General, Healthcare Reform by Coolidge Wall

Many employers are implementing wellness programs associated with providing employees health insurance. The EEOC is concerned about wellness programs and has filed at least two complaints this year alleging that an employer’s wellness program violated the Americans with Disabilities Act of 1990. In the first complaint, EEOC v. Orion Energy Systems, Inc., the employer implemented a wellness program under which the employees were required to complete a health risk assessment that included a physical fitness component. The health risk assessment required that employees disclose their medical history, answer disability-related inquiries, and have blood work performed. One employee objected to participation …

Failure to Provide COBRA Notice Results in Penalties Even When Employer Pays the Bills

In Employee Benefits, Employment Law, Healthcare Reform by Coolidge Wall

Regina Honey was pregnant with her second child and experiencing pre-term labor. Her doctor ordered bed rest for about two weeks. When Ms. Honey was ready to return to work at Dignity Health, she was told her employment was terminated. About two months later she was reinstated. However, the pre-term labor returned and her doctor ordered bed rest for the remainder of the pregnancy. Ms. Honey remained on bed rest until her son was born in July 2010. When the doctor approved her return to work in September 2010, she was never scheduled to return. After several attempts to reach …

The Supreme Court Narrows Affordable Care Act Contraception Mandate

In Business Law, Employee Benefits, General, Healthcare Reform by Coolidge Wall

The Affordable Care Act requires health plans to cover “preventive services” at no cost to participants. The federal government has identified 20 forms of contraception that are required to be included as part of preventive services. Various “for-profit” companies have challenged ACA’s birth control coverage requirement in about 50 lawsuits now pending across the country. Many of these employers are family owned, closely held or controlled companies whose owners object to the provision of contraceptive coverage on faith-based grounds. On June 30th, the last day of its 2013-2014 term, the Supreme Court issued a 5-4 decision in Burwell v. Hobby …