ACA Compliance


We understand the need to be continually informed about how the new Affordable Care Act (ACA) will impact you. We are pro-actively communicating with our clients and brokers on an ongoing basis, providing the tools and resources necessary to comply with the key previsions in this legislation as they impact your benefit plan.

If the IRS or DOL comes knocking, are you ready to answer ACA questions?

Patient Centered Outcomes Research Institute (PCORI) Fee

$1.00 per covered health care participant (2013).
$2.00 per covered health care participant (2014).
Due July 31, on IRS Form 720.

Transitional “Pre-Existing” Reinsurance Program

$63.00 ($5.25 per month) per covered health care participant.
November 15th is the reporting date to Health and Human Services (HHS).
January 15th is the due date.

ERISA and ACA Notifications

Health Insurance Exchange (Marketplaces) Notices (ACA).
COBRA Election Notices—to include Exchange Notices (ACA).
Summary of Benefits and Coverage (ACA).
Children’s Health Insurance Program (ERISA).
Women’s Health and Cancer Rights. (ERISA).
Notice of Special Rights (ERISA).
Notice of Privacy Practices (ERISA).
Medicare Part D Creditable Coverage (ERISA).
Calculating Full Time Equivalents (ACA).

IRS Reporting - “Play or Pay”

Section 4980H - “Applicable Large Employer”.
Employers with 50+ Full-Time or Equivalents.
Section 6055 - “Minimum Essential Coverage”.
Section 6056 - “Affordable Cost of Care”.
W2 Reporting - Group Health Plan Cost.


Recently an uptick in ACA enforcement appears to be underway
with the DOL using it’s broad authority under ERISA to investigate
or audit employee benefit plan’s compliance.

Are you ready?

 

PREFERRED HEALTH PLAN OF THE CAROLINAS
PO BOX 749 MATTHEWS, NC 28106
LOCAL: 704.847.2321     Toll Free: 866.636.0239     FAX: 704.847.3014