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Executive Order on Strengthening Medicaid and the Affordable Care Act

3/24/2021 Update: CMS has extended the new special enrollment period for marketplaces using the platform until August 15, 2021. See the updated CMS FAQs for more information. On January 28, 2021, President Biden signed an Executive Order on Strengthening Medicaid and the Affordable Care Act (ACA) (Executive Order). The Executive Order instructs the Department … Continued

Option For Some To Renew Policies That Do Not Fully Meet ACA Standards

In the fall of 2013, the Department of Health and Human Services (HHS) announced a transitional reliefprogramthat allowed state insurance departments to permit early renewal at the end of 2013 of individual and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act (ACA) and for … Continued

The U.S. Supreme Court and the Future of the Affordable Care Act | PART 1

Amy Coney Barrett was sworn in as President Trump’s third U.S. Supreme Court (Supreme Court) Justice on October 26, 2020, to fill the seat vacated by Justice Ruth Bader Ginsburg’s death. During the contentious confirmation hearings, along political party lines, Justice Barrett was continuously questioned regarding her views on the constitutionality of the Patient Protection … Continued

July 2020 Compliance Recap

July was a busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) upheld the religious exemption and moral exemption final rules to the Patient Protection and Affordable Care Act (ACA) contraceptive mandate. The Internal Revenue Service (IRS) released the indexed 2021 ACA affordability percentage. The President signed a law extending the … Continued

IRS Releases the Indexed 2021 Affordability Percentage

The IRS released  Revenue Procedure 2020-36, which increases the affordability threshold for ACA employer mandate pay or play purposes to 9.83% for plan years beginning in 2021 from 9.78% for 2020. An employer uses the affordability percentage to determine whether it has offered affordable coverage under the ACA’s employer shared responsibility provisions to avoid Penalty … Continued

PCORI Fee Amount Adjusted for 2020

PCORI Fee Amount Adjusted for 2020 The Affordable Care Act (ACA) imposes a fee on health insurance issuers and self-insured plan sponsors in order to fund comparative effectiveness research. These fees are widely known as Patient-Centered Outcomes Research Institute (PCORI) fees, and were originally scheduled to expire for plan or policy years ending on or … Continued

Status of Court Case Challenging ACA Constitutionality

On January 21, 2020, the U.S. Supreme Court (Supreme Court) declined to hear the court case challenging the ACA’s constitutionality. For now, the case is going back the U.S. District for the Northern District of Texas (District Court) for additional analysis. On December 18, 2019, the U.S. Court of Appeals for the Fifth Circuit (Appeals … Continued

Compliance Recap | Dec 2019

The U.S. Court of Appeals for the Fifth Circuit held that the Patient Protection and Affordable Care Act’s (ACA’s) individual mandate is unconstitutional. The Internal Revenue Service (IRS) released final instructions and final 1094-B, 1095-B, 1094-C, and 1095-C forms for 2019. The IRS also extended good-faith relief from penalties for employers that report inaccurate or … Continued