Benefits pros may be patiently waiting for the Supreme Court to say the health reform law can’t stand, but for the government agencies that are responsible for overseeing the law, it’s business as usual.
And the feds continue to roll out guidance on what firms must do to comply.
The latest compliance area: What health plans constitute “minimum value” under the health reform law. To that end, both IRS and the HHS have released new guidance for employers.
3 new documents
IRS just issued three separate guidance documents on this reform rule:
Starting in 2014, eligible individuals can purchase health insurance through a state exchange and get a premium tax credit unless they’re eligible for minimum essential coverage from other places – such as their employer.
Employer-sponsored health plans lack minimum value if “the plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs.”
And employers with 50 or more employees can be hit with penalties if any full-time workers receive a tax credit because their plan doesn’t meet minimum levels.
IRS Notice 2012-31 offers three different methods — actuarial value or minimum value calculators, checklists or an appropriate certification by a certified actuary — to determine whether the coverage offered through an employer-sponsored health plan meets the reform law’s “minimal value.”
Notice 2012-32 requests comments on the requirements from health insurance issuers, employers with self-insured plans and other entities that provide minimal essential coverage to an individual. Notice 2012-33 is asking for comments from companies with health plans that are considered large employers under the health reform law.
In addition to IRS guidance, the HHS rolled out a bulletin that deals with the verification of an individual’s access to employer-sponsored healthcare coverage to determine if they’re eligible for the tax credit for getting coverage through the Exchanges.