The America First Health Care Plan
The America First Health Care Plan aims to Protect People with Preexisting Conditions and
Combat Surprise Medical Billing
On Sept. 24, 2020, President Donald Trump introduced his plan for affordable, high-quality health care, called the America First Health Care Plan. This plan, issued in an executive order, is primarily aimed at protecting people with preexisting conditions and combating surprise medical billing.
The executive order directs the Departments of Health and Human Services (HHS), Labor, and the Treasury to maintain and build upon existing actions to:
Expand options for affordable health care and access to affordable medicines;
Ensure consumers have access to meaningful price and quality information before the delivery of care; and
Reduce waste, fraud, and abuse in the health care system.
The executive order specifically directs HHS to work with Congress to reach a legislative solution to end surprise medical billing by Dec. 31, 2020. If a legislative solution is not reached by that date, the executive order directs HHS to take administrative action to prevent out-of-pocket expenses that cannot be reasonably foreseen.
An executive order is a broad policy directive used to establish how laws will be enforced by the administration. The order does not make any changes to existing laws or regulations but directs federal agencies to issue new guidance to implement the order's policies. As a result, the executive order's specific impact will remain largely unclear until agencies issue further guidance, or Congress takes action in response to the order.
2020 ACA Reporting for Large Groups is Due in Early 2021
The IRS has released final 2020 forms and instructions for use in early 2021 to report under IRS Code Sections 6055 and 6056 for the 2020 calendar year.
2020 Form 1094-B and Form 1095-B (and related instructions) will be used by providers of minimum essential coverage (MEC), including self-insured plan sponsors that are not ALEs, to report under Section 6055.
2020 Form 1094-C and Form 1095-C (and related instructions) will be used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
The forms and instructions include a number of changes and clarifications related to 2020 reporting.
The deadline for furnishing statements to individuals under Sections 6055 and 6056 has been extended to March 2, 2021.
Good faith relief from penalties for reporting incorrect or incomplete information has been extended to 2020 reporting.
The IRS has extended relief from penalties for reporting entities that furnish individual statements under Section 6055 only upon request for the 2020 calendar year reporting.
The "Plan Start Month" box on Form 1095-C is now required for 2020 reporting.
Certain additions were made to the 2020 Forms 1095-B and 1095-C related to individual coverage HRAs (ICHRAs). Form 1095-B includes a new code G to be used on line 8, Origin of the Health Coverage, to identify coverage under an ICHRA. In addition, Form 1095-C includes new codes in Code Series 1 for reporting offers of ICHRAs, as well as new lines for reporting, required information.
Employers should become familiar with these forms and instructions for reporting for the 2020 calendar year. Individual statements must be furnished by March 2, 2021, and IRS returns must be filed by Feb. 28, 2021 (March 31, 2021, if filed electronically).
2020 ACA Reporting for Large Groups Deadline Delayed and Additional Transition Relief Granted
The IRS has delayed the deadlines by which employers must furnish 2020 Forms 1095-C and 1095-B in early 2021. For 2020, the furnishing deadline was Feb. 1, 2021, Since Jan. 31, 2021, is a Sunday. The IRS has provided an additional 30 days for furnishing the 2020 Form 1095-B and Form 1095-C, extending the due date from Feb. 1, 2021, to March 2, 2021. The deadline for filing with the IRS under Sections 6055 and 6056 remains March 1, 2021 (since Feb. 28, 2021, is a Sunday), or March 31, 2021, if filing electronically.
The IRS provided additional relief from penalties related to failures to furnish 2020 forms to individuals under Section 6055 only, under certain circumstances. Under this relief, employers will only have to provide Form 1095-B to covered individuals upon request.
The IRS also provided a final extension of good-faith relief from penalties related to incorrect or incomplete information returns filed for the 2020 calendar year under Sections 6055 and 6056. This is the last year that the IRS intends to provide good-faith relief from penalties since it was intended to be transitional relief only.
Notice Compliance Requirements
As many of our clients prepare for year-end open enrollment, we offer a general reminder that many of our clients are subject to varying notice compliance requirements under federal law such as the following areas.
· Employee Retirement Income Security Act (ERISA)
· Health Care Reform (HCR)
· Health Insurance Portability and Accountability Act (HIPAA)
· Special Health Care
· Consolidated Omnibus Budget Reconciliation Act (COBRA)
· Family and Medical Leave Act (FMLA)
Requirements can change based upon a company’s overall size or based upon the different types of benefits being sponsored. Please note, additionally, that your company may be exempt from certain requirements and/or subject to additional obligations under state-specific law.
That said, the following chart provides an overview of key required special healthcare-related benefits notices that are generally required of all employer groups sponsoring medical coverage regardless of group size. It’s a good idea to familiarize yourself with the various notice requirements and due dates for distribution.
Special Health Care Notices
For more information on additional notice requirements, please Login to Your HR360 Account! or consult directly with your CBG representative!
Are You Questioning How Your Benefits Package Compares? Look No Further!
CBG commissioned a report this past year from David P. Lind Benchmark for our clients. David P. Lind Benchmark is an independent, for-profit, and non-partisan organization that focuses on scientifically-based research to provide credible, reliable, and objective information to assist decision-makers – for both private and public employers and policymakers.
David P. Lind has conducted annual research with thousands of Iowa organizations focusing on employee benefit trends. The Iowa Employer Benefits Study© is a comprehensive statistical review of Iowa employee benefits that is a key resource for employers and policymakers in Iowa. Survey results provide Iowa employers with reliable, relevant, and customized information that you can’t find anywhere else in Iowa.
HR Training
Access the live recording and video from the ‘Who is a Full-Time Employee Under the ACA Play or Pay Rules’ training session that was offered earlier this month. In this webinar, our attorney partners provide an overview of the methods applicable large employers can use to correctly determine full-time employee status under the ACA's employer shared responsibility rules.
Please check this HR Training Video: Click Here