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Review of Employer Shared Responsibility (1095 or 6056/6066): Starting in 2016, all employers that are considered an applicable large employer ("ALE"), as defined by the IRS, must report specific employee population and health coverage information based on the prior calendar year. In addition to filing information with the IRS, self-funded ALEs also need to provide 1095-C and 1095-B forms (which can be on a single combined form) to all employees that are eligible for insurance coverage. This form identifies: read more

Starting in 2016, all employers that are considered an applicable large employer ("ALE"), as defined by the IRS, must report specific employee population and health coverage information based on the prior calendar year. Reporting is due by February 29, 2016 or March 31, 2016 (if filing electronically). Please visit www.irs.gov to view and download a copy of the IRS 1094-C and 1095-C forms that must be filed as well as detailed instructions and indicator codes. read more

As indicated in June 2013, healthcare reform created a new nonprofit corporation, the Patient-Centered Outcomes Research Institute (PCORI), to support clinical effectiveness research. This entity will be funded in part by fees (referred to as "PCORI fees" or "CER fees") paid in part by applicable sponsors of self-insured health plans. read more

Healthcare reform requires health insurers and self-funded group health plans to fund a Transitional Reinsurance Program from 2014 to 2016. The purpose of the program is to help offset the high medical costs of individuals enrolled in the non-grandfathered individual market. It is anticipated the individual market, which includes insurance purchased through the Health Insurance Exchange, will attract a disproportionate amount of individuals who have a tendency to incur high medical costs. Reinsurance contributions will help to offset these costs. read more

All Plan Sponsors must determine if their Plan(s) meet Minimum Value. Minimum Value determinations will affect employers and their employees in terms of coverage decisions and the potential for employer penalties to be incurred if an employee participates in the exchange and qualifies for a subsidy. Whether the Plan(s) met Minimum Value or not is information that must be included in the Summary of Benefits and Coverage (SBC) as well as the Exchange Marketplace Notice (which must be distributed to all employees by October 1, 2013). read more