New Summary of Benefits and Coverage Template Posted

On Wednesday, the Department of Labor and the Centers for Medicare and Medicaid (CMS) posted the new and improved Summary of Benefits and Coverage form.  The SBC was designed to help employees compare benefit provisions and make educated decisions when shopping for a medical plan. However, employers provided feedback indicating confusion among SBC recipients.

The CMS press release explains “The SBC includes coverage examples that demonstrate the cost sharing amounts an individual might be responsible for in three common medical situations.  In addition to the current coverage examples that address diabetes care and childbirth, the updated template has a new coverage example that addresses coverage for a foot fracture so that a consumer understands what a plan covers in an emergency scenario.

Changes have also been made to the SBC to improve readability for consumers. The new templates include more information about cost sharing, such as enhanced language to explain deductibles and a requirement that plans address individual and overall out-of-pocket limits in the SBC.”

These enhancements, including hyperlinks to the definitions section in electronic versions, should make reading the SBC a bit easier come open enrollment time.

Most employers will begin to use this new template on the first day of the first open enrollment period that begins on or after April 1, 2017.

To access the existing SBC template, or to review the new one, visit the DOL website via the link below.

http://www.dol.gov/ebsa/healthreform/regulations/summaryofbenefits.html

ACA Update – Reporting Deadline Relief

Good news arrived from the IRS just in time for the New Year. On December 28th, the IRS released Notice 2016-4 providing additional time for employers to comply with upcoming ACA reporting requirements.

  • The deadline to provide Form 1095 to employees has been pushed to March 31, 2016. The extension provides roughly nine additional weeks for employers to prepare and distribute the forms to full time employees who received an offer of coverage in 2015.
  • Deadlines for filing with the IRS have also been extended. If filing paper copies of Form 1094 (Transmittal of Health Coverage Information Returns) along with fewer than 250 copies of Form 1095, the deadline has been shifted from February 29, 2016 to May 31, 2016. If filing electronically with the IRS through the AIR system, employers now have until June 30, 2016 to transmit their forms.

The IRS indicated “automatic and permissive extensions of time for filing information returns…will not apply to extended due dates.” The service also encouraged employers to “furnish statements and file the informational returns as soon as they are ready.”

Read the full notice.

ACA Reporting Requirements & Seminars

There is a mountain of data to pull together by the deadline. We will help you prepare and organize your documents to help you before this deadline. Enroll in our one day seminar today.

You'll receive:

  • Detailed questions to determine the data you'll need
  • Answers on how to complete the forms
  • How to decipher the transition relief available
  • Tips on obtaining missing data
  • What codes your company may want to use
  • Details on best practices for employee education

ACA Reporting Seminar

Wednesday, December 16, 2015
from 8:30 AM to 10:00 AM (EST)
Camp Hill, PA

Please note: This communication is designed for introductory informational purposes. The contents are summaries and are not intended to cover every aspect of the topic, law or regulation being discussed. The information contained in this post and website does not constitute legal or tax advice. To ensure full compliance based on your unique organizational requirements, discussion with your attorney or tax professional is recommended.

Auto-Enroll Mandate Removed from ACA

Finally, some good news for employers when it comes to ACA compliance. Today, President Obama signed the Bipartisan Budget Act of 2015. Included, was a provision repealing the auto-enrollment requirement for organizations with over 200 employees.

This change comes as a relief for most large employers. Fears of “defaulting” employees into a medical plan they didn’t want were a significant cause of stress. Thankfully, there’s one less thing to worry about or implement.

Please note: This communication is designed for introductory informational purposes. The contents are summaries and are not intended to cover every aspect of the topic, law or regulation being discussed. The information contained in this post and website does not constitute legal or tax advice. To ensure full compliance based on your unique organizational requirements, discussion with your attorney or tax professional is recommended.