fisherphillips.com Affordable Care Act Spring 2016 Updates Presented by: Lorie Maring Phone: (404)

fisherphillips.com Affordable Care Act Today’s agenda: Patient Centered Outcome Research Institute (PCORI) Fee Transitional Reinsurance Fee (TRF) Correcting errors on ACA reporting forms Annual HSA contribution limits ACA out-of-pocket maximums Updates on Employer Shared Responsibility provisions

fisherphillips.com Affordable Care Act Patient Centered Outcome Research Institute (PCORI) Fee August 1, 2016 deadline (amount based on last day of 2015 PY) Amounts: $2.08 per covered life for plan years ending on or after October 1, 2014 and before October 1, 2015 $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016 Who must pay: Insured plans – Insurance carriers pay for policy holders Self-insured plans – Employers/plan sponsors pay (multiple plans with same plan year treated as single plan)

fisherphillips.com Affordable Care Act Patient Centered Outcome Research Institute (PCORI) Fee How to File IRS Form 720, Quarterly Federal Excise Tax Return Payment due when filed on 7/31 Electronic filing (Electronic Federal Tax Payment System ) available, not required Exceptions: Excepted Benefits EAPs, disease mgmt. or wellness programs not providing significant medical benefits

fisherphillips.com Affordable Care Act Correcting PCORIs File Form 720X “Amended Quarterly Federal Excise Tax Return” Missing or late PCORIs Penalties and late fees may be excused if reasonable-cause criteria are met If the IRS sends a notice about a penalty, reply to the notice with an explanation Do not self-correct overpayments in prior year on next year’s return

fisherphillips.com Affordable Care Act Transitional Reinsurance Fee (TRF) Key Deadlines: DateActivityContribution Amount January 15, 2016Remit first contribution for 2015 benefit year; or Full contribution for 2015 benefit year. $33 per covered life $44 per covered life November 15, 2016Remit second contribution for 2015 $11 per covered life

fisherphillips.com Affordable Care Act TRFs expire after this year TRFs must be paid through pay.gov Self-insured plans are responsible for TRFs BUT third party administrators can submit forms on the plan’s behalf Self-insured, self-administered plans are exempt from TRFs

fisherphillips.com Affordable Care Act Correcting TRFs Overpayments may be refunded Missing or late TRFs Generally, subject to Federal debt collection rules Ensure that file corrective contributions prior to IRS notification

fisherphillips.com Affordable Care Act ACA Reporting for 2015 Information returns must be filed accurately and timely or penalties may apply Relief for information returns filed in 2016 with good faith efforts Error correction is part of the good faith effort to file accurate and complete information returns Acceptance/Rejection Codes: Rejected (requires complete resubmission – not correction) Accepted with Errors (may be corrected) Accepted without Errors (may be corrected, if necessary)

fisherphillips.com Affordable Care Act Correcting 1094-B No correction – transmittal only Correcting 1095-B Complete a new form and put an X the CORRECTED checkbox File a Form 1094-B Transmittal with the corrected Form 1095-B Provide a copy of the corrected 1095-B to the affected individual

fisherphillips.com Affordable Care Act Correcting 1094-C Complete a new form and put an X the CORRECTED checkbox Submit the corrected form only. The associated 1095-C does not have to be submitted. Correcting 1095-C Complete a new form and put an X the CORRECTED checkbox File a Form 1094-C Transmittal with the corrected Form 1095-C Provide a copy of the corrected 1095-C to the affected individual

fisherphillips.com Affordable Care Act Common Error - Incorrect or missing TINs Correct under IRS Pub 1568 Initial solicitation First annual solicitation Second annual solicitation Third annual solicitation (beyond Pub 1568) If you can’t obtain employees’ TINs, include their birthdays Penalties will not be imposed for filing incorrect or incomplete forms if there was a “good faith effort” Relief will not be available if returns are late unless reasonable cause

fisherphillips.com Affordable Care Act Contribution and Out-of-Pocket Limits for Health Savings Accounts and High Deductible Plans For 2016For 2015Change HSA contribution limits (employer & employee) Individual: $3,350 Family: $6,750 Individual: $3,350 Family: $6,750 Individual: no change Family: +$100 HSA catch-up contributions $1,000 No change HDHP minimum deductibles Individual: $1,300 Family: $2,600 Individual: $1,300 Family: $2,600 Individual: $1,300 Family: $2,600 HDHP maximum Out-of- Pocket amounts Individual: $6,550 Family: $13,100 Individual: $6,450 Family: $12,900 Individual: +$100 Family: +$200

fisherphillips.com Affordable Care Act Embedded deductibles 2016 ACA Out-of-Pocket Maximums Self-coverage -- $6,850 Other than self-coverage -- $13,700 HSA-Compatible HDHP OOP maximums are lower than ACA maximums Self-coverage -- $6,550 Other than self-coverage -- $13,100

fisherphillips.com Affordable Care Act Example A, B, C, and D are enrolled in HDHP/HSA compatible family coverage with $13,100 max cost-sharing in A incurs $10,000 in expenses, B, C, and D each incur $3,000 ACA self-only maximum on cost-sharing of $6,850 in 2016 applies to each individual. A is only responsible for $6,850, Plan is required to bear the difference between the $10,000 in cost-sharing for A and the maximum annual limitation for A (plan pays $3,150). The total costs incurred by all four individuals under the policy of $15,850 ($6,850 + $3,000 + $3,000 + $3,000) must be limited to $13,100 (HSA/HDHP limit – not ACA $13,700 limit). The plan must bear the $2,750 difference between the $15,850 in expenses and the $13,100 annual limitation.

fisherphillips.com Affordable Care Act Employer Shared Responsibility Affordability Percentages Plan YearAffordability Percentages % % %

fisherphillips.com Affordable Care Act Employer Shared Responsibility Penalties Plan YearPenalty Amounts ALE’s not offering minimum essential coverage ALE;s offering minimum essential coverage 2015$2,000$3, $2,080$3, $2,160$3,240

fisherphillips.com Final Questions Presented by: Lorie Maring Phone: (404)

fisherphillips.com Thank You Presented by: Lorie Maring Phone: (404)