IRS and HHS Issue Proposed Regulations on Individual Mandate

On January 30, 2013, the Internal Revenue Service (IRS) and the Department of Health and Human Services (HHS) issued two sets of proposed regulations related to the individual mandate provision of the Patient Protection and Affordable Care Act (PPACA).

ACA Penalty Flowchart for Employers

A flowchart illustrating the penalties for employers not offering affordable coverage under the ACA beginning in 2014.

Proposed Contraceptive Exemption for Religious Employers

The departments of HHS, Labor and Treasury issued a proposed rule that would exempt religious employers from covering contraceptive services. The proposed rule also would simplify the definition of a religious employer as it relates to contraceptive coverage

State Exchange Map of the United States

The last deadline for developing state health insurance exchanges was officially over on February 15, 2013. States were required to announce by that deadline whether they would start their own exchange, partner with the government, or completely allow the government to run an exchange in that state.

The states with exchanges completely run by the government or through a partnership must decide whether they want to make decisions about rate control or who may participate in state plans. Insurers need to decide where they will offer plans and whether they will offer them through the federal exchange program. All of these decisions must be made by October. The October deadline allows time for individuals to enroll in the new insurance plans in time for January 1, 2014 when PPACA requires the exchanges to be open.

As of the deadline 17 states and the District of Columbia decided to start their own exchange, seven states (including Michigan) have asked to partner with the government, and 26 states have defaulted to federally run exchanges.

Health Care Reform -
Kapnick Disclamer

The health care reform law—the Affordable Care Act (ACA)—has many complex requirements for employers and health plans. Please contact Kapnick Insurance Group with any questions about how you can prepare for any of the health care reform requirements. This Kapnick Insurance Group Update is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.