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Medical Loss Ratio (MLR)

To lower the cost of care, the Affordable Care Act (ACA) requires health insurance issuers to spend a minimum percentage of premium dollars on health care. If an issuer doesn’t … Continued

Affordability Safe Harbors for ALEs

Under the Affordable Care Act (ACA), Applicable Large Employers (ALEs) are vulnerable to one of two potential employer shared responsibility penalty assessments. The “Subsection (a) Penalty” applies where the ALE … Continued

Executive Order Issued to Strengthen the ACA

Aimed at strengthening the Affordable Care Act (ACA) and Medicaid, President Biden signed an executive order on January 28 that directs the Department of Health and Human Services (HHS) to … Continued

PCORI Fee Amount Adjusted for 2021

The Internal Revenue Service (IRS) has released the adjusted Patient-Centered Outcomes Research Institute (PCORI) fee for 2021. As such, for plan years beginning on or after October 1, 2020 and … Continued

ACA Pay or Play Penalties Will Increase for 2021

The Affordable Care Act (ACA) establishes under Section 4980H penalties for applicable large employers (ALEs), i.e., those with 50 or more full-time employees (FTEs) who do not: Offer coverage that … Continued

2021 Open Enrollment Checklist

Open enrollment for the 2021 plan year is fast approaching and it is important for employers to be aware of the regulatory requirements and actions that need to be followed … Continued