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Healthcare Reform Update: Employer Mandate, Consumer Assistance and Premium Assistance Credit

Posted 6:15 PM by

Employer Mandate

The Internal Revenue Service issued Notice 2013-45 formalizing the one-year delay of the mandate that applicable large employers must offer adequate health coverage to their full-time employees and the information reporting required under IRC Sec. 6055 and 6056.

Final Regulations on Health Insurance Marketplace Consumer Assistance Roles

Consumers will be able to obtain live in-person help as they go through the process of applying for and choosing health insurance in the new health insurance marketplace. Navigators, non-navigator assistance personnel and certified application counselors will be available to help consumers prepare applications to establish eligibility and enroll in coverage through the marketplace.

Final Rules on Verifying Eligibility for Premium Assistance Credits

The Department of Health and Human Services (HHS) issued final regulations that explain the process that the state insurance marketplaces will use to verify whether individuals are eligible for advanced payment of the premium assistance credits. To qualify, an individual must attest on his or her marketplace application that he or she is not enrolled in employer-sponsored health coverage nor has access to employer-sponsored coverage that is affordable and provides minimum value. The marketplace must verify the individual’s attestations using available data from certain approved sources. However, under the final rules, for advanced premium assistance credit eligibility determinations that are effective before 2015, the marketplace may accept an individual’s attestation regarding their employer-sponsored health coverage without further verification from other approved sources.

Source: Thomson Reuters

About Us
Katz, Sapper & Miller’s Healthcare Resources Group serves healthcare providers, including physicians, hospitals and health systems, surgery centers, and long-term care facilities. Our team of healthcare professionals has the scope and depth to meet client needs. Learn more.

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