link to Home page US Health Care
Consolidated PPACA and Reconciliation Act PPACA (as enacted) Reconciliation Act (as enacted) Committee Reports (consolidated by ERIC)
DOL Key regulation site
Court cases King v. Burwell National Federation of Independent Business, et al v. Sebelius Burwell v. Hobby Lobby Stores, Inc., et al. State of California et al vs. Donald J. Trump
Indexed amounts under the ACA
Best private websites Henry J. Kaiser Foundation Henry J. Kaiser frequently asked questions
Government Sources 1. General HealthCare.gov IRS ACA Publication 5200 (summary page for employers) IRS ACA for individuals and families EBSA ACA Home Page HHS regulations and guidance CMS Center for Consumer Information and Insurance Oversight CCIIO Regs and Guidance
ACA topics ACA Numbers and Limits (2014-2020)
Shared Responsibility Penalty assessments 266j Letter 14674 Correction worksheet I2014 final regulations Notice 2014-49 change of measurement period Multiemployer plan rules Segal 3/2015 Moulder law blog on 95% rule and non assessment period Transition relief in regs explained: Mondaq Staffing firm employees- Alston and Byrd 3/2014 Assurex helpful q&a
Reporting and Disclosure 2019 reporting extension Notice 2019-63 2018 reporting extension Notice 2018-94 IRS Notice 2012-9 W-2 reporting cost of coverage Feb. 14, 2012 final regulations and templates (Fed register) Foreign language requirement article Deloitte article
Essential Health Benefits, Actuarial Value, Cost Sharing IRS Notice 2014-69 Minimum Value must have hospitalization coverage CMS May 2014 Q&A's Market Reforms May, 2013 MVP Healthcare outline QHP Regulations 2013 Buck explains
FLSA 1. DOL Notice 2013-02 sample notices: (employers w/ plans) -- notice (employers w/o plans) 2. Nursing mothers DOL Fact Sheet
Market Reforms Overview: Center for Consumer Information & Insurance Oversight
Final regulations: Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections final regulations
1. Cafeteria Plans, HRAs, EPPs, Excepted Benefits
2019 Final Trump HRA Regulations
2019 FAQs on new HRA rules 2019 Model HRA Employee Notice 2019 Model Attestation
March 2015 regulations on wrap-around policies
2018 Proposed regulations: HRAs Winstead & Strawn analysis Notice 2018-88: HRA and effect on employer penalties
2016 Proposed regulations (Opt out plans) IRS Notice 2015-87 (payment plans, opt outs, and other key issues) IRS Notice 2015-17 (small plan extension and medicare payment plans and misc.) DOL 2014 FAQ on employer premium reimbursements IRS Notice 2013-54(Employer payment plans) DOL Tech Release 2013-03 (Employer payment plans) July 2016 proposed regulations (Opt out programs)
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2014 final regulation for excepted benefits
2. Waiting and orientation periods Orientation period final regulations 90 day waiting period 2014 final regulations SEGAL explains 90 day final regulation and proposed regulation
3. Children up to 26th birthday (coverage) DOL / IRS / HHSA interim final rule DOL Q&As Model disclosure notice: special enrollment Tax treatment: IRS Notice 2010-38 (includes 125 plan rules
4. Annual limits: Out of pocket maximums DOL FAQ Part XXVII Proskauer analysis
5. Preventative Services Final regulations: 2015 ERIC explains
6. Grandfathered plans Interim regulations DOL Grid Model disclosure notice: grandfathering Segal Co comparison: grandfathering ERISA Diagnostics Grid: Worst case analysis BBA Health Law Analysis Interim regulation to allow change of insurer
Minimum Essential coverage August 30, 2013 final IRS regulations IRS Q&As
Nondiscrimination rules for insured plans IRS Notice 2011-1 (extension until further guidance) IRS Notice 2010-63
Preventive Care Mandate 2014 proposed Burwell regulations 2013 final regulations 2013 Proposed regulations on contraception 2011 Interim regulation
Wellness Programs 2015 EEOC proposed regulations 2015 EEOC Q&As about proposed regulations The differences between EEOC and the proposed 2015 regs: Ballard Bryan Cave comments on EEOC proposal
Groom explains proposed 3/2015 legislation 2013 final HIPAA regulations Pillsbury explains RODRIGUES v.EG SYSTEMS, INC. d/b/a SCOTTS LAWNSERVICE
Miscellaneous 1. Small group expansion to 100 in 2016 American Academy of Actuaries study
2. Early Retiree Assurance Program HIS Interim Final Rule (5/5/2010) Sutherland Asbill checklist Deloitte analysis
3. Long term care (the Class Act) NY Times summary
4. Prescription Drug Limit IRS Notice 2010-59
5. Discrimination rules Seyfarth analysis
The taxes Cadillac tax Notice 2015-16 and EBIA Notice 2015-52
Individual responsibility penalties IRS Form 8965 instructions IRS Form 8965 IRC calculator for individual responsibility penalties IRS Page #1 IRS page #2 HHS.Gov page
Investment tax Groom describes investment tax Final 2013 Medicare tax regulations IRS Q&As / new medicare tax
TRP Fees on Self Insured Plans 2015 TRP instructions 2015 TRP slide show TRP final regulations 2013 TRP Q&As re/ fiscal year plans TRP final March 23, 2012 regulations Summary from Willis
PCORI IRS Form 720 PCORI 2015 guidance (Lockton) PCORI regulation SHRM overview of TRP and PCORI
The credits Individual Credits IRS 36B / 162(l) final regulations IRC 36(b)(2) regulations IRS Publication 502 / individual claiming the tax credit 2015 Poverty levels Section 1411 Certification by Exchange Trucker Huss presentation Coverage tool form individual provides to Exchange for certification
Small employer credit IRS Q & A's 2014 Proposed SHOP Exchange regulations Notice 2010-13 list of benchmark premiums IRS web page IRS Notice 2010-44 IRS instructions: Form 8941
Related laws and Topics CHIP and Medicaid Notice 2015-37: eligibility for CHIP buy-in does not disqualify person for ACA credit. specimen special enrollment notice
Cafeteria Plans and other tax consequences IRS Publication 969 (for 2017 returns) CCM 201547006 Notice 2014-55 changes in election
COBRA New 2014 COBRA Notice Form 8928 penalties (COBRA and HIPAA)
Employer payment plans (105 and 106 analysis) Rev. Rul. 61-146 Publication 15-B Note 17 comments on coverage of spouse's premiums not covering employee
EMPLOYER OPT-OUT PAYMENTS IRS Notice 2015-87 IRS proposed 2016 rules DOL Technical Release 2013-03 McGraw Hill summary Opt-outs count as base for overtime Flores v. City of San Gabriel (9th Cir 2016)
ERISA 1. Appeals Procedure Allston & Bird comment DOL site w/ regulation links DOL Technical Advice 2010-1 2. Medical Loss ratio refunds DOL Technical release 2011-4 Plan assets IRS FAQs (2012)
GINA 2015 proposed regulations Impact on wellness programs (Pepper Hamilton) GINA DOL Site
HIPAA HHS Audit pre-screening questionnaire Phase 2 Audit Program Notifying state regulators of HIPAA breaches: McDermott 2013 Final regulations HHS.Gov site 2014: Upcoming HIPAA Desk audits New rules explained McGraw Wentworth 2015 extension explained (McDermott) 2015 extension of certification requirements (Practical Law) Tagalong explanation
HSAs & HDHPs Q&As on HSAa (Sterling) Chief Counsel Memo on FSA grace periods and HSA eligibility
Medicaid Expansion Medicaid enrollment services: Benestream 2014 McGraw Hill explanation
Medicaid Secondary laws Bulletin
Medicare Part D Notice 2015 Buck Memo
Medicaid: Low Income individuals Medicaid and CHIP: Healthcare.gov link CMS: new way to determine income thru MAGI
Mental Health Parity
MEWA DOL Explanation August 2013 M-1 Instructions and form 2016
QSHERA extended disclosure date: Notice 2017-20
Self Insured Plans (taxation)
Subchapter S Tax rules IRS site
Wellness Plans 2018,1_Outline_A Gallagher Court extends time for EEOC compliance / ARP v EEOC AARP v EEOC invalidates regulations New EEOC regulations analyzed by PLI
2015 ABA q&As
Annual Limit Waivers SBC requirements: McGraw Wentworth June 17, 2011 application info (w/ extension info) June 17, 2011 CCIIO link to Waiver info June 17, 2011 info w/ employee notice Original MiniMed Annual limits waiver procedure (HHS) Original MiniMed Notice for plans with waivers (HHS)
ACA fee chart: Kaufman & Canoles
The regulators HHS key personnel
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