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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
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

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)


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
Model disclosure notice: special enrollment
Tax treatment: IRS Notice 2010-38 (includes 125 plan rules

4. Annual limits: Out of pocket maximums
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

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

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

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

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

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)

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)

2015 proposed regulations
Impact on wellness programs (Pepper Hamilton)

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

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

Medicare Part D Notice
2015 Buck Memo

Medicaid: Low Income individuals
Medicaid and CHIP: link
CMS: new way to determine income thru MAGI

Mental Health Parity

DOL Explanation August 2013
M-1 Instructions and form 2016

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