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The Patient-Centered Outcomes Research Trust Fund fee, often referred to as the PCORI fee, can be a source of confusion for employers offering health insurance plans. This article aims to simplify what the PCORI fee is, why it exists, and how it impacts your business. What is the PCORI Fee? The PCORI fee is an … Continued
Attention Employers: Don’t Miss Your Form 5500 Deadline! Here’s a simplified breakdown of what you need to know about filing your employee benefit plan report: Who Needs to File? Employers subject to ERISA (Employee Retirement Income Security Act) with employee benefit plans, unless exempt. What to File? Form 5500 (annual report) for each employee benefit … Continued
A health plan is more than a product or service; it’s a relationship. All productive and healthy relationships—especially in the benefits space—rely on trust. When an employer extends trust in a broker or insurance carrier to purchase something as critical as healthcare—for people as critical as their workers and families—we’re obligated to raise all factors … Continued
IRS Releases ACA Pay-or-Play Penalties for 2025 The IRS recently released updated penalty amounts for 2025 related to the employer shared responsibility (pay-or-play) rules under the Affordable Care Act (ACA). For calendar year 2025, the adjusted $2,000 penalty amount is $2,900, and the adjusted $3,000 penalty amount is $4,350. This is a decrease from the … Continued
Final Forms and Instructions for 2023 ACA Reporting Released The IRS has released final 2023 forms and instructions for reporting under Internal Revenue Code Sections 6055 and 6056: 2023 Forms 1094-B and 1095-B (and instructions) will be used by providers of minimum essential coverage, including self-insured plan sponsors that are not applicable large employers (ALEs), … Continued
Gag Clause Attestations Are Due by Dec. 31, 2023 On Feb. 23, 2023, the Departments of Labor, Health and Human Services and the Treasury (Departments) issued FAQs on the prohibition of gag clauses under the transparency provisions of the Consolidated Appropriations Act, 2021 (CAA). These FAQs require health plans and health insurance issuers to submit … Continued
By way of background, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to study clinical effectiveness and health outcomes. To finance the Institute’s work, a small annual fee—commonly called the PCORI fee—is charged on group health plans. Grandfathered health plans are not exempt. Most employers do not have to take any … Continued
New transparency in coverage requirements apply to group health plans and health insurers in the individual and group markets. These rules require plans and issuers to disclose certain price and cost information to participants, beneficiaries and enrollees. These provisions only apply to non-grandfathered coverage, including both insured and self-insured group health plan sponsors. The requirements … Continued
Affordable Care Act (ACA) reporting under Section 6055 and Section 6056 for the 2021 calendar year is due in early 2022. Specifically, reporting entities must: Furnish statements to individuals by March 2, 2022; and File returns with the IRS by Feb. 28, 2022 (or March 31, 2022, if filing electronically). Penalties may apply for reporting … Continued
The EEO-1 Component 1 report is a mandatory annual data collection that requires all private sector employers with 100 or more employees, and federal contractors with 50 or more employees meeting certain criteria, to submit demographic workforce data, including data by race/ethnicity, sex and job categories. The filing by eligible employers of the EEO-1 Component … Continued