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Top 5 End-of-Year ACA Compliance Updates

While we are all busy with open enrollment and renewal season, HHS, IRS, and CMS are steadily making new compliance announcements. Here are the top 5 ACA compliance updates you should not overlook while preparing for the 2018 benefit plan year.

1. Final Transitional Reinsurance Fee Payment Due November 15

The Affordable Care Act (ACA) established the transitional reinsurance program to help stabilize premiums in the individual market by collecting contributions from certain entities, such as health insurance issuers and self-insured group health plans, for the 2014, 2015, and 2016 benefit years. Contributing entities that elected to make two installment contribution payments for the 2016 benefit year must use pay.gov to submit its final payment of $5.40 per covered life no later than November 15, 2017. Learn more about the Transitional Reinsurance Fee.

2. IRS Increases Health FSA Limit for 2018

The IRS issued Revenue Procedure 2017-58 which increased the Health Flexible Spending Arrangement (FSA) employee contribution limit for 2018 to $2,650. This represents a $50 increase from the 2017 limit of $2,600. Learn more about Health FSAs.

3. Additional Mandated Preventive Health Services for 2018

The ACA requires most health plans to cover certain preventive health care services at no cost-sharing to the participant. The U.S. Preventive Services Task Force (USPSTF) added the following preventive services recommendations for implementation under the ACA:

Topic Description Grade
Vision Screening: Children The USPSTF recommends vision screening at least once in all children ages 3 to 5 years to detect amblyopia or its risk factors. B
Obesity Screening: Children and Adolescents The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. B
Preeclampsia Screening The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy. B
Folic Acid Supplementation The USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid. A

 

4. Individuals Must Report Health Coverage on Taxes

In a shift from prior years’ requirement, the IRS recently announced that for the upcoming 2018 tax filing season, it will not accept electronic returns and may suspend paper returns until the taxpayer indicates whether or not they had health coverage, were eligible for an exemption, or will make an individual shared responsibility payment. The 2018 filing season is the first year the IRS will not accept returns missing this information. While taxpayers are required to report their health coverage status, the IRS is not requiring taxpayers to attach a copy of the 1095-A, 1095-B, or 1095-C.

5. IRS Announces New PCORI Fee Amount

The Patient-Centered Outcomes Research Fund fee is a fee on health insurance issuers and self-insured group health plans that helps fund the Patient-Centered Outcomes Research Institute (PCORI). The IRS issued Notice 2017-61 which increases the applicable dollar amount for the PCORI fee from $2.26 to $2.39 for policy years and plan years ending on or after October 1, 2017, and before October 1, 2018. Learn more about methods of calculating the PCORI fee.

Plan Year Ending Applicable Rate Due Date
January 2017 – September 2017 $2.26 July 31, 2018
October 2017 – September 2018 $2.39 July 31, 2018

 

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