Affordable Care Act - Employer Rights and Responsibilities (Course Id 869)

Taxes - Taxes for Course Id 869

The Patient Protection and Affordable Care Act (PPACA) has brought about the most significant change in healthcare since the passage of the 1965 legislation that authorized Medicare. It imposes healthcare-related requirements on health plans, health insurers and employers.

Eligible small employers may receive tax credits for providing health insurance coverage to their employees, and large employers may find themselves subject to tax penalties for failing to provide such employee coverage. This course will review the principal coverage provisions of the law and will examine its tax impact on employers. 

NASBA QAS - Text - NASBA Registry - IRS Enrolled Agents - 869

Course Learning Objectives

• List the principal coverage provisions of the PPACA;
  
• Recognize the shared responsibility requirements for applicable employers with respect to employee health coverage;
  
• Compute the potential tax penalties that may be imposed under the PPACA for an employer’s failure to meet the applicable shared responsibility requirements; and
  
• Calculate the tax credits for which a small employer may be eligible for providing employee health insurance coverage.

Chapter 1
Overview of PPACA Coverage Provisions

• Identify the rules applicable to –
  o grandfathered health plans,
  o the use of pre-existing condition exclusions, and
  o annual and lifetime benefit limits;
• List the conditions that would permit an insurer to rescind health insurance coverage; and
  
• Recognize the requirements imposed by healthcare reform legislation with respect to –
  o patient protection provisions, and
  o dependent coverage to young adults.

Chapter 2
Employer Credits & Requirements

• Identify the –
  o W-2 reporting requirements imposed on employers providing employer-sponsored health coverage, and
  o transition relief provided concerning W-2 reporting;
• Define “full-time employee” and “full-time equivalent employee” for purposes of employer tax credits and penalties under the PPACA;
  
• Recognize the –
  o rules that apply to a small employer’s eligibility for a health insurance premium credit, and
  o nature of a “qualifying arrangement” under which an employer pays premiums for employee health insurance coverage;
• Identify the types of coverage that meet the PPACA definition of health insurance coverage for purposes of the small employer health insurance premium credit;
• Apply the various limitations that may reduce the amount of health insurance premium credit available to an otherwise eligible small employer;
• Calculate the potential penalties that may be imposed on large employers under the PPACA; and
• Identify the annual return and notification requirements imposed by the PPACA on applicable large employers.

Course Learning Objectives

Introduction

Chapter 1 - Overview of PPACA Coverage Provisions

Chapter Learning Objectives

Introduction

Grandfathered Health Plans

Losing Grandfathered Status

Disclosure Requirements

Documentation Requirements

Actions Resulting in Loss of Grandfathered Status

Eliminating Benefits

Increasing Participants’ Cost-Sharing Requirement

Increasing a Fixed-Amount Copayment

Reducing Employer Contribution Rates

Violating Anti-Abuse Rules

Pre-Existing Condition Exclusions Prohibited

Two Criteria Present in Pre-Existing Condition Exclusion

Grandfathered Group Health Plans Not Exempt

Benefit Limits Prohibited

Benefit Limit Prohibition Applicable only to Essential Health Benefits

Contract Rescission Limited

Patient Protections

Emergency Services

Large Employer Requirement to Provide Health Coverage

Adult Children Coverage

Plans Required to Extend Dependent Coverage

Eligibility for Extended Dependent Coverage

Summary

Chapter Review

Chapter 2 - Employer Credits & Requirements

Chapter Learning Objectives

Introduction

Form W-2 Reporting of Employer-Sponsored Health Coverage

Effective Date for W-2 Reporting

Cost of Coverage Transition Relief

Reporting on the Form W-2

Cost of Health Coverage Excluded from Income

Certain Types of Coverage Not Reportable

Small Employer Health Insurance Premium Credit

Eligibility Requirements

Qualifying Arrangements Generally

Qualifying Arrangement Variations

Arrangements with Composite Billing

Arrangements with List Billing

Health Insurance Coverage Defined

Some Benefits Don’t Qualify as Health Insurance Coverage

Employees of the Employer

Employees Possessing Ownership Interests

Leased Employees

Seasonal Employees

Household and Other Nonbusiness Employees

Ministers

Controlled Group

Limitations Affect Health Insurance Premium Credit

Full-Time Equivalent Employee (FTE) Limitation

Average Annual Wage Limitation

Average Premium Limitation

State Premium Subsidy and Tax Credit Limitation

Calculating the Credit

Large Employer Shared Responsibility

Large Employer Defined

Aggregation Rules Apply

Full-Time Employee

Safe Harbor Method for New Employees

Safe Harbor Method for Current Employees

Penalty for Non-Compliance

Employers Not Offering Coverage

Employers Offering Coverage

Medicaid Expansion Option may affect Employer Penalties

Large Employer Reporting Requirements

Large Employer Notification Requirements

Self-Insured Plan Fees

Summary

Chapter Review

Appendix A

Appendix B

Appendix C

Glossary