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The Wagner Law Group

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 22 attorneys engaged exclusively in employee benefits, estate planning and employment law. Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Boston 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Palm Beach Gardens 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

Tampa

Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 

 

San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
100 South 4th Street, Suite 550
St. Louis, MO  63102 

 

www.wagnerlawgroup.com

 

 

 

 

February 19, 2016

 

 Health and Welfare Law Alert

 

 

 

Agencies Release Guidance on ACA Issues Impacting Student Employees 

 

 

 

IRS, DOL and HHS (collectively, the "Agencies") have jointly issued Notice 2016-17, which provides guidance to institutions of higher education (i.e., colleges and universities) on compliance with certain group market reform provisions of the Affordable Care Act ("ACA"), including the issue of whether the school may offer premium reduction arrangements to its students. Notice 2016-17 also provides a temporary transition period for non-compliant employers to come into compliance with the ACA market reform mandates and avoid enforcement actions by the Agencies.

 

Background. Many colleges and universities provide students with student health coverage at greatly reduced (or no) cost. Student health coverage can be provided either through individual health insurance or through coverage that is self-insured by the school. In many cases, the premium for student health coverage may take into account a premium reduction arrangement. Because some students also perform services for the school (e.g., teaching or research), it is possible that such premium reduction arrangements might be viewed by the Agencies as employer-sponsored group health plans that violate the ACA's market reform provisions.

 

The Agencies issued guidance in 2013 which provides that an employer payment plan ("EPP") (i.e., a group health plan that directly reimburses employees for all or some of the premium costs incurred for individual market coverage) or a health reimbursement arrangement ("HRA") could only comply with the ACA to the extent that the EPP or HRA was integrated with a group health plan. This is because the ACA prohibits annual dollar limits on essential health benefits, and by their definition, EPPs and HRAs are limited to the amount credited to the EPP or HRA.

 

Under federal law, student health plans are treated as individual health policies that are not part of a group health plan. Thus, student health plans cannot be integrated with an EPP or HRA, at least with respect to students who are employees of the university or college sponsoring the student health plan. Accordingly, to comply with ACA's market reform requirements, institutions of higher education must obtain alternative coverage for affected student-employees.

 

Transition Relief. Notice 2016-17 provides a transition period so that colleges and universities can find replacement group coverage for affected student-employees. Under this transition period, colleges and universities will have until the first day of the first policy or plan year beginning on or after January 1, 2017 to provide students who are full-time employees with an offer of coverage that complies with the ACA.

 

EXAMPLE: If a student-employee's policy year runs from September 1 through August 31, the college or university will have until September 1, 2017 to offer the student-employee group health coverage that is compliant with the ACA or face a penalty under the (ACA's) employer mandate.

 

Takeaway for Employers. Educational institutions must carefully reconsider the health coverage offered to students-whether the students are employees or not and whether the coverage is student health coverage or coverage under an employer's group health plan-to ensure that all coverage offered meets ACA requirements. However, they should also bear in mind that the Agencies may reconsider their current position on this matter.

 

Notice 2016-17 is available at: https://www.irs.gov/pub/irs-drop/n-16-17.pdf

     

 

 

 

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This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.