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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

 

 

 

 

September 18, 2015

 

 Health and Welfare Law Alert

 

 

 

IRS Issues New Proposed "Minimum Value" Regulations

 

 

 

 

 

IRS has issued new proposed regulations which revise the definition of "minimum value" under the Affordable Care Act ("ACA"). Employers may be subject to the ACA's employer shared responsibility penalties if they fail to offer affordable, minimum value health coverage to all full-time employees.

 

Background. Prior regulations provided that a health plan met the ACA's minimum value requirement if, generally speaking, it was designed to cover at least 60 percent of the total cost of covered benefits. The IRS and HHS developed an on-line Minimum Value Calculator to help employers determine whether their plan met the minimum value requirement.

 

Subsequent to the release of the prior regulations, the IRS and HHS became aware that promoters were marketing health plans designs to employers which satisfied the 60 percent minimum value calculation even though the plans did not provide coverage for inpatient hospitalization services or certain physicians' services. In response, the IRS released a notice indicating that it and HHS would update the regulations to provide that a health plan would not be deemed to provide minimum value unless it covered substantial hospitalization and physician services.

 

The IRS notice also provided transition relief to employers that, as of November 3, 2014, had either enrolled employees in such a plan or had entered into a contract to adopt such a plan. The relief provided that as long as the plan satisfied all other minimum value requirements, the employer would not be liable for employer shared responsibility penalties through to the end of a plan year beginning on or before March 31, 2015. In addition, the IRS said the employer's offer of coverage did not prevent employees from qualifying for premium subsidies.

 

Earlier this year, HHS issued regulations stating that health plans that do not provide substantial coverage of inpatient hospitalization and physician services do not satisfy the ACA's minimum value requirement.

 

Proposed Regulations. IRS's proposed regulations provide that eligible employer-sponsored health plans will be deemed to provide minimum value only if the plan's share of total allowed costs of benefits provided to an employee is at least 60 percent and if the plan covers substantial inpatient hospitalization and physician services.

 

Action Steps for Employers. Employers should review their plans to confirm that they are in compliance with the revised minimum value standards.

 

The proposed regulations are accessible at: http://www.gpo.gov/fdsys/pkg/FR-2015-09-01/pdf/2015-21427.pdf

 

 

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

 

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.