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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 24, 2015

 

 Health and Welfare Law Alert

 

 

 

 IRS Grants Relief for many Integrated HRAs in Final Instructions for ACA Reporting Forms

 

 

 

 

 

The IRS has issued final instructions for Forms 1094 and 1095 (collectively, the "Forms"). Notably, the final instructions eliminate the requirement that employers report the coverage provided to employees under Health Reimbursement Arrangements ("HRA") that are integrated with the group health plans they sponsor. (Note: An integrated HRA conditions an employee's eligibility for enrollment upon enrollment in the employer's group health plan.)

 

Background. Applicable Large Employers are required to file Forms 1094 and 1095 to report their compliance with the Affordable Care Act's ("ACA's") employer shared responsibility provisions (i.e., employer mandate). In particular, Forms 1094 and 1095 provide certain information to the IRS and taxpayers regarding individuals who are covered by Minimum Essential Coverage ("MEC") and, therefore, not subject to the ACA's individual shared responsibility provisions (i.e., the individual mandate).  

 

For fully-insured group health plans, the insurance carrier is responsible for furnishing the Forms 1095-B to the IRS and employees, and the employer is responsible for furnishing Forms 1095-C to the IRS.  (Note: Employers that sponsor fully-insured group health plans need only complete Parts I and II of the Form 1095-C.)  For self-funded group health plans, the employer/sponsor is generally responsible for issuing and filing both Forms 1095-B and -C.

 

The applicable final regulations provide an exception to the reporting requirements for MEC that provides benefits as a supplement to a group health plan or arrangement. However, this exception only applies if the primary and supplemental coverages have the same plan sponsor.

 

IRS's draft instructions for the Forms explained that coverage isn't provided by the same plan sponsor if it isn't reported by the same entity. Thus, employers' integrated HRAs that were paired with fully-insured group health plans were not considered supplemental coverage. As a result, employers sponsoring such arrangements would be required to issue Forms 1095 to covered employees (and transmit copies to the IRS on Form 1094) enrolled in the HRA despite the insurance carrier's issuing Forms 1095 for the fully-insured coverage.

 

Final Instructions. Under the revised final instructions for the Forms, an employer that sponsors an integrated HRA paired with a group health plan that provides MEC need only report the major medical coverage. In other words, employers sponsoring such arrangements are no longer required to report the integrated HRA coverage. However, where an employee is covered by an HRA sponsored by one employer and a group health plan sponsored by another employer (e.g., spousal coverage), both employers must report the coverage that each provides using the Forms.

 

The final instructions for the Forms are available at: http://www.irs.gov/pub/irs-pdf/i109495c.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.