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ACA Reporting Guide and Final Forms

The IRS has issued a guide for electronically filing ACA information returns (i.e., Forms 1094/1095). Employers who submit their own Forms 1094/1095 through the AIR System may want to review this guide in preparation for filing in January 2017. The IRS also issued the 2016 instructions and final forms for Forms 1094-B and 1095-B, with minor changes from the 2015 versions.

DOL Settles with Group Health Plan Over Findings of Affordable Care Act and ERISA Violations

The DOL issued a press release announcing its recent settlement with fiduciaries of a group health plan (the ?Ç£Plan?Ç¥) sponsored by Sierra Pacific Industries, a major western lumber producer. The press release followed the conclusion of a DOL investigation that determined the Plan did not comply with the Affordable Care Act (?Ç£ACA?Ç¥) and ERISA in certain respects. In particular, the DOL found problems with the Plan?ÇÖs claims processing, with the clarity of the Plan?ÇÖs documents, and with the application of the Plan?ÇÖs procedures for deciding claims. In addition, the DOL found the Plan had been administered erroneously under ACA ?Ç£grandfathered status?Ç¥ since January 1, 2013. As a result of this investigation, the Plan?ÇÖs fiduciaries agreed to (i) revise the Plan?ÇÖs documents and internal procedures; (ii) re-adjudicate past claims for preventive services, out-of-network emergency services, claims affected by an annual limit, and pay claims in compliance with the ACA and ERISA;… Continue Reading

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