Category Archives: Healthcare Reform

COBRA FAQ’s for Employer Reporting

Q.  Does an employer need to complete Form 1095-C for an employee who terminates employment mid-year causing a COBRA qualifying event?

 A.  Yes, Form 1095-C is required to be completed in the year that an employee terminates. When employment termination is the COBRA-qualifying event, COBRA is never reported as an offer of coverage – even if the former employee actually enrolls in COBRA coverage. Per the IRS’ final instructions, report as follows for the months that COBRA was offered:

  • Line 14 – Always use Code 1H (no offer of coverage).
  • Line 15 – Leave Line 15 blank. You do not report cost information.
  • Line 16 – Always use Code 2A (employee not employed during the month).
  • Part III – Employers with self-insured plans will complete this section for former employees and dependents that enroll in COBRA and will continue to report for as long as COBRA coverage is in force.

Continue reading COBRA FAQ’s for Employer Reporting

FAQ’s for Employer Reporting 6055 and 6056

By: Christine Gaiser, Senior Advisor and Simone Torneo, Senior Advisor 

Q: Which employers are subject to the IRS reporting requirements?

A: All “Applicable Large Employers” (ALE’s) have ACA annual reporting responsibilities. An ALE is generally one with 50 or more full-time employees, including full-time equivalent employees. All ALE’s will need to provide the IRS and their full-time employees information returns concerning whether and what health insurance was offered to their full-time employees. Remember that regardless of size, all employers that provide self-insured health coverage to their employees must file an annual return reporting certain information for each employee they cover. Continue reading FAQ’s for Employer Reporting 6055 and 6056

Everything You Need to Know About Accountable Care Organizations (ACOs)

Health Care Reform has brought about significant changes in the healthcare market, arguably some good and some not-so-good. One major change is the transformation of how care is delivered. We are experiencing a change in the structure of paying providers for the number of services delivered, to paying for improved outcomes and cost efficiency through a variety of models called Accountable Care Organizations (ACO). These models use a combination of technology and data, along with financial incentives to help providers coordinate care and improve clinical outcomes. Medicare was an early adopter, and approximately 423 organizations are participating in the Medicare ACO program. Future Medicare ACO programs will allow Medicare beneficiaries to choose an ACO versus other care models, and may provide a financial incentive to the Medicare beneficiary to do so. Continue reading Everything You Need to Know About Accountable Care Organizations (ACOs)