Home | FAQs | Contact Us

Regulatory Guidance
  • Share
  • Print this page

2014
Date Guidance Issued Agency
3/10/2014 Final Rule: Employer Reporting Requirements The IRS released a final rule explaining major new reporting requirements for employers and insurers under sections 6055 and 6056 of the Internal Revenue Code. First reports must be filed in early 2016, based on data collected in 2015.
>> Final rule on Section 6056 reporting (applies to employers with 50+ FTE employees): Federal Register, March 10, 2014
See also:

>> Final rule on Section 6055 reporting (applies to health insurers, self-insured employers, and others): Federal Register, March 10, 2014
See also:
IRS
2/12/2014 Final Rule: Shared Responsibility for Employers Regarding Health Coverage. Final regulation explains health care law’s employer mandate. Includes definition of “applicable large employer,” full-time employment, employer penalties, health-plan affordability for employees, and more.
>> Final rule: PDF, HTML
Treasury/IRS
6/25/14 Final Rule: Ninety-Day Waiting Period Limitation. Implement the 90-day waiting period limitation.
>> PDF, HTML
IRS/HHS
6/4/2013 Final Rule: Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program. Includes details on SHOP exchanges, which are generally open to businesses with 2 to 50 employees in 2014 and 2015. Clarifies that federally facilitated SHOP exchanges will limit employers to a single plan until 2015, rather than giving employers/employees a range of choices; says state SHOP exchanges have the same option through 2014. >
>> Final Rule: PDF, HTML.
>> See also: SHOP application forms for employers, employees.
>> See also: Final Rule, March 27, 2012, Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (Exchange Establishment Rule), which sets standards for the administration of SHOP exchanges and explains which employers are eligible to participate: PDF, HTML.
HHS
5/8/2013 Temporary Guidance: FLSA Employee Notice. Guidance on mandate that requires employers covered by the Fair Labor Standards Act to give employees written notice about coverage options through exchanges. Notice must be provided to existing employees by Oct. 1, 2013.
>> DOL Technical Release 2013-02.
>> See also: DOL model notices, including for employers with health plans and without.
DOL
5/3/2013 Notice of Proposed Rulemaking: Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Guidance on determining whether employer-sponsored plans are affordable and provide minimum value. Includes details on how to calculate minimum value and affordability for wellness programs, health savings accounts and health reimbursement accounts.
>> Notice of Proposed Rulemaking: PDF, HTML
>> See also: Notice of Proposed Rulemaking: Incentives for Nondiscriminatory Wellness Programs in Group Health Plans, Nov. 26, 2012: PDF , HTML

>> See also: Minimum Value Calculator
Treasury/IRS
4/30/2013 Exchange/Marketplace Consumer Application. Forms individuals can use starting Oct. 1 to apply for coverage and/or subsidies to buy private health plans on public exchanges. Includes optional sections for employers to complete.
>> Press release
>> Exchange coverage application forms: For Individuals seeking financial assistance), individuals not seeking financial assistance, Family (includes additional "Employer Coverage Tool" that employers can fill out)
HHS
2/27/13 Interim Final Rule: Procedures for the Handling of Retaliation Complaints. Explains "whistleblower" protections to prevent employers from retaliating against employees who report potential violations of the health care law.
>> Interim final rule: PDF, HTML
>> OSHA fact sheet
 
2/27/13 Final Rule: Health Insurance Market Rules; Rate Review. Implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans.
>> Final Rule: PDF, HTML
HHS
2/25/13 Final Rule: Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation. Among provisions, final rule outlines several approaches for determining whether an employer’s health coverage provides minimum value under the health care law.
>> Final Rule: PDF, HTML
HHS
2/1/13 Various: Individual Shared Responsibility. Regulations from IRS/HHS on requirement that most Americans obtain minimum essential coverage or pay penalties, how individuals can apply for exemption from mandate, and which individuals may qualify for a premium tax credit to buy private insurance on a public exchange.
>> Notice of Proposed Rulemaking (IRS): Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage: PDF, HTML
>> Notice of Proposed Rulemaking (HHS): Eligibility for Exemptions: HTML, PDF >> IRS Q&A on individual mandate
IRS/HHS
2/1/13 Final Rule: Premium Tax Credit. Explains whether health coverage under an employer-sponsored plan is affordable for individuals who are eligible to enroll in the plan by reason of their relationship to an employee (related individuals).
>> Final Rule: PDF, HTML
IRS
1/22/13 Proposed Rule: Exchanges. Lengthy proposed rule covers many parts of the law. One section describes how employers will interact with exchanges when exchanges determine that individuals qualify for federal tax subsidies because they can't get access to affordable, minimum value coverage through their employer. Outlines appeals process for employers who disagree with exchange determinations.
HTML, PDF
HHS


2012
Date Guidance Issued Agency
5/30/2012 IRS Notice: Flexible Savings Act Limits. Explains new $2,500 limit on employee contributions to FSAs.
>> IRS Notice 2012-40.
IRS
12/5/12 Notice of Proposed Rulemaking: Net Investment Income Tax.  Explains extra 3.8% "Medicare contribution" surtax imposed on net investment income (such as capital gains, rents, royalties and interest for taxpayers in households with adjusted gross income over $200,000 (single)/$250,000 (married, filing jointly), starting Jan. 1, 2013.
>> Notice of Proposed Rulemaking: HTML, PDF
IRS
12/5/12 Notice of Proposed Rulemaking: Additional Medicare Tax.  Explains extra .9% payroll tax imposed on wages over $200,000 (single)/$250,000 (married, filing jointly), starting Jan. 1, 2013.
>> Notice of Proposed Rulemaking: HTML, PDF
IRS
2/14/12 Final rule: Summary of Benefits and Coverage.  Explains new standards for group health plans and insurers offering group/individual coverage to provide a “Summary of Benefits and Coverage” that explains cover in easy-to-understand, consistent language.
>> Final Rule: HTML, PDF
>> Templates, instructions and related materials: HTML, PDF
>> FAQs
IRS, DOL, HHS
1/6/2012 PCORI Fee. Explains new annual fee to support research at the Patient-Centered Outcomes Research Institute created by the health care law. Fee is paid by health insurers for fully insured plans; for self-insured plans, sponsors pay.
>> IRS Q&A
HHS
1/3/2012 W-2 Reporting. Explains requirement for employers to report value of health benefits on employees' W-2 forms.
>> IRS Notice 2012-9 (interim guidance restated/amended), IRS Notice 2011-28 (interim guidance), IRS Notice2010-69 (interim relief for employers)
HHS


2011
Date Guidance Issued Agency
1/10/2011 IRS Notice: Nondiscrimination Provisions Applied to Group Health Plans Addresses the timing of the application of the health care law's provisions prohibiting insured group health plans from discriminating in favor of highly compensated individuals.
>> IRS Notice 2011-1
DOL

2010
Date Guidance Issued Agency
11/17/2010 Interim Final Rule/Amendment to Interim Final Rule: Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan. Explains how plans qualify for "grandfathered" status under the 2010 health care law.
>> Amendment to Interim Final Rule and Request for Comments (11/17/2010): PDF
HTML
>> Interim Final Rule (6/17/2010): HTML
IRS, DOL, HHS
12/21/10 Request for information: Break time for nursing mothers. Preliminary interpretation of the health care law’s requirements that employers to provide reasonable break time and a place for nursing mothers to express breast milk for one year after their child's birth.
HTML, PDF, DOL fact sheet
DOL