RESOURCES

Affordable Care Act (ACA) - The Affordable Care Act  provides Americans with better health security by putting in place comprehensive health insurance reforms that will: Expand coverage, hold insurance companies accountable, lower health care costs, guarantee more choice, and, enhance the quality of care for all Americans.  

 

COBRA - gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events.

• COBRA FAQ

 

Illinois State Continuation (Mini COBRA; 19 or less in group/HMO) -  State and federal laws give certain employees, spouses and dependent children the right to continue employer-sponsored health benefits at group rates if they lose their benefits because of specific “qualifying events.”  The type of qualifying event determines who is qualified for continued coverage and for how long.

 

HSA - A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. 

 

FSA - A Flexible Spending Account (FSA) is a tax-favored program offered by employers that allows their employees to pay for eligible out-of-pocket health care and dependent care expenses with pre-tax dollars. - https://www.healthcare.gov/flexible-spending-accounts/

 

HRA - A Health Reimbursement Arrangement (HRA), commonly referred to as a Health Reimbursement Account, is an IRS approved, employer-funded, tax-advantaged employer health benefit plan that reimburses employees for out-of-pocket medical expenses and individual health insurance premiums. - https://www.healthcare.gov/glossary/health-reimbursement-account-HRA/

 

Reporting by Health Coverage Providers

The Affordable Care Act (ACA) created new reporting requirements under Internal Revenue Code (Code) Section 6055. These new reporting rules require health insurance issuers, sponsors of self-insured health plans, government agencies that administer government-sponsored health insurance programs, and any other entity that provides minimum essential coverage (MEC) to provide information to the Internal Revenue Service (IRS) about the health plan coverage they offer.

 

• Section 6055 - Beginning in 2014, PPACA requires all nonexempt individuals to either maintain minimum essential coverage (“MEC”) or pay a penalty as part of their income tax returns for every month they go without MEC. Section 6055 reporting is necessary to determine whether individuals are maintaining MEC. The entity required to report must file an information return with the IRS and furnish covered individuals with a statement.

• Section 6056 - PPACA requires applicable large employers (those with 50 or more full-time and full-time equivalent employees) to file returns with the IRS containing information about health care coverage offered to fulltime employees and furnish a statement to every full-time employee with the same information. Section 6056 reporting is needed for the administration of the employer shared responsibility requirement and the premium tax credits offered through the Marketplaces. The final regulations provide a general method for preparing and filing the 6056 return, along with alternatives that are available to applicable large employer members in lieu of the general method.