Wrap Documents for Welfare Benefit Plans

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for employee benefit plans maintained by private-sector employers. Under ERISA, employer-sponsored welfare benefit plans, such as group health plans, must be described in a written plan document. In addition, employers must explain the plans’ terms to participants by providing them with a summary plan description (SPD).

The insurance certificate or benefit booklet provided by an insurance carrier or other third party for a welfare benefit plan typically does not satisfy ERISA’s content requirements for plan documents and SPDs.

However, employers may use wrap documents in conjunction with the insurance certificate or benefit booklet in order to satisfy ERISA’s requirements. This document is called a “wrap document” because it essentially wraps around the insurance certificate or benefit booklet to fill in the missing ERISA-required provisions. When a wrap document is used, the ERISA plan document or SPD is made up of two documents— the insurance certificate or benefit booklet and the wrap document.

Erisa coverage

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Covered Employers

ERISA applies to virtually all private-sector employers that maintain welfare benefit plans for their employees, regardless of the size of the employer. This includes corporations, partnerships, limited liability companies, sole proprietorships and nonprofit organizations.

ERISA exempts only two types of employers:

  1. Employee benefit plans maintained by governmental employers are exempt from ERISA’s requirements. This exemption includes plans maintained by the federal, state or local (for example, a city, county or township) governments.
  2. Church plans are also exempt from ERISA. A church plan is any employee benefit plan established or maintained by a church or by a convention or association of churches that is exempt from tax under Section 501 of the Internal Revenue Code (Code), and that has not made an election under Code Section 410(d) to be subject to ERISA.

Small employers are subject to ERISA’s requirements, unless they meet the exemption for governmental employers or churches.

Welfare Benefit Plans

Many employment plans or programs that provide nonretirement benefits to employees are considered employee welfare benefit plans that are subject to ERISA. To qualify as an ERISA plan, there must be a plan, fund or program that is established by the employer for the purpose of providing ERISA-covered benefits (through the purchase of insurance or otherwise) to participants and their beneficiaries.

ERISA generally applies to the following common employee benefits, regardless of whether they are insured or self-funded:
·         Medical, surgical or hospital benefits;

·         Dental and vision benefits;

·         Prescription drug benefits;

·         Health reimbursement arrangements (HRAs);

·         Health flexible spending accounts (FSAs);

·         Group life insurance benefits;

·         Wellness programs (when medical care is provided);

·         Employee assistance plans (when medical care is provided);

·         Disability benefits, if insured or funded other than as a payroll practice; and

·         Disease-specific coverage (for example, cancer policies).

Written Plan Document

ERISA requires welfare benefit plans to “be established and maintained pursuant to a written instrument.” Thus, an employer’s welfare benefit plans must be described in a written plan document. There is no small employer exception to ERISA’s plan document requirement.

ERISA does not require that a plan document be in any particular format. However, there are several topics that must be addressed in the written plan document for a welfare benefit plan. For example, the plan document must address:

  • Benefits and eligibility;
  • Funding of benefits;
  • Procedures for allocating and delegating plan responsibilities;
  • Plan amendment and termination procedures;
  • Designation of named fiduciary; and
  • Required provisions for group health plans, such as COBRA rights and HIPAA compliance.

Does the Booklet Prepared by the Insurer or TPA Qualify as a Plan Document?

In general, the detailed coverage document (or certificate of coverage) provided by an insurance carrier for a welfare benefit does not contain all of the information required by ERISA for a plan document. For example, while carrier certificates include detailed benefit information, they generally do not designate plan fiduciaries or provide procedures for amending or terminating the plan. Thus, the carrier’s certificates, on their own, are not ERISA-compliant plan documents. Benefit booklets provided by TPAs for self-insured welfare benefits may also fail to include the ERISA-required information for plan documents.

Wrap Documents

A wrap document is a relatively simple document that supplements existing documentation for a welfare benefit plan (for example, an insurance certificate or benefit booklet). This document is called a wrap document because it essentially wraps around the certificate or booklet to fill in the missing ERISA-required provisions. Because the wrap document incorporates the insurance certificate or benefits booklet by reference, the plan’s benefit provisions continued to be governed by the terms of those documents.

When a wrap document is used, the ERISA plan document is comprised of two pieces:

1 The insurance certificate or benefits booklet, reflecting many of the plan’s important terms and requirements; and
2 The wrap document that fills in the ERISA-required information that is missing from the insurance certificate or benefits booklet.

Thus, the wrap document and the carrier certificate (or TPA booklet), together, make up the plan document.

Mega Wrap Plans

Wrap documents can be used to combine more than one welfare benefit under a single plan, which is sometimes referred to as a “mega wrap plan” or an “umbrella plan.” For example, a wrap document could be used to bundle medical benefits, dental benefits, disability coverage and an HRA under one single ERISA plan. This document would wrap around all the third-party documentation (for example, insurance certificates or benefit booklets) to include the missing ERISA provisions and combine the benefits into one plan.

The decision of whether to combine (or bundle) welfare benefits often depends on how it will affect the Form 5500 filing obligation.

  • For larger employers, combining different benefits together may simplify the annual reporting requirement because only one Form 5500 will be required for the bundled plan.
  • For smaller employers, however, each benefit offered as a separate plan may qualify for the Form 5500 exemption for small plans. Combining the benefits together under a bundled plan might cause the plan to exceed the threshold for small plans, which would trigger the Form 5500 filing requirement.
  • Form 5500 Exemption—Small welfare plans are exempt from the Form 5500 filing requirement if they have fewer than 100 covered participants and their benefits are insured or unfunded.

Summary Plan Descriptions

Virtually all welfare benefit plans that are subject to ERISA must provide participants with an SPD, regardless of the size of the sponsoring employer. An SPD is a document that is provided to plan participants to explain their rights and benefits under the plan document. ERISA also includes detailed content requirements for welfare benefit plan SPDs.

In general, a carrier’s insurance certificate will not include all the information that must be included in an SPD under ERISA. A benefit booklet prepared by a TPA may also fail to include the ERISA-required information for SPDs. To create an SPD in this situation, an employer can use a wrap document (wrap SPD) that includes the ERISA-required information that the certificate or booklet prepared by the insurer or TPA does not include. In this scenario, the wrap SPD and the insurance certificate or booklet, together, make up the plan’s SPD. To comply with ERISA, both the wrap SPD and the insurance certificate or booklet must be distributed to plan participants by the appropriate deadline.

Thus, a welfare benefit plan can have a wrap plan document and a wrap SPD, with both of these ERISA documents being comprised of the underlying insurance certificate or benefits booklet and also a wrap document that fills in the missing ERISA-required information.

Also, some ERISA welfare benefit plans only have one wrap document, which serves as the plan document and is also distributed to plan participants as the SPD. When one wrap document is used, it must comply with ERISA’s content requirements for plan documents and SPDs, and it must be written in a manner that is understandable to plan participants. Also, the document should prominently state that it is intended to serve as both the plan document and the SPD.

Noncompliance

There are no specific penalties under ERISA for failing to have a plan document or SPD. However, not having a plan document or SPD can have serious consequences for an employer, including the following:

  • Inability to respond to participant requests: The plan document/SPD must be furnished in response to a participant’s written request. The plan administrator may be charged up to $110 per day if it does not provide the plan document within 30 days after an individual’s request. These penalties may apply even where a plan document/SPD does not exist.
  • Benefit lawsuits: Not having a plan document may put an employer at a disadvantage in the event a participant brings a lawsuit for benefits under the plan. Without a plan document, it will be difficult for a plan administrator to prove that the plan’s terms support benefit decisions. Also, without a plan document, plan participants can use past practice or other evidence outside of the actual plan’s terms to support their claims. Additionally, courts will likely apply a standard of review that is less favorable to the employer (and more favorable to participants) when reviewing benefit claims under an unwritten plan.
  • DOL audits: The Department of Labor (DOL) has broad authority to investigate or audit an employee benefit plan’s compliance with ERISA. When the DOL selects an employer’s health plan for audit, it will almost always ask to see a copy of the plan document and SPD, in addition to other plan-related documents. If an employer cannot respond to the DOL’s document requests, it may trigger additional document requests, interviews, on-site visits or even DOL enforcement actions. Also, the DOL may impose a penalty of up to $152 per day (up to $1,527 per request) for failing to provide information requested by the DOL.

Clark & Associates provides Wrap Documents for our valued clients as an added service. Please contact us if you do not have a Wrap Document in place!

Addressing Opioids in the Workplace

There are over 42,000 opioid-related deaths in the United States each year, according to the Centers for Disease Control and Prevention (CDC)—a figure that has been rising steadily since the turn of the century. The opioid death rate is now more than five times greater than it was in 1999.

In addition to the skyrocketing opioid-related deaths, there are countless Americans who are still abusing prescription medications. This means employers must figure out how best to address this crisis with employees. That is where Clark & Associates can help.

The purpose of this toolkit is to help employers understand and deal with the opioid epidemic, create a healthier and more productive workforce, and reduce costs. This toolkit is not intended to replace the advice of a medical or legal professional. In many cases, you may need to contact a professional for assistance. However, this information can serve as a starting point for developing a meaningful opioid strategy.

We have published a helpful toolkit to help you address this problem.

Click Here to Download the Workbook: Benefits Toolkit – Addressing Opioids in the Workplace

Contact Us if you have any questions or need assistance putting a policy in place for this growing problem.

New Rules for Disability Claims Take Effect on April 1, 2018

Click Here to Download: New Rules for Disability Claims Take Effect on April 1, 2018

On Jan. 5, 2018, the Department of Labor (DOL) announced that, effective April 1, 2018, employee benefit plans must comply with new requirements for disability benefit claims.

In 2016, the DOL released a final rule to strengthen the claims and appeals requirements for plans that provide disability benefits and are subject to the Employee Retirement Income Security Act (ERISA). The final rule was scheduled to apply to claims that are filed on or after Jan. 1, 2018. However, on Nov. 24, 2017, the DOL delayed the final rule for 90 days—until April 1, 2018—to give stakeholders the opportunity to submit comments on the final rule’s benefits and costs.

According to the DOL, the information it received during the delay period did not justify modifying or rescinding the final rule. Thus, the final rule will take effect without change.

ACTION STEPS

ERISA plans that include disability benefits must comply with the new procedural protections, effective for claims that are submitted after April 1, 2018. Entities that administer disability benefit claims, including issuers and third-party administrators, will need to revise their claims procedures to comply with the final rule.

ERISA Requirements

Section 503 of ERISA requires every employee benefit plan to:

  • Provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for the denial, written in a manner calculated to be understood by the participant; and
  • Afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim.

The DOL first adopted claims procedure regulations for employee benefit plans in 1977. In 2000, the DOL updated its claims procedure regulations by improving and strengthening the minimum requirements for employee benefit plans, including plans that provide disability benefits. Effective for plan years beginning on or after Sept. 23, 2010, the Affordable Care Act (ACA) amended ERISA to include enhanced internal claims and appeals requirements for group health plans.

Additional Protections for Disability Claimants

The final rule requires that plans, plan fiduciaries and insurance providers comply with additional procedural protections when dealing with disability benefit claimants. The final rule includes the following requirements for the processing of claims and appeals for disability benefits:

  • Improvement to Basic Disclosure Requirements: Benefit denial notices must contain a more complete discussion of why the plan denied a claim and the standards used in making the decision.
  • Right to Claim File and Internal Protocols: Benefit denial notices must include a statement that the claimant is entitled to receive, upon request, the entire claim file and other relevant documents. Benefit denial notices also have to include the internal rules, guidelines, protocols, standards or other similar criteria of the plan that were used in denying a claim, or a statement that none were used.

Contact us here or call our office if you have any questions or concerns about this new procedure.

Business Travel Accident Insurance

Travel Insurance for Businesses  

Travel insurance offers a broad range of benefits and services, such as worldwide emergency hotline services, medical evacuation, reimbursement for unexpected cancellation or delay, and more. Companies with employees who travel for business may want to consider supplemental coverage from a travel insurance policy.

Why Buy?

Travel insurance is designed for problems that arise suddenly during a trip. Basic coverage usually includes reimbursement for trip cancellation, interruption and delay because of illness, bad weather, baggage loss or delay, medical insurance and medical evacuation (in case of illness or injury during travel), and a 24-hour assistance telephone line. Typical coverage costs 4 to 8 percent of the cost of the trip, depending on the trip’s length, the destination, the traveler’s age and the type of coverage. For example, insurance for a $2,000 trip may cost $80 to $160. If you consider the expense for any troubles your employees may encounter, travel insurance can be a cost-effective option to avoid that risk.

Insurance for International Business Travelers

Think about the following scenarios when traveling for business:

  • You receive notice that a top executive in your company was in a car accident while on a business trip in Milan.
  • You get a telephone call that an employee stationed for the month in Sydney experienced symptoms of a stroke.
  • There was an earthquake in Chile, which prevented an employee from returning on time from a business trip.
  • Several of your employees traveling together in Beijing came down with pneumonia.

These situations should prompt you to examine whether you would know what steps to take next. Do you know what guidance to give these employees? Could you direct them to any specific medical facilities? How familiar are you with the medical system of that country? How much would it cost to arrange alternate travel plans in the event of a delay or setback?

Purchasing an international travel insurance policy may be the only way you can cover all your bases. Employers can purchase insurance specific to employees they send overseas for business purposes—even if the trip is short term. Obtaining medical treatment and hospital care abroad can be expensive. Generally, American medical insurance is not accepted overseas, nor do the Social Security, Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States.

Instead employers can purchase supplemental medical coverage for their employees that their current health plan does not supply. For instance, medical travel insurance will pay for medical evacuation by helicopter if traveling in a place with inadequate facilities. This can otherwise cost up to $50,000. Employers with workers who travel internationally for business purposes should find out exactly what their health plans cover, in the event the employee needs medical treatment overseas.

Another form of travel insurance that an employer of overseas workers will want to consider purchasing is K&R insurance (Kidnap, Ransom and Extortion Insurance). In certain parts of the world, kidnapping and extortion of wealthy American executives has become a business. A basic K&R policy includes such things as hostage negotiations, ransom payment, loss of income, interest on bank loans and medical/psychiatric care. In most cases, the deductible requires the insured to pay about 10 percent of any loss. Policies carry about $20 million to $30 million limits, which is generally more than enough to pay a typical ransom. This insurance is particularly beneficial for those employees who travel to high-risk countries, which include Brazil, Colombia, Ecuador, India, Mexico, Nigeria, the Philippines and Venezuela.

Most insurance companies offer comprehensive policies for international employers in which K&R is only part of the package.  These policies can also cover areas such as foreign business auto rental, foreign commercial general liability, foreign voluntary workers’ compensation, foreign travel accident/sickness, marine ocean cargo, foreign commercial crime and political risk.

Additionally, the U.S. Government requires that employees hired by contractors and subcontractors to work on international government contracts be protected by Defense Base Act Coverage (DBA), regardless of their assignment or location. This coverage provides workers’ compensation benefits in the event of a work-related injury or illness. There are five employment situations which require this coverage:

  1. Any employee working on a military base or reservation outside the United States
  2. Any employee engaged in U.S. government-funded public works business outside the United States
  3. Any employee engaged in public works or military contract with a foreign government which has been deemed necessary to U.S. National Security
  4. Those employees who provide services funded by the U.S. government outside the realm of regular military issue or channels
  5. Any employees of sub-contractors of the prime or letting contractor involved in a contract like numbers 1-4 above

Purchase Considerations

Before buying travel insurance, consider the following:

  • Always comparison shop. Some plans include extras such as psychiatric treatment, a natural disaster benefit and even disposition of remains in the event of death.
  • Do not tell your employees if you purchased K&R insurance. This is to prevent employees from revealing this fact to potential kidnappers, making them a more lucrative target.
  • Be aware that some plans require your out-of-pocket payment, and then will pay claims after the traveler returns home.

 

For more information on travel insurance, including medical and K&R, go to the U.S. Department of State – Bureau of Consular Affairs Travel website at http://travel.state.gov/.

If your employees travel on business, it is imperative that you provide them with Accident Insurance Protection.

Call us at 775-828-7420 to learn more about Business Travel Accident Insurance.

 

 

Fight Cancer with Food

A healthy lifestyle supports disease prevention, and adding the following body-strengthening foods into your diet can really go the extra mile.

Beans contain phytochemicals, which have been shown to prevent or slow genetic cell damage. Their high fiber content has been connected with a lower risk of digestive cancers.

Berries contain ellagic acid (most common in strawberries and raspberries) and anthocyansides (most common in blueberries). Ellagic acid helps prevent skin, bladder, lung and breast cancer by acting as an antioxidant and by slowing the reproduction of cancer cells.

Cruciferous vegetables such as broccoli, cauliflower, cabbage and kale are rich in a variety of compounds linked to slowing cancer growth and development, especially lung, stomach, colorectal, prostate and bladder cancer.

Dark, leafy green vegetables including romaine lettuce, mustard greens, chicory and Swiss chard contain carotenoids, a form of antioxidant that removes cancer-promoting free radicals from the body. These veggies are also rich in folate, which has been shown to reduce the risk of lung and breast cancer.

Flaxseed—eaten in the form of oil and meal—is believed to reduce the risk of breast, skin and lung cancer because of the presence of phytoestrogens.

Garlic, Onions, Scallions, Leeks and Chives contain compounds that are believed to slow tumor growth, especially in skin, colon and lung cancer.

Red grapes contain resveratrol, which is thought to prevent cell damage.

Green tea is rich in flavonoids, which slow or prevent the development of colon, liver, breast and prostate cancer cells.

Soy contains isoflavones that protect against bladder, cervix, lung and stomach cancer. Soy is also comprised of compounds that are similar to the body’s natural hormones, which may guard against breast and prostate cancer development.

Tomatoes are rich in Lycopene, which has been shown to fight prostate cancer, especially when consumed as tomato sauce, paste or juice. Lycopene may also protect against breast, lung, stomach and pancreatic cancer.

Whole grains contain fiber, antioxidants and phytoestrogen compounds, beneficial in decreasing the risk of developing most types of cancer.

Spices such as ginger and cumin are powerful cancer fighters.

Click Here to download the full article: Fight Cancer with Food

Set of berry on white close up

Broccoli and Cauliflower

Cluster of five tomatoes on a white background with basil.

 

5470 RENO CORPORATE DRIVE RENO, NV 89511

We have exciting news!

We’re moving to our new space and we are looking for some like-minded business professionals to share our building with.

The entire top floor of our new building is available for lease. This location is conveniently located in South Reno, off of Reno Corporate and Double R Blvd.

Please contact Valerie Clark if you are interested or have any questions about this property.

Click here for the rental brochure: 5470 Reno Corporate Lease

5470 reno corporate imageproperty sitefloor plan

Updated HSA Limits for 2018

Recently, the IRS released Internal Revenue Bulletin 2018 to show changes to the HSA contribution amounts. These contribution limits are different from the previously released contribution limits. Please make your employees aware of these changes and make any necessary adjustments.

We have a simplified breakdown of the updated limits below.
Click Here to download the full document: HSA Limits for 2018

Type of Limit 2017 2018 Change
HSA Contribution Limit Self-only $3,400 $3,450 Up $50
Family $6,750 $6,850 Up $100
HSA Catch-up Contributions (not subject to adjustment for inflation) Age 55 or Older $1,000 $1,000 No change
HDHP Minimum Deductible Self-only $1,300 $1,350 Up $50
Family $2,600 $2,700 Up $100
HDHP Maximum Out-of-pocket Self-only $6,550 $6,650 Up $100
Family $13,100 $13,300 Up $200

 

If you have any questions on this information, please feel free to call our office at 775-828-7420.

Have you visited the doctor this year?

Click Here to Download: Annual Health Check Up Article

Visiting your primary care doctor at least once a year is essential to keeping your health on the right track. In fact, those who take preventive care seriously tend to be healthier and lead more productive lives. Take a look at the following three ways you can benefit from scheduling your annual checkup:

  • Control Chronic Diseases:

According to the Partnership to Fight Chronic Disease, nearly 100,000 lives could be saved each year with preventive care services. In other words, visiting your doctor for an annual checkup can help you detect and receive treatment for chronic conditions before they cause serious health problem.

  • Establish a Baseline

If you schedule annual checkups, your doctor will likely be more familiar with your personal health history. This knowledge will help create a health baseline, allowing your doctor to detect any unusual or abnormal health concerns before they become a more serious issue.

  • Form a Relationship

Research shows that patients who have a good relationship with their doctor receive better care and are happier with the care they receive. Going to your annual checkup will help strengthen the relationship between the two of you, increasing your trust and comfort in the care you receive.

Give us a call if you have any questions! We are here to help.

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LIVE WELL, WORK WELL NEWSLETTER – March, 2018

Click Here to Download: Live Well, Work Well – March 2018

This Deadly Flu Season is the Worst in Nearly a Decade

According to the Centers for Disease Control and Prevention (CDC), the 2017-18 flu season is more intense than any other since the 2009 swine flu pandemic. Unfortunately, the CDC says this flu season is going to get worse.

In addition to the increasing number of individuals falling ill with the flu, the hospitalization rate for the flu has jumped. This year’s dominant virus, H3N2, has been around for 50 years, but it is usually the most lethal of the seasonal strains.

As a result, the CDC urges those who haven’t yet gotten the flu vaccine to do so, as it is the best way to prevent the flu. Because some doctors and pharmacies have run out of vaccines, check here to find out where you can obtain your vaccination.

Eating Healthy Doesn’t Have to Be Expensive

Eating a well-balanced diet is a key component in living a long, healthy life. Many Americans think that eating healthy means they have to empty their wallets, which isn’t necessarily the truth. Keep the following money-saving tips in mind next time you’re grocery shopping:

  1. Make a weekly meal plan. Before you go to the store, think about what meals and snacks you want for the week. Read recipes thoroughly so you can make an accurate list of everything you need, reducing the risk that you’ll have to run back to the store later in the week.
  2. Create a list—and stick to it. Make a detailed list of what you need to buy before you go to the store. When you get to the store, don’t buy anything besides what’s on the list.
  3. Plan where you’re going to shop. Many grocery stores run sales or offer coupons on various healthy foods. Check out the ads and plan your grocery list around what’s on sale.
  4. Shop seasonally. Fresh fruits and vegetables that are in season are usually easier to get and may be a lot less expensive. Click here for a list of what’s in season.
  5. Cook at home as often as possible. Many foods prepared at home are cheaper and more nutritious. Go back to the basics and find a few simple and healthy recipes that your family enjoys.

Sleep and Your Health

The National Sleep Foundation sponsors Sleep Awareness Week every March to educate Americans on the importance of sleep to their overall health and well-being. The CDC has linked insufficient sleep to the development of chronic diseases and conditions, including diabetes, heart disease, obesity and depression. In honor of Sleep Awareness Week occurring this March 11-17, try adopting the following five healthy sleep habits:

  1. Keep a regular schedule—try to go to bed and wake up at the same time each day, including weekends.
  2. Create a good sleep environment, including comfortable room temperature, minimal noise and sufficient darkness.
  3. Keep track of habits that help you fall asleep, like relaxing music or reading before bed. Repeat those activities each night.
  4. Avoid caffeine and nicotine three to four hours before going to bed.
  5. Limit alcohol before bed, as it can reduce sleep quality.
 We all love healthy Recipes: Here’s one you’re sure to enjoy!
One Pan Potatoes & Chicken

4 medium potatoes

1 pound chicken breast (boned and skinned)

2 Tbsp. oil

1 cup salsa

1 15-ounce can whole kernel corn (drained)

 

PREPARATIONS

1.       Cut potatoes into ¾-inch cubes.

2.       Cook potatoes over medium-high heat until fork-tender. Remove from pan.

3.       Heat the oil in a skillet over high heat. Brown the chicken for 5 minutes.

4.       Add the potatoes back into the pan and cook until lightly browned.

5.       Add salsa and corn. Cook until heated through.

6.       Serve warm.

 

Makes: 6 servings

 

Nutritional Information (per serving)

Total Calories 285
Total Fat 7 g
Protein 21 g
Carbohydrates 35 g
Dietary Fiber 4 g
Saturated Fat 1 g
Sodium 316 mg
Total Sugars 3 g

 

Source: USDA

 

 

FURNISHING DEADLINE DELAYED FOR 2017 ACA REPORTING

Click Here to Download the Full Article: Furnishing Deadline Delayed for 2017 ACA Reporting

On Dec. 22, 2017, the Internal Revenue Service (IRS) issued Notice 2018-06 to:

  • Extend the due date for furnishing forms under Sections 6055 and 6056 for 2017 for 30 days, from Jan. 31, 2018, to March 2, 2018; and
  • Extend good-faith transition relief from penalties related to 2017 information reporting under Sections 6055 and 6056.

Notice 2018-06 does not extend the due date for filing forms with the IRS for 2017. The due date for filing with the IRS under Sections 6055 and 6056 remains Feb. 28, 2018 (April 2, 2018, if filing electronically).

ACTION STEPS

The IRS is encouraging reporting entities to furnish statements as soon as they are able. No request or other documentation is required to take advantage of the extended deadline.

Section 6055 and 6056 Reporting

Sections 6055 and 6056 were added to the Internal Revenue Code (Code) by the Affordable Care Act (ACA).

  • Section 6055 applies to providers of minimum essential coverage (MEC), such as health insurance issuers and employers with self-insured health plans. These entities will generally use Forms 1094-B and 1095-B to report information about the coverage they provided during the previous year.
  • Section 6056 applies to applicable large employers (ALEs)­­—generally, those employers with 50 or more full-time employees, including full-time equivalents, in the previous year. ALEs will use Forms 1094-C and 1095-C to report information relating to the health coverage that they offer (or do not offer) to their full-time employees.

Extended Furnishing Deadline

The IRS has again determined that some employers, insurers and other providers of MEC need additional time to gather and analyze the information and prepare the 2017 Forms 1095-B and 1095-C to be furnished to individuals. Therefore, Notice 2018-06 provides an additional 30 days for furnishing the 2017 Form 1095-B and Form 1095-C, extending the due date from Jan. 31, 2018, to March 2, 2018.

Despite the delay, employers and other coverage providers are encouraged to furnish 2017 statements to individuals as soon as they are able.

Filers are not required to submit any request or other documentation to the IRS to take advantage of the extended furnishing due date provided by Notice 2018-06. Because this extended furnishing deadline applies automatically to all reporting entities, the IRS will not grant additional extensions of time of up to 30 days to furnish Forms 1095-B and 1095-C. As a result, the IRS will not formally respond to any requests that have already been submitted for 30-day extensions of time to furnish statements for 2017.

Impact on Filing Deadline

The IRS has determined that there is no need for additional time for employers, insurers and other providers of MEC to file 2017 forms with the IRS. Therefore, Notice 2018-06 does not extend the due date for filing Forms 1094-B, 1095-B, 1094-C or 1095-C with the IRS for 2017. This due date remains:

  • February 28, 2018, if filing on paper; or
  • April 2, 2018, if filing electronically (since March 31, 2018, is a Saturday).

Because the due dates are unchanged, potential automatic extensions of time for filing information returns are still available under the normal rules by submitting a Form 8809. The notice also does not affect the rules regarding additional extensions of time to file under certain hardship conditions.

Employers or other coverage providers that do not meet the due dates for filing and furnishing (as extended under the rules described above) under Sections 6055 and 6056 are subject to penalties under Section 6722 or Section 6721 for failure to furnish and file on time. However, employers and other coverage providers that do not meet the relevant due dates should still furnish and file. The IRS will take this into consideration when determining whether to abate penalties for reasonable cause.

Impact on Individuals

Because of the extended furnishing deadline, some individual taxpayers may not receive a Form 1095-B or Form 1095-C by the time they are ready to file their 2017 tax returns. Taxpayers may rely on other information received from their employer or other coverage provider for purposes of filing their returns, including determining eligibility for an Exchange subsidy and confirming that they had MEC for purposes of the individual mandate.

Taxpayers do not need to wait to receive Forms 1095-B and 1095-C before filing their 2017 returns. In addition, individuals do not need to send the information they relied upon to the IRS when filing their returns, but should keep it with their tax records.

Extension of Good-faith Transition Relief from Penalties for 2017

Notice 2018-06 also extends transition relief from penalties for providing incorrect or incomplete information to reporting entities that can show that they have made good-faith efforts to comply with the Sections 6055 and 6056 reporting requirements for 2017 (both for furnishing to individuals and for filing with the IRS).

This relief applies to missing and inaccurate taxpayer identification numbers and dates of birth, as well as other information required on the return or statement. No relief is provided for reporting entities that:

  • Do not make a good-faith effort to comply with the regulations; or
  • Fail to file an information return or furnish a statement by the due dates (as extended).

In determining good faith, the IRS will take into account whether a reporting entity made reasonable efforts to prepare for reporting the required information to the IRS and furnishing it to individuals (such as gathering and transmitting the necessary data to an agent to prepare the data for submission to the IRS or testing its ability to transmit information to the IRS). The IRS will also take into account the extent to which the reporting entity is taking steps to ensure that it will be able to comply with the reporting requirements for 2018.