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07 Oct
The Pay or Play Percentage Increase for 2025
Posted: October 7, 2024
The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees. The affordability rate for employer-sponsored health coverage will increase from 8.39% to […]
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09 Sep
Medical Loss Ratio (MLR) Rebates: A Timely Reminder
Posted: September 9, 2024
The Affordable Care Act (ACA) introduced the Medical Loss Ratio (MLR) to ensure that health insurance companies spend a significant portion of premiums on medical care and quality improvement activities rather than administrative costs and profits. When insurers fail to meet the MLR threshold, they are required to issue rebates to plan sponsors. Understanding MLR […]
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09 Jul
PCORI Fee Filing Deadline
Posted: July 9, 2024
The Patient-Centered Outcomes Research Trust Fund fee, often referred to as the PCORI fee, can be a source of confusion for employers offering health insurance plans. This article aims to simplify what the PCORI fee is, why it exists, and how it impacts your business. What is the PCORI Fee? The PCORI fee is an […]
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17 Nov
Biden-Harris Administration Issues Third Rule To Implement No Surprises Act
Posted: November 17, 2021
WASHINGTON – The Biden-Harris administration – through the departments of Labor, Health and Human Services, Treasury and the Office of Personnel Management – today issued an interim final rule with comment period to continue implementation of the No Surprises Act, a consumer protection law that helps curb the practice known as “surprise billing” for medical care. The […]
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28 Oct
The Affordability Test for 2022 Health Plans
Posted: October 28, 2021
The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play […]
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