Employers sponsoring self-insured group health plans and insurers are reminded that the deadline to report and pay the fee new fees required by the Patient Protection and Affordable Care Act (ACA) to help fund the Patient-Centered Outcomes Research Institute (PCORI) is July 31, 2013.

The PCORI fee, required to be reported annually on the second quarter Form 720 and paid by its due date, July 31, is based on the average number of lives covered under the policy or plan.  The annually required PCORI fee applies to policy or plan years ending on or after October 1, 2012, and before October. 1, 2019.

The PCORI fee is just one of a number of new fees and costs that ACA imposes upon employers and individuals as part of the health care reforms enacted under ACA.

Employers of more than 50 full-time employees recently received a temporary retrieve from another of these looming potential fees, the employer “shared responsibility” payment that ACA added to the Internal Revenue Code (Code) under new Code Section 4980H.

Earlier this month, the Internal Revenue Service (IRS) announced that it will delay until 2015 enforcement of the employer shared responsibility or “pay-or-play” rules of Code Section 4980H.  See July 2 Blog and Notice 2013-45.   Slated prior to the delayed enforcement announcement to take effect January 1, 2014, the employer shared responsibility rules generally will require employers which individually or collectively with other commonly controlled or affiliated employers employee 50 or more full-time employees that do not offer group health coverage that meets the minimum essential coverage, minimum value and affordability standards of the Affordable Care Act to pay an “assessment” that the Supreme Court ruled last year to be a tax, as well as to comply with certain reporting requirements.

While Notice 2013-45 gives large more time to prepare to comply with Code Section 4980H, it provides no relief from the obligation to pay the PCORI fee or from other group health plan mandates imposed by ACA or other applicable federal laws.  Consequently, as businesses continue to prepare for the delayed implementation of Code Section 4980H in 2015, they also need to ensure that they timely pay any required PCORI fees and meet other applicable federal group health plan mandates as they continue to diligently prepare to deal with Code Section 4980H.

While businesses work to meet current and impending federal health plan responsibilities, most business leaders also will want to continue to closely monitor and provide regular input to members of Congress and regulators on proposed regulatory and enforcement guidance and potential Congressional amendments to the Affordable Care Act or other health care or tax policy reforms.

For Help or More Information

If you need help with preparing these or other ACA compliance or with reviewing and updating, administering or defending your group health or other employee benefit, human resources, insurance, health care matters or related documents or practices, please contact the author of this update, Cynthia Marcotte Stamer.

A Fellow in the American College of Employee Benefit Council, immediate past Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Group and current Co-Chair of its Welfare Benefit Committee, Vice-Chair of the ABA TIPS Employee Benefits Committee, a council member of the ABA Joint Committee on Employee Benefits, and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer is recognized, internationally, nationally and locally for her more than 25 years of work, advocacy, education and publications on cutting edge health and managed care, employee benefit, human resources and related workforce, insurance and financial services, and health care matters including extensive experience on HIPAA and other privacy and data security issues.

A board certified labor and employment attorney widely known for her extensive and creative knowledge and experienced with these and other employment, employee benefit and compensation matters, Ms. Stamer continuously advises and assists employers, employee benefit plans, their sponsoring employers, fiduciaries, insurers, administrators, service providers, insurers and others to monitor and respond to evolving legal and operational requirements and to design, administer, document and defend medical and other welfare benefit, qualified and non-qualified deferred compensation and retirement, severance and other employee benefit, compensation, and human resources, management and other programs and practices tailored to the client’s human resources, employee benefits or other management goals.  A primary drafter of the Bolivian Social Security pension privatization law, Ms. Stamer also works extensively with management, service provider and other clients to monitor legislative and regulatory developments and to deal with Congressional and state legislators, regulators, and enforcement officials about regulatory, investigatory or enforcement concerns.

Recognized in Who’s Who In American Professionals and both an American Bar Association (ABA) and a State Bar of Texas Fellow, Ms. Stamer serves on the Editorial Advisory Board of Employee Benefits News, the editor and publisher of Solutions Law Press HR & Benefits Update and other Solutions Law Press Publications, and active in a multitude of other employee benefits, human resources and other professional and civic organizations.   She also is a widely published author and highly regarded speaker on these matters. Her insights on these and other matters appear in the Bureau of National Affairs, Spencer Publications, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, Modern and many other national and local publications.   You can learn more about Ms. Stamer and her experience, review some of her other training, speaking, publications and other resources, and register to receive future updates about developments on these and other concerns from Ms. Stamer here.

Other Resources

If you found this update of interest, you also may be interested in reviewing some of the other updates and publications authored by Ms. Stamer available including:

• Use New Government Health Care Reform Resources With Care
• OCR Warns Others Learn From WellPoint’s $1.7 M HIPAA Settlement
• “Pay Or Play” Reprieve Still Leaves Employers Facing Challenging 2014 Health Care Reform Deadlines

• HHS Continues Preparations For New Health Insurance Marketplace By Awarding Grants To Promote Kids Enrollment
• HHS Touts Enrollment Tools, Says Exchange Enrollment Ready Despite GAO Concerns
• HIPAA Sanctions Triggered From Covered Entity Statements To Media, Workforce
• Consider OCR Technical Corrections When Updating Privacy Practices & Agreements For Omnibus Restatement of HIPAA Privacy, Security, Breach Notification & Enforcement Rules
• Id & Manage Hidden Employee Benefit Exposures In Business Insolvency Or Other Transactions
• Final Regulations Update HIPAA Health Plan Wellness Program Rules
• Beware:  Not All Products Marketed As “Fixed Indemnity Coverage” Products Are HIPAA/ACA Exempt
• Updated Kaiser Family Foundation Tool May Help Project Which Employees Will Get Exchange Subsidies
• New IRS Guidance On ESOP Investment Diversification Reminder To Tighten Compliance, Risk Management
• EBSA Releases Model ACA Notices Discussing Coverage Options
• Group Health Plans &No-Fault & Worker’s Comp Ruled Primary Plans When Coordinating With Medicare Advantage Plans
• Changing Plan Years Won’t Extend Health Plan’s Affordable Care Act Annual Limit Waiver Eligibility
• Deadline To Send ACA Summary of Benefits & Coverage Adds Pressure To Finalize 2014 Plan Designs As Agencies Add MEC & MV Disclosures To SBC
• Study Finds Down Economy, Not Health Care Reform Accounts For Slower Health Care Cost Increases; Projects Renewed Costs When Economy Improves
• IRS Witholding Calculator Can Help Avoid Over & Underwithholding
• Responding To West, Texas, Boston & Other Tragedies: Information and Reassurance Resources
• Justice Department Charges Employer, Pension Plan With Violating USERRA Reemployment Rights
• Administration Proposes To Let PBGC Board Set Premiums In Effort To Shore Up Finances
• Administration Proposes Expanding Eligibility, Simplifying Small Employer Health Care Tax Credit
• Health Care Transparency Effectiveness & Value Depends On Data Quality, Understanding & Awareness
• Test Your Health Care Reform Knowledge On 3rd Anniversary of Reform Passage
• Insured “Expatriate Plans” Get Temporary Reprieve From Affordable Care Act Compliance Thru 2015 If Meet Other Health Plan Mandates
• Insured “Expatriate Plans” Get Temporary Reprieve From Affordable Care Act Compliance Thru 2015 If Meet Other Health Plan Mandates
• OCR Plans To Survey Health Plans, Other Covered Entities Hit With HIPAA Audits in 2012
• Businesses Urged To Strengthen Their Worker Classification Defenses As IRS, Other Agencies Step Up Audits & Enforcement
• Alert Employees Claiming Qualified Adoption Expenses and Education Credits About Changed IRS Procedures
• 13 Employer Tips For Coping With Health Care Reform Now!
• Sequester Will Cut ACA Small Businesses Health Care Tax Credits

For important information about this communication click here. THE FOLLOWING DISCLAIMER IS INCLUDED TO COMPLY WITH AND IN RESPONSE TO U.S. TREASURY DEPARTMENT CIRCULAR 230 REGULATIONS.  ANY STATEMENTS CONTAINED HEREIN ARE NOT INTENDED OR WRITTEN BY THE WRITER TO BE USED, AND NOTHING CONTAINED HEREIN CAN BE USED BY YOU OR ANY OTHER PERSON, FOR THE PURPOSE OF (1) AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER FEDERAL TAX LAW, OR (2) PROMOTING, MARKETING OR RECOMMENDING TO ANOTHER PARTY ANY TAX-RELATED TRANSACTION OR MATTER ADDRESSED HEREIN.

©2013 Cynthia Marcotte Stamer, P.C.  Nonexclusive license to republish granted to Solutions Law Press, Inc.  All other rights reserved

This entry was posted on Friday, July 26th, 2013 at 3:17 PM and is filed under ADA, Affordable Care Act, Claims Administration, Corporate Compliance, Data Security, Disability, EEOC, Employee Benefits, Employers, ERISA, Excise Tax, Fiduciary Responsibility, GINA, Health Care Reform, Health Plans, HIPAA, Human Resources, Insurance, MEWA, Patient Protection and Affordable Care Act, Reporting & Disclosure, Tax, Uncategorized, Wellness Programs. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.