ACA, DOL Legal and Compliance Updates
IRS Released 2019 Deductibles, Out of Pocket Maximums,
Health Savings Account (HSA) Limits
The IRS has released the 2019 cost of living adjusted limits for HSA’s and HDHP’s.
ACA Employer Mandate Affordability Threshold for 2019
The IRS announced an increase in the affordability percentage for 2019.
- 9.56% 2015
- 9.66% 2016
- 9.69% 2017
- 9.56% 2018
- 9.86% 2019
Special Tidbits for NFP’s in New York
MSC employee’s moving to a newly form Coordinated Care Organization (CCO)or another similar type newly formed organization.
Once an employee resigned from a NFP and are hired at a newly formed Coordinated Care Organization (CCO) or similar type organization, they will lose their existing PFL rights under their current employer even if they are currently in an approved PFL claim. Employees will have to meet the 26 consecutive weeks/175 days eligibility period before they are eligible for PFL under the new CCO.
Today IRS released Revenue Procedure 2018-30 which provides the 2019 amounts for high deductible health plans Health Savings Accounts.
New York State Average Weekly Wage (NYSAWW)
Workers’ Compensation Law § 2(16)
Pursuant to Workers’ Compensation Law § 2(16), the maximum weekly benefit that may be paid on or after July 1, 2010 and each July 1st thereafter is two-thirds of the New York State Average Weekly Wage (NYSAWW*).
If your plan is not administered correctly and in compliance with the regulations, you risk losing the plan all together. Is it time to review your TPA’s substantiation process?
While the IRS has issued guidance, FAQ’s, information letters and the like on substantiation requirements, some TPA’s simply ignore or deem them insignificant.
IRS Notice 2015-60 Patient-Centered Outcomes Research Fee (PCORI)
Code Sections 4375 & 4376 – Insured and Self-Insured Health Plans through October 1, 2019
The PCORI fees are due by July 31st. The chart below shows the fees to be paid in 2018, which rose slightly from the fees owed in 2017.
PFL Tidbits #2
Employers are questioning what wages they are to take Paid Family Leave contributions from. I have reached out to the attorneys at the Worker’s Compensation Board and their response was “employers are to take PFL contributions from any “Wages” as defined under 12 CRR-NY. We have provided the definition of wages under Title 12 below.
OFFICIAL COMPILATION OF CODES, RULES, AND REGULATIONS OF THE STATE OF NEW YORK, TITLE 12. DEPARTMENT OF LABOR; CHAPTER V. WORKERS’ COMPENSATION; SUBCHAPTER H. DISABILITY BENEFITS; ARTICLE 1. REGULATIONS UNDER DISABILITY BENEFITS LAW; PART 357. WAGES