Same-Sex Couples (still) Not “Married” for Federal Tax Purposes

by Robert A. Browning,

The Internal Revenue Service (IRS) has  recently issued guidance, through answers to frequently asked questions (FAQs), clarifying how same-sex couples who are in state recognized domestic partnerships, civil unions, or marriages should file their federal income tax returns. These FAQs address a key provision of the Defense of Marriage Act (DOMA), which denies recognition of same-sex marriages or unions for purposes of administering federal law.

Even though the Obama administration has decided not to defend this key DOMA provision, and even though a number of federal courts (including two appellate courts) have held the provision to be unconstitutional, the IRS continues to maintain that same-sex couples do not qualify for the same tax benefits that are available to taxpayers who are married to someone of the opposite sex. This is true even if a same-sex couple is legally married under state law. This IRS position could have implications in a number of benefit-plan contexts.

Background

Section 3 of DOMA defines “marriage,” for purposes of administering federal laws, as a “legal union between one man and one woman as husband and wife.” It also defines “spouse” as “a person of the opposite sex who is a husband or wife.” Consequently, DOMA prohibits the federal government from recognizing same-sex marriages (or domestic partnerships or civil unions). This prohibition affects federal income taxes, Social Security benefits, and more than 1,000 other federal laws – including ERISA and the tax laws governing employee benefits.

A number of federal trial courts (now joined by two federal appellate courts) have ruled in favor of plaintiffs challenging this provision of DOMA in various tax-related contexts. In Massachusetts v. Health and Human Services, the First U.S. Court of Appeals upheld a lower court’s ruling that Section 3 of DOMA violates the U.S. Constitution. More recently, in Windsor v. U.S., the Second U.S. Court of Appeals upheld a trial court’s ruling that DOMA violates the Equal Protection Clause of the U.S. Constitution. In Windsor, the appellate court concluded that laws affecting homosexuals as a class are subject to heightened scrutiny, and when viewed in light of such scrutiny, the disparate treatment of same-sex spouses is not “substantially related” to an important government interest.

On February 23, 2011, Attorney General Eric Holder published a statement indicating that both he and President Obama had concluded that Section 3 of DOMA is unconstitutional. The Attorney General’s statement provided that the Department of Justice would no longer defend the constitutionality of DOMA’s Section 3 as applied to same-sex married couples in cases filed within the Second Circuit. However, the statement also noted that DOMA remains in effect until Congress repeals it or there is a final (i.e., Supreme Court) judicial decision striking it down. The statement concluded by noting that, although the Justice Department would not defend DOMA in court, the Executive Branch would continue to enforce the law.

The Obama administration has formally asked the Supreme Court to step in (as the 3 final arbiter of the constitutionality of the law), and many legal experts expect the Supreme Court to rule on DOMA’s constitutionality in the near future – possibly as early as the spring of 2013.

IRS Guidance

In its recent FAQs, the IRS continues to defer to DOMA on questions concerning same-sex couples’ federal income tax returns. In summary, the guidance provides that:

  •  Same-sex couples who are legally married for state-law purposes may not file a return using either the “married filing jointly” or “married filing separately” status;
  • An individual may not file as a “head of household” based solely on his or her same-sex partner, regardless of whether the same-sex partner is the taxpayer’s dependent;
  • If a child is a “qualifying child” (under Code Section 152(c)) of both parents who are same-sex partners, then either parent – but not both – may claim a dependency deduction for the child;
  • If a same-sex couple adopts a child together, each partner may claim the adoption credit in an amount equal to the qualified adoption expenses paid or incurred by that partner, but the partners may not both claim a credit for the same expenses; and
  • If an individual adopts the child of his or her same-sex partner, the individual may claim an adoption credit for the qualifying adoption expenses.

These FAQs confirm that, notwithstanding the President’s decision not to defend DOMA in court, and notwithstanding the fact that DOMA has now been held unconstitutional by two appellate courts, the IRS will continue to apply and enforce federal tax laws in accordance with DOMA’s Section 3.

Therefore, until there is action by either Congress or the Supreme Court, employers must (by way of example) continue to report the value of health insurance provided to an employee’s non-dependent, same-sex spouse or partner as additional taxable  income to the employee, and they must continue to limit “spousal” rights under  ERISA-covered plans to participants who are  married to someone of the opposite sex.


IRS Issues Three Proposed Regulations Addressing Open Issues Under PPACA

On Nov. 20, 2012, the Department of Health and Human Services issued three sets of proposed rules that provide some of the needed details on how PPACA will probably unfold.  The proposed rules address:

  • Wellness programs under PPACA
  • Essential health benefits and determining actuarial value
  • Health insurance market reforms
All three rules are still in the "proposed" stage, which means that there may - and likely will - be changes when the final rules are issued.  There is a 30-day public comment period on the essential health benefits and market reforms rules, and a 60-day comment period on the wellness rule.
Nondiscriminatory Wellness Incentives
The proposed rule largely carries forward the rules that have been in effect since 2006.  There still would not be limits on the incentives that may be provided in a program that simply rewards participation, such as a program that pays for flu shots or reimburses the cost of a tobacco cessation program, regardless whether the employee actually quits smoking.  Programs that are results-based (which will be called "health-contingent wellness programs") still would need to meet several conditions, including a limit on the size of the available reward or penalty.  Beginning in 2014, the maximum reward/penalty would increase to 50 percent for tobacco nonuse/use and to 30 percent for other health-related standards.
Essential Health Benefits (EHBs) and Actuarial Value
The proposed rule confirms that nongrandfathered plans in the exchanges and the small-group market will be required to cover the 10 essential health benefits and provide a benefit expected to pay 60, 70, 80 or 90 percent of expected allowed claims.  The proposed rule also says that self-funded plans and those in the large employer market would not need to provide the 10 EHBs; instead, they would need to provide a benefit of at least 60 percent of expected allowed claims and provide coverage for certain core benefits.  The proposed rule would consider current year employer contributions to a health savings account (HSA) or a health reimbursement arrangement (HRA) as part of the benefit value calculation.
Market Reforms
The proposed rule confirms that nongrandfathered health insurers (whether operating through or outside of an exchange) would be prohibited from denying coverage to someone because of a pre-existing condition or other health factor.  The proposed rule also provides that premiums for policies in the exchanges and individual and small-group markets could only vary based upon age, tobacco use, geographic location, and family size and sets out details on how premiums could be calculated.
Important: These rules are still in the "proposed" stage, which means that there may be changes when the final rule is issued.  Employers should view the proposed rules as an indication of how plans will be regulated beginning in 2014, but need to understand that changes are entirely possible.

Failure to Timely Allocate Forfeitures

by: Chadron J. Patton

Sponsors of 401(k) plans often fail to timely use or allocate forfeitures, thereby potentially disqualifying the plan. Recent IRS audits have revealed a renewed focus on the proper use of forfeitures – making compliance a top priority for plan sponsors.

Forfeitures are generally created when a participant leaves employment before completing the period of service needed to become fully vested in matching or other employer contributions. The non-vested portion of the participant’s account may then be forfeited. (In practice, many plans specify that the forfeiture occurs only after the participant has incurred five consecutive oneyear breaks in service.) Some plan sponsors or third party administrators (TPAs) then place the forfeited amounts into a plan’s suspense account, allowing the forfeitures to accumulate over a period of several years. This practice is impermissible.

The IRS requires that forfeitures be used or allocated for the plan year in which they arise or, in appropriate circumstances, the following plan year. Forfeitures may be used 5 to (1) pay a plan’s reasonable administrative expenses, (2) reduce employer contributions, (3) restore previously forfeited participant accounts, or (4) provide additional contributions to participants. The plan document must clearly define how and when forfeitures will be used. (Note: The IRS has recently taken the position that forfeitures cannot be used to fund 401(k) safe harbor contributions, because those contributions must be 100% vested when made to the plan. Future guidance is expected on this issue, however.)

Among the most common reasons for failing to timely allocate forfeitures are the following:

  • A plan sponsor or TPA fails to monitor the plan's forfeiture account to ensure that forfeitures generated during a plan year are used according to the plan's terms.
  • A plan sponsor and TPA both assume that the other party will be taking care of the forfeitures - and neither does so.
  • A plan sponsor erroneously assumes that it has discretion over how and when forfeitures held in a suspense account are to be applied.
  • A plan's terms are vague in describing how forfeitures are to be handled.
  • A plan sponsor elects not to make a discretionary contribution for a plan year and, because there are no contributions to offset with forfeited amounts, the sponsor fails to allocate the forfeitures.
  •  A plan sponsor pays administrative expenses directly or through revenue sharing, without thinking to use forfeitures to pay those expenses.

This common plan mistake may be corrected by reallocating all forfeitures in the plan’s forfeiture suspense account to any participants who should have received them had the forfeitures been allocated on a timely basis. Depending on the plan’s terms, or on the facts and circumstances of a particular situation, it may also be appropriate to apply forfeitures from prior years as an employer contribution for the current year.

Plan sponsors may correct this mistake under the IRS’s Employee Plans Compliance Resolution System (EPCRS). Under the EPCRS’s Self-Correction Program, the mistake must generally be corrected within two years following the close of the plan year in which it occurred (unless the failure can be classified as insignificant). The Voluntary Correction Program (VCP) must then be used after this two-year period. VCP must also be used if the plan’s terms are defective and must be retroactively corrected through a plan amendment.

Finally, here are some suggestions for plan sponsors looking to avoid this common plan mistake:

  • Review your plan document to ensure that there are clear procedures in place for the timing and use of forfeitures - and follow those procedures. If there are no procedures, or if they are vague, amend the plan document to add or clarify them.
  • Review the forfeiture suspense account at least annually to verify that forfeitures are actually being used or allocated.
  • Communicate with your TPA or record keeper to avoid any uncertainty as to whose responsibility it is to handle forfeitures.

Losing by Winning, Case Offers Harsh Reminder Concerning Preventable Expenses

The circumstances behind a recent court decision were typical, and their consequences painfully predictable. Although the plan administrator “won,” that victory does not reflect the huge—and entirely unnecessary—cost to the plan sponsor in terms of overhead and legal fees.

Herring v. Campbell was a fight over who would receive the retirement benefits accrued by John Wayne Hunter, a participant in an ERISA-governed plan. When Mr. Hunter died, he left behind a $300,000 account balance. Although he had properly designated a beneficiary (his wife), she died before he did. And because he had never designated a new beneficiary, it fell to the plan administrator to choose between the two parties who claimed Mr. Hunter’s benefits.

The plan document included a fairly typical list of default beneficiaries. These were, in order of priority, Mr. Hunter’s surviving spouse, his children, his parents, his brothers and sisters, and his estate. Mr. Hunter left no spouse, no natural or adopted children, and no parents. He was, however, survived by two stepsons and six siblings. The plan administrator therefore had to decide which of these two groups was entitled to split Mr. Hunter’s money. If the stepsons were his “children” under the plan, they would be his beneficiaries. If not, then his siblings would receive the benefit.

The plan’s ambiguity as to the definition of this single word (children) caused the administrator and sponsor to be dragged into court. The litigation lasted several years, leading all the way to the United States Court of Appeals for the Fifth Circuit—just one step short of the Supreme Court.

None of this was necessary. Here were the entirely preventable steps in this matter:

  • First, the administrator considered and rejected the stepsons' (weak) claim that they were entitled to the $300,000 under the Texas probate law doctrine of "equitable adoption." She instead distributed the account, in equal shares, to Mr. Hunter's siblings.
  • The stepsons appealed the decision. The plan administrator reviewed the appeal and again denied their claim.
  • The stepsons then moved their claim to federal court, and the trial judge ruled in their favor.
  • The plan administrator filed a motion for reconsideration, which the trial-court judge denied.
  • The administrator was therefore forced to file her own appeal in the Fifth Circuit, where a three-judge panel reversed the district court's ruling, bringing the matter full circle.

The fact that the second-highest court in the land vindicated the administrator’s decision is of little comfort to the administrator, who spent years on an entirely pointless legal battle in which she had no real stake. Nor was being right on the law any comfort to the plan sponsor, which had to pay the (presumably massive) legal fees and court costs in both the federal district court and the Fifth Circuit.

In other words, the interesting legal issues in this case (for example, the proper standard for reviewing a plan administrator’s decision when the plan document is silent about something) are beside the point. Rather, the lesson is that the entire conflict could have been avoided by simply stating, in the plan document, that stepchildren either are or are not “children” for purposes of determining a beneficiary when a participant dies without designating one.

Plan sponsors should review their plans’ default beneficiary provisions and see what— entirely preventable—dangers might lurk there.

Lawrence Jenab, Partner Spencer Fane Britt & Browne LLP


Correcting Operational Mistakes Can Eliminate Fiduciary Liability

Over the past decade, plan sponsors have become familiar with the voluntary correction programs offered by the IRS and Department of Labor, including the Service’s Employee Plans Compliance Resolution System (EPCRS) and the DOL’s Voluntary Fiduciary Correction Program (VFCP). These programs offer formal ways for sponsors to correct certain administrative errors in the operation of their plans. Even if employers choose not to avail themselves of these formal programs, however, correcting administrative mistakes can eliminate the risk of fiduciary liability under ERISA.

Operational errors in administering a retirement plan not only threaten the plan’s “qualified” status under the Tax Code, but can also result in fiduciary liability under ERISA for those who are responsible for the errors. One of the primary duties imposed on ERISA fiduciaries is to administer the plan “in accordance with the documents and instruments” governing it. Failing to do so is a violation of that fiduciary duty, which can lead to personal liability. And administrative errors almost always involve a failure to comply with a plan’s terms.

A Massachusetts employer recently prevailed on a fiduciary breach claim because the employer had voluntarily corrected its administrative error. In this case, Altshuler v. Animal Hospitals Ltd., the employer had failed to timely remit an employee’s salary deferral contributions to its SIMPLE 401(k) plan. After learning that several months of her contributions had not been deposited into the plan, Ms. Altshuler complained to the company’s president. The company voluntarily corrected its error by making all of the outstanding contributions, plus interest, and then fired Ms. Altshuler. She filed suit against the employer under ERISA, claiming (among other things) that the company breached its fiduciary duty to promptly deposit employee contributions, as required by the plan document.

The court ultimately determined that the employer had, in fact, breached its fiduciary duty under ERISA. It also ruled, however, that because the employer had already made the delinquent deposits – and thus had made the participant “whole” – the participant was not entitled to any remedy. Ms. Altshuler had been given everything to which she was entitled under the plan (the contributions and earnings), and the limited scope of remedies available under ERISA precluded her from receiving anything else from the company. Thus, although the company’s voluntary correction of its administrative error did not excuse the resulting fiduciary breach, it effectively insulated the company from liability.

Gregory L. Ash, Partner
Spencer Fane Britt & Browne LLP

 


Court orders new look at health care challenge

BY 

Source: https://www.benefitspro.com

WASHINGTON (AP) — The Supreme Court has revived a Christian college's challenge to President Barack Obama's healthcare overhaul, with the acquiescence of the Obama administration.

The court on Monday ordered the federal appeals court in Richmond, Va., to consider the claim by Liberty University in Lynchburg, Va., that Obama's health care law violates the school's religious freedoms.

The court's action at this point means only that the 4th U.S. Circuit Court of Appeals must now pass judgment on issues it previously declined to rule on.

A federal district judge rejected Liberty's claims, and a three-judge panel of the 4th Circuit voted 2-1 that the lawsuit was premature and never dealt with the substance of the school's arguments. The Supreme Court upheld the health care law in June.

The justices used lawsuits filed by 26 states and the National Federation of Independent Business to uphold the health care law by a 5-4 vote, then rejected all other pending appeals, including Liberty's.

The school made a new filing with the court over the summer to argue that its claims should be fully evaluated in light of the high court decision. The administration said it did not oppose Liberty's request.

Liberty is challenging both the requirement that most individuals obtain health insurance or pay a penalty, and a separate provision requiring many employers to offer health insurance to their workers.

Liberty law school dean Mathew Staver said, "This case now will go back to the federal court of appeals where we will address the undecided issues that the Supreme Court did not address."

When Liberty's case was in front of the 4th Circuit, Judge Andre Davis broke with his colleagues who thought the challenge was premature. Davis said of Liberty's claims, "I would further hold that each of appellants' challenges to the act lacks merit."

The appeals court could ask the government and the college for new legal briefs to assess the effect of the Supreme Court ruling on Liberty's claims before rendering a decision.

Liberty's case joins dozens of other pending lawsuits over health reform, many involving the requirement that employer insurance plans cover contraception. These cases are working their way through the federal court system.

The case is Liberty University v. Geithner, 11-438.

Associated Press writer Brock Vergakis in Norfolk, Va., contributed to this report.


Communication Techniques in the Workplace

by Leigh Richards, Demand Media
Source: https://smallbusiness.chron.com

Communication skills are critical in all walks of life, but communicating effectively in the workplace is critical to professional success. Whether interacting with colleagues, subordinates, managers, customers or vendors, the ability to communicate effectively using a variety of tools is essential. Building strong communication skills requires a focus on effective interactions and the ability to listen so you understand and focus on meeting the needs of others. In addition, in today's technology-driven world, effective communicators stay up to date on the tools available to them.

Step 1

Determine your communication objective. Every communication has a purpose, and identifying that purpose is the first step in effective communication. Whether you want to inform, influence, persuade or sell, having an end goal in mind can help you communicate effectively.

Step 2

Analyze your audience. The more you know about your audience, the better job you will do in communicating with it. For instance, if you want your boss to give you approval to attend a conference and you know he's concerned about staying up to date on key industry trends, that's a point you can bring up in your interactions. If you know your boss is most concerned about the bottom line, consider how your attendance at the program could help increase sales or improve efficiencies that might cut costs.

Step 3

Select communication tools—or a mixture of tools. Your purpose and audience will help you determine the best communication tool, or combination of tools, to use. When communicating one on one, some people prefer email, some the phone and some in-person discussions. Choosing the wrong method can hinder your ability to be effective. Consider also the timing of your communications. Approaching the boss right after a tense sales meeting is probably not the best time.

Step 4

Create key messages. People often try to convey too much in a single communication. Decide what your most important points are, given your audience and your objectives. A good rule of thumb is to use no more than three to five main points. These points should become your focus as you craft your message.

Step 5

Listen and learn. Effective communication is often two-way, offering communicators the opportunity to listen and learn, but only if they take advantage of that opportunity. Every opportunity for interaction offers the chance to learn and improve. Finding out areas where you have been misunderstood, or where objectives have not been met, can help you be more effective when engaging with others.


Sick of Sick Time

By Kathryn Mayer
Source: Benefitspro.com

All week, I’ve been hearing hacking and sneezing and various other upsetting noises coming from all different corners of my office.

It’s likely you have, too.

According to a survey of office workers by Staples, nearly 80 percent of office workers come to work even when they know they’re sick. That’s a whopping 20 percent increase just over last year.

And even worse, for those who stay home, more than two-thirds return to work when they’re still contagious, putting coworkers’ health and business productivity at risk.

This isn’t good news: For one, it’s flu season. (If you haven’t heard, that spreads easily and fast.)

It’s a pretty obvious problem we have here, and of course, a pretty obvious solution: Workers who are sick shouldn't come to work. Period. Instead of getting better, you’ll prolong your recovery and sulk around all day not getting work done while spreading germs to a significant amount of people. And that’s just mean.

Too bad following that solution isn’t all that easy. For the sickly workers, they have a valid excuse to show up: For example, the survey shows nearly half of workers cited concerns about completing work as the reason they don’t stay home sick. And, more than a quarter of respondents come to work to avoid using a sick day, even though a majority of those surveyed indicated their average productivity level while sick was only around 50 percent.

In a struggling economy and competitive job market, workers are less likely to spend their time away from the office even if it’s truly needed. And for PTO workers like myself, if you want to take a vacation, it means you better not get sick. If I caught the flu this year, I’d have to cancel a visit to my parents’ home in Boston. That’s a tough, if not unfair, decision to make.

It’s a two-way street to fix the issue. Employees shouldn’t be coming to work, but employers need to encourage them not to—and that’s not happening in a lot of places. If there really needs to be something done, employers should encourage a telecommuting option so they still work while quarantining themselves (win-win—at least for the employer).

But the main issue is our country’s lack of sick time. The United States is actually the only country that doesn’t guarantee paid sick leave. As a result, close to one quarter of adult workers say they’ve been threatened with termination or fired for taking time off for being sick or taking care of a sick family member.

I don't know about you, but that makes me feel ill.


Employer-Provided Health Insurance and the Market

By Casey B. Mulligan
Source: https://economix.blogs.nytimes.com/

The future of employer-provided health insurance is better considered together with the future of total employee compensation, both cash and fringe benefits like health insurance. From that perspective, the likelihood that most employers will continue to offer health insurance is not necessarily good news for employees.

The Patient Protection and Affordable Care Act, President Obama’s initiative, offers large health-insurance subsidies to the majority of the population beginning in 2014, but only if their employer does not offer affordable insurance. The subsidies are frequently much larger than the subsidies coming through the tax exclusion of employer-provided health insurance.

Some economists are predicting that eligible employees, especially those in line for the largest subsidies, will prefer employers who do not offer affordable insurance. As a result, they say, many more employers will not offer insurance.

Others have different expectations, pointing out that employers dropping insurance will pay penalties and throw away the tax exclusion for their employees who are not subsidy-eligible (typically the ones who earn more). Moreover, perhaps because people are comfortable with their existing coverage even if it is not subsidized, employer coverage did not decline in Massachusetts when it began a similar plan (by my estimate, only 5 percent of the people in Massachusetts who could get subsidized individual-market insurance actually receive it, largely because they have coverage through the employer of the head of the household or that person’s spouse). Note that Massachusetts has lower subsidies and a narrower eligible population than the Affordable Care Act and lower employer penalties for dropping coverage.

How many employers will drop their coverage when the new health care law gets under way? The answer makes for a nice headline, but that’s the wrong question. Would it be so bad if many employers dropped their coverage but replaced it with huge cash raises? Or would it be so good if every employer continued to offer coverage but required employees to take big pay cuts?

All sides agree that some otherwise subsidy-eligible employees will work for employers that keep their coverage, and other subsidy-eligible employees will work for employers that drop it. Market forces must be considered, because some employees will be moving between these two types of employers.

Low-income employees will ultimately cost less to employers without coverage (or without “affordable” coverage; the important issue is that their low-income employees are subsidy-eligible) than they cost to employers with coverage. If they didn’t, low-income employees would be better off at employers without coverage and would line up to work there. Meanwhile, the employers with coverage would find it more difficult to retain and attract low-income employees. That situation defies supply and demand.

Another way to see the same result: by getting low-income employees at lesser cost, employers without coverage can, without going out of business, compete aggressively for the high-income employees who are considering positions that offer coverage.

By the same logic, high-income employees will cost more to employers without coverage than they do to employers with coverage. Thus, high-income employees will lose one way or another — either they will lose their tax exclusion because their employer eliminates coverage or they will see their cash compensation fall below what it would have been without the Affordable Care Act.

At the same time, the low-income employees will enjoy the subsidy either way: either their employer drops coverage, in which case they receive the subsidy directly, or their employer increases their compensation above what it would be without the Affordable Care Act to attract them from the employers without coverage. Tax economists will recognize this as the Harberger model applied to the Affordable Care Act; international economists will recognize it as the Heckscher-Ohlin model.)

The same sorts of market competition will ultimately prevent most employers from dropping their coverage and thereby incurring the penalties. Employers keeping coverage will raise the pay of subsidy-eligible employees and get by with fewer of them. Those who remain will typically not want to leave for no-coverage employers because doing so would cut their pay. The same employers will hire a few more high-income employees at lesser pay, because for those employees, the alternative is a no-coverage employer.


2012 Election: PPACA Is Here to Stay

The votes have been counted and the campaign signs are gone from yards and highway medians (at least most of them). Now, employers are evaluating what the election results will mean for their businesses in the coming years.

On the national level, Americans chose to keep the status quo with President Barack Obama's re-election and split party control of Congress. For employers, the most significant and immediate impact of the election will be the preservation and advancement of the Patient Protection and Affordable Care Act (PPACA), according to a Reuters report.

"There's sort of an immediate acceptance that this law will stay in place in some meaningful way," Chris Jennings, who served as an advisor to former President Bill Clinton, told Reuters. "It's sort of like a big barrier has been removed."

Although the survival of the law now seems all but certain, its final form has yet to take shape. A number of provisions still lack guidance from federal agencies, and employers should expect an "avalanche" of regulations in the coming months, Gretchen Young of the ERISA Industry Committee told Business Insurance.

For example, the details of the penalty ($2,000 per full-time employee) on some employers that don't offer adequate coverage remain sketchy. Also, employers are still waiting for full guidance on how much they will have to contribute to the federal reinsurance program that is mandated by the law, Business Insurance reports.

In the meantime, employers should focus on the immediate requirements that are known. Some of these include:

  • Expanding first-dollar preventive care to include a number of women's services, including contraception, unless the plan is grandfathered
  • Issuance of summaries of benefits and coverage (SBCs) to all health plan enrollees
  • Reducing the maximum employee contribution to $2,500 if the employer sponsors a health flexible spending account (FSA), beginning with the 2013 plan year
  • Providing information on the cost of coverage on each employee's 2012 W-2 if the employer issued 250 or more W-2s in 2011
  • Calculating and paying the Patient Centered Outcomes Fee in July 2013 if the plan is self-funded (insurers are responsible for calculating and paying the fee for insured plans but will likely pass the cost on)
  • Providing a notice about the upcoming health care exchanges to all eligible employees in March 2013

 

The issue of the exchanges -- marketplaces that will allow employees and employers to shop for health care coverage represents another question mark for employers. State leaders have until mid-February to decide whether they will set up their own exchange or let the federal government run the show in their state. Nearly a half-dozen Republican-controlled states have already stated they won't set up exchanges, and more may follow. Because the makeup of these exchanges will affect a wide range of employers, companies should keep an eye on what's happening in their state, UBA notes.

Of course, the law still faces dozens of lawsuits, including one aimed at overturning the requirement that church-affiliated organizations must cover contraceptives for their employees, Reuters reports. Yet the reality for employers seems clear: PPACA is here to stay.

"There is no way the law is going to be repealed in the next two years, and Republicans know that," Chantel Sheaks of Buck Consultants L.L.C. told Business Insurance.