Life & Health Insurance Updates
ACA Compliance Bulletin:
CMS Resumes ACA Risk Adjustment Payments
On July 24, 2018, the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) issued a final rule adjusting the risk adjustment methodology, allowing payments to resume under the risk adjustment program.
Risk adjustment is a permanent program under the Affordable Care Act (ACA) that provides payments to insurers that attract higher risk populations by transferring funds from plans that enroll the lowest risk individuals to those plans that enroll the highest risk individuals. Previously, on July 7, 2018, CMS halted payments to insurers under the risk adjustment program as a result of ongoing litigation. According to CMS, conflicting federal court rulings prevented the federal government from collecting or disbursing funds under the risk adjustment program. [...]
ACA Compliance Bulletin: Draft Forms for 2018 ACA Reporting Released
The Internal Revenue Service (IRS) released draft 2018 forms for reporting under Internal Revenue Code (Code) Sections 6055 and 6056.
- 2018 draft forms 1094-C and 1095-C were released July 11, 2018, and will be used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
- 2018 draft forms 1094-B and 1095-B were also released in July 2018, and will be used by entities reporting under Section 6055, including self-insured plan sponsors that are not ALEs.
Draft instructions for these forms have not yet been released. The draft 2018 forms are substantially similar to the final 2017 versions. [...]