Hamilton Headlines
May 16, 2016

Instructions to Help You Complete the Appeal Request Form 

If you received a Marketplace notice stating that you may be subject to the Employer Shared Responsibility Payment, you can request an appeal by submitting this form or mailing in a letter that includes the information requested on this form.

Use this form if you're appealing a notice you received from: 
  • The federally-facilitated Health Insurance Marketplace
  • A state-based Marketplace operating in:

    New York
    District of Columbia
This appeal may determine if an employee was eligible for help with the costs of coverage through the Marketplace at the same time that you may have offered them affordable health coverage that met the minimum value standard. This appeal will NOT determine if your organization has to pay the Employer Shared Responsibility Payment.  Only the Internal Revenue Service (IRS), not the Health Insurance Marketplace or the Marketplace Appeals Center, can determine which employers are subject to the Employer Shared Responsibility Payment as stated under section 4980H of the Internal Revenue Code.
Suicide Prevention

Suicide is a major public health concern. Over 41,000 people die by suicide each year in the United States; it is the 10th leading cause of death overall.  Suicide is tragic.
But it is often preventable. Knowing the risk factors for suicide and who is at risk can help reduce the suicide rate.     

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk for suicide. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:

  • Depression, other mental disorders, or substance abuse disorder
  • A prior suicide attempt
  • Family history of a mental disorder or substance abuse
  • Family history of suicide
  • Family violence, including physical or sexual abuse
  • Having guns or other firearms in the home
  • Incarceration, being in prison or jail
  • Being exposed to others' suicidal behavior, such as that of family members, peers, or media figures.
Group Health Plan Notices

The attached calendar provides information on key required notices and filings for group health plans under the federal Employee Retirement Income Security Act
(ERISA). The information is subject to change and should be used for general reference purposes only. Plan administrators, sponsors, and employers are advised to refer to the current law, regulations and applicable form instructions, or other guidance issued by the U.S. Employee Benefits Security Administration. For the most up-to-date information on Health Care Reform, please visit

The reporting and disclosure requirements for group health plans are very complex. The applicability of certain requirements may depend on a number of factors, including the number of employees in your organization and the type of benefits offered under your health plan. Additionally, your plan may be subject to other requirements that are not included in this calendar, such as certain reporting and disclosures required by the Internal Revenue Service or under state law. Employers who have questions are encouraged to consult with their plan administrators, the U.S. Employee Benefits Security Administration (1-866-444-3272), the Internal Revenue Service (1-877-829-5500), or a knowledgeable employment law attorney for further guidance.

Complete Calendar
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IRS Guidance for Individuals Receiving a Corrected or Voided Form 1095-A
Individuals that were enrolled in Health Insurance Marketplace coverage in 2015 should have received a Form 1095-A, Health Insurance Marketplace Statement, from the Marketplace. Some individuals may have received corrected or voided Forms 1095-A, because the information on their initial forms were incorrect or incomplete. Alternatively, they may have received a letter from the Marketplace indicating that they should disregard a received Form 1095-A, which means that the form has been voided.

The Internal Revenue Service (IRS) is providing the following guidance for such individuals:

Corrected Forms 1095-A

Individuals who have already filed a tax return will need to determine the effect the changes to the corrected forms might have on their returns. Some changes may require an individual to file an amended tax return. For information on how to assess the changes made, please visit the IRS' webpage on
corrected or voided Forms 1095-A . Individuals uncertain about whether to amend a tax return may also want to consult with a tax preparer.

Individuals that believe the information on a corrected Form 1095-A is incorrect or that have additional questions about the form should contact the Marketplace .
Complete Updates  
ACA Tips for Employers With Fewer Than 50 Employees
The Internal Revenue Service (IRS) is reminding small employers about key provisions of the Affordable Care Act (ACA) which may or may not apply to them:
  • "Pay or Play" Provisions Do Not Apply: If an employer has fewer than 50 full-time employees, including full-time equivalent employees (FTEs), on average during the prior year, the employer is not considered an applicable large employer (ALE) for the current calendar year and is therefore not subject to the ACA's employer shared responsibility provisions for the current year. Calculating the number of employees is especially important for employers that have close to 50 employees or whose workforce fluctuates throughout the year.
  • Information Reporting Requirements May Apply: Employers that provide self-insured health coverage (regardless of size) must file an information return reporting certain information for individuals they cover. These employers should have provided the 2015 Forms 1095-B to their employees by March 31, 2016. The deadline for sending Forms 1094-B and 1095-B to the IRS is May 31, 2016 (or June 30, 2016 if filing electronically).
Plants: Partners in Health?

Vegetables, Fruits, Herbs, and You
Is there anything more delicious and nutritious than vine-ripened tomatoes, just-harvested peaches and corn, or fresh herbs and spices? Growing your own edible plants-whether in a backyard garden or a few pots on your windowsill-can be fun, rewarding, and healthful. If you share your garden's bounty with friends and neighbors, you might even expand your social connections and spread the health around.

"Gardening has many health benefits. It allows you to get outside, get active, and sit less, which might help to reduce stress," says Dr. Philip Smith, a life-long gardener who oversees obesity research at NIH. "Gardening can also help to improve your diet if you eat more fruits and vegetables. They're especially delicious, with a more intense flavor, when ripe and freshly picked."

Fruits and vegetables are packed with fiber and essential vitamins and minerals. Research has shown that eating fruits and vegetables as part of an overall healthy diet can reduce your risk for long-term diseases, such as heart disease, stroke, and some types of cancer. The fiber in fruits and vegetables can help relieve constipation and normalize your bowel movements.
ACA Reporting Requirements:
Forms 1094-C and 1095-C to be filed with the IRS by May 31, 2016 (instead of February 29, 2016) or June 30, 2016 (instead of March 31, 2016), if filing electronically.  
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Please note that Hamilton Insurance does not provide legal advice, and this does not constitute advice of any kind for any 
particular situation. Instead, this is intended as non-comprehensive general information serving as a starting point for further 
discussion. Please contact your tax and/or legal advisors for information about how these issues affect you.  
About Us
H amilton Insurance , a top ranked independent broker in the Washington DC/Metropolitan Area and the nation, has over 35 years of experience in providing insurance brokerage, risk management and employee benefit solutions. It represents a full suite of commercial, health & welfare, and personal insurance solutions, supported by risk compliance and group benefit administrative services. 

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