Have a look at some of the top employee benefits stories from this quarter.
ACA Pay or Play Penalties Will Increase for 2023
On August 16, 2022, the IRS updated its frequently asked questions (FAQs) on the employer shared responsibility (pay or play) rules under the Affordable Care Act (ACA) to include updated penalty amounts for 2023. For calendar year 2023, the adjusted $2,000 penalty amount is $2,880 and the adjusted $3,000 penalty amount is $4,320.
Pay or Play Affordability Percentage Decreased for 2023
On August 1, 2022, the IRS issued Revenue Procedure (Rev. Proc.) 2022-34 to index the contribution percentages in 2023 for determining the affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2023, the ACA’s affordability contribution percentages are updated to:
• 9.12% under the pay or play rules
• 9.12% under the premium tax credit eligibility rules
• 8.17% under an exemption from the individual mandate
Supreme Court Turns Abortion Regulation to the States: Considerations for Group Health Plans and Employers
On June 24, 2022, the United States Supreme Court (“the Court”) released its much anticipated decision in Dobbs, State Health officer of the Mississippi Department of Health, et al. v. Jackson Women’s Health Organization, et al., which examined the Mississippi abortion law that, with limited exceptions for the health of the mother or severe abnormality of the fetus, prohibits performing abortions on a fetus of greater than 15 weeks gestation. This gave the Court the opportunity to re-examine its historical decisions in Roe v. Wade and Planned Parenthood v. Casey.
Update on Machine Readable Files
The new rules that went into effect July 1, 2022, require most group health plans to make available to the public machine-readable files for health services cost information and cost-sharing disclosures. These rules require the group health plan to post links to the machine-readable files containing pricing information on a publicly available website.