Insurance Market Reform

These final regulations provide guidance to individual taxpayers on the liability for the shared responsibility payment for not maintaining minimum essential coverage.

This proposed rule provides guidance on the tax credit available to certain small employers that offer health insurance coverage to their employee, detailing eligibility for and calculating the tax credit. Comments on the rule are due by November 25, 2013.

On June 28, the Departments of the Treasury, Labor, and Health and Human Services issued the final rules on the ACA requirements that health plans cover contraceptives for women with no cost-sharing. For employees of religious non-profits, insurers and third-party administrators will be required to provide contraceptives to employees. The final rule also provides further clarification on exemption of houses of worship from this requirement.

The Department of Health and Human Services (HHS) issued the final regulation explaining the eligibility rules for receiving an exemption from the individual shared responsibility provision through a health exchange, as well as two subcategories of exemptions that will be available through the tax filing process. HHS’s final regulation includes rules that will ease implementation and help to ensure that the shared responsibility payment obligation applies only to the limited group of taxpayers who have ready access to affordable coverage but choose to spend a substantial period of time uninsured.

The Department of Treasury, Department of Labor, and Department of Health and Human Services issued a joint final rule on employment-based, nondiscriminatory wellness programs. Specifically, these final regulations increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan from 20 percent to 30 percent of the cost of coverage. The final regulations further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other clarifications regarding the reasonable design of health-contingent wellness programs and the reasonable alternatives they must offer in order to avoid prohibited discrimination