Providers

In Revenue Procedure 2019-29, the IRS announced that the 2020 shared-responsibility affordability percentage will be decreased from the 2019 limit. Under the Affordable Care Act (ACA), employer-sponsored health coverage will satisfy the affordability requirement if the lowest-cost self-only coverage option available to employees does not exceed 9.78 percent of an employee’s household income.

As of January 1, 2020, responsible reporting entities (RREs) must report prescription-drug coverage to the Centers for Medicare & Medicaid Services (CMS). Currently, RREs are required to report information to CMS about individuals who are entitled to Medicare and are covered under a group health plan, so CMS may determine whether the plan is primary to (pays before) Medicare.

The Patient-Centered Outcomes Research Institute (PCORI) fee under the Affordable Care Act is due from sponsors of applicable self-funded health plans by July 31, 2019.

The IRS has released the 2020 cost-of-living amounts (COLAs) for HSA-qualifying high-deductible health plans.

The Department of Labor (DOL) recently issued an Information Letter reminding plan sponsors of ERISA benefit plans to document procedures for appointing authorized representatives in the benefit claim and appeal process.