Federal Health Care Reform

Published: February 11, 2020

Cities need to make sure they are complying with the federal Affordable Care Act (ACA). Here you will find resources to help you stay abreast of the constantly changing legislative environment. The League has partnered with Arthur J. Gallagher & Co. to provide many of these resources.

Resources

Sections 6055 and 6056 Reporting Requirements Toolkit

Two tenets that are central to the ACA are the individual mandate and the employer mandate. To administer these regulations, the government needs to gather information from employers regarding coverage and offers of coverage. This is provided via 6055 and 6056 reporting:

  • IRS Code Section 6055 requires employers providing minimum essential coverage to report certain information to the IRS about the coverage provided and who it is provided to. This supports administration of the individual mandate.
  • IRS Code Section 6056 requires applicable large employers to report information regarding the coverage offered to their employees. This supports administration of the employer mandate.
  • Both Sections 6055 and 6056 also require statements to be furnished to the individuals that are mentioned in the reports to the IRS.

Compliance experts at Gallagher have created this toolkit to help employers comply with these requirements.
Access the toolkit from the Gallagher website

Counting Hours Toolkit

Determining who is a full-time employee for purposes of the employer mandate is not as simple and straightforward as it seems. A city must be mindful of temporary, seasonal, and variable hour employees, among others.

Gallagher developed the Counting Hours Toolkit to help employers determine the number of full-time employees they have. The toolkit includes articles about the regulations, employer frequently asked questions, and more.
Get the toolkit on the Gallagher website

Employer Shared Responsibility Mandate Toolkit

The employer shared responsibility mandate requires applicable large employers to offer employer-sponsored coverage to full-time employees and their dependents, or face potential penalties.

To assist employers in their efforts to fully understand this important provision of healthcare reform, the Gallagher compliance experts have constructed this toolkit that covers all aspects of the mandate. The toolkit includes information on potential penalties, background on the employer mandate, a set of Frequently Asked Questions, webinars and more.
Download the toolkit on the Gallagher website

Healthcare Reform Fees Toolkit

One of the more difficult aspects of compliance with the ACA is keeping track of the fees and taxes brought forth by the law.

This toolkit emphasizes two remaining fees: the Patient-Centered Outcome Research Institute (PCORI) fee and the health insurer fee. The SECURE Act extended the PCORI fee until September 30, 2029. In addition, the SECURE Act repealed the “Cadillac Plan” Tax effective January 1, 2020 and the Annual Health Insurer Fee effective January 1, 2021.
Access the toolkit on the Gallagher website

Wellness Toolkit

The Wellness Toolkit was designed by Gallagher’s compliance team to help you evaluate your wellness program and determine which of the requirements from the Americans with Disabilities Act (ADA), Genetic Information Nondiscrimination Act (GINA), and Health Insurance Portability & Accountability Act (HIPAA) apply to your organization.
See the toolkit on the Gallagher website

Summary of Benefits & Coverage Disclosure Toolkit

In an attempt to help employees compare plans more easily, the government now requires employers to provide participants and dependents a standardized “summary of benefits and coverage” (SBC). This toolkit is designed to help you understand, prepare, and comply with the SBC requirements.
Get the toolkit on the Gallagher website

W-2 Reporting Toolkit

Healthcare reform amended the Internal Revenue Code to require employers to report the aggregate cost of “applicable employer-sponsored coverage” on employee W-2s. As a result of the requirement, many employers have been wondering:

  • If their plans are subject to the healthcare reform W-2 reporting requirement.
  • How to correctly calculate the value of the benefits provided.
  • What types of benefits need to be included on employees’ W-2s.

In an effort to help you navigate the W-2 requirements, Gallagher has developed this toolkit to help you understand, comply, and communicate these changes to your employees.
Check out the toolkit on the Gallagher website

Provisions Unique to Small Employers

While most healthcare reform provisions apply to employers uniformly, regardless of size, there are a few provisions that may benefit small employers. These include an exemption from penalty, the availability of coverage through state exchanges, health insurance tax credits, exemption from reporting health costs on W-2s, and the use of a SIMPLE Cafeteria Plan.
Read more about Healthcare Reform Provisions Unique to Small Employers (pdf)

Additional resources