August 2013 - Employee Benefits I AP Benefit Advisors

IRS Issues Final Rule on the Individual Mandate

On August 27, the Internal Revenue Service (IRS) issued a final rule for the individual mandate provision of the Patient Protection and Affordable Care Act (PPACA). As a reminder, the individual mandate requires most individuals to have minimum essential coverage (MEC) in 2014 or pay a penalty. The penalty is called a shared responsibility payment. […]

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Tax Answers to FAQs for Same-Sex Spouses

You may have read our prior news article DOMA Unconstitutional: What’s Next for my Employee Benefit Plans?  And, you’ve thought through the issues about eligiblity for you health plans, spousal life insurance plans, etc. Now, the IRS has responded with questions and answers that should provide individuals of the same sex, who are lawfully married […]

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Employee Health Improvement & Corporate Wellness Plans

Increasingly, employers are looking to data analysis and predictive modeling to identify and understand the health factors driving the cost of their health benefits program. With approximately 75% of health care cost attributable to people with chronic diseases, and the extensive body of evidence attributing chronic disease to lifestyle factors such as smoking, poor eating […]

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Benefits Administration & Consultation Services

Employee benefits vary greatly between types of locations, types and sizes of organization, and a litany of other factors. Knowing which benefits plans work best for your company, and how to implement and regulate them, can prove quite challenging. Consulting the experts at AP Benefit Advisors can set your company down the path to success […]

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Court Overturns Benefit Denial Due to Plan’s Improper Application of Experimental Exclusion

From EBIA This decision replaces an earlier decision that upheld a self-insured health plan’s denial of benefits for a participant’s surgical procedure because the plan language clearly excluded the procedure as experimental. But after learning that the language actually came from the claims administrator’s internal policy document (not the plan itself), the court vacated its […]

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How Will Income be Verified in the Exchanges?

We’ve all been asking ourselves how will the IRS/DOL/HHS verify the income that consumers say they are earning?  Will they only look at last year’s filed W-2/1040? Well, wait no longer.  CMS issued guidance this week on just this issue.  Their new FAQ describes a multi-step verification process that begins with the projected annual household […]

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Exchange plans could cost less than expected

by Allison Bell, lifehealthpro.com Typical exchange plan rates are lower than expected. That’s the word from the U.S. Department of Health and Human Services, which highlighted the new information in a report Thursday. Eleven states have released rates for next year for their plans sold under the Patient Protection and Affordable Care Act’s exchanges. HHS analysts found that […]

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