on November 6, 2014 the department of Labor (DOL) has a new set of frequently asked questions (FAQs) confirms that premium reimbursement arrangements are group health plans. Repeat the FAQs, the positions outlined in Technical Release 2013-03 of 2013, and further emphasize the importance of having the Public Health Service (PHS ) Act §§ 2711 and 2713 (hereinafter referred to ensure in the FAQ as "market reforms") health insurance reimbursement fulfill programs. 
, an employer may reimburse employees for health insurance premiums?
Yes. However, it needs it, a premium refund Arrangement in compliance with current group health plan rules, including the market reforms.
What are the frequently asked questions about premium reimbursement arrangements?
The FAQs Average confirm to be taken to design that arrangements premium refund (regardless of whether refunds made on a pre-tax or after-tax basis) are subject to group health plans are the market reforms. For employers employees want to refund premiums for health insurance, this underlines the importance of premium reimbursement arrangement warranty is designed and in accordance with the market reforms and other applicable group health plan rules (such as plan documents and summary plan descriptions) administered.
How can premium reimbursement arrangements comply with the market reforms?
to the market reforms to comply, an arrangement premium refund must be structured in 2711 annual ceiling comply with PHS Act Section rules and PHS Act Section 2713 pension rules.
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PHS Act Section 2711 requires plans group health (including arrangements premium refund) not put annual or lifetime limits "substantially health benefits. "
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PHS Act Section 2713 plans group health requires (including premium reimbursement arrangements) to cover basic preventative care services without cost sharing.
It is important that PHS Act Section 2711 health plans group to note (including premium reimbursement arrangements) to place annual limits on benefits allows that are not essential health benefits. Since insurance premiums are not essential health benefits, group health plans (including arrangements premium refund) can set. A "Premium-specific" annual ceiling for premium refunds
However, group health plans (including arrangements premium refund) can not be an annual ceiling for the basic pension expenses under § PHS Act 2713 instead necessary because preventive care costs essential health benefits are considered.
As already mentioned, one way to structure a conformal premium refund arrangement is to design the arrangement to reimburse employees:
- health insurance premiums up to a certain monthly health allowance and
- Preventive care as required by PHS Act § 2713.
will could meet these market reforms, an employer excise duties suspend IRC section 4980D of up to $ 100 per day if the fault has been rectified (Note: this control is granted to 10% of the amount under the plan, if the failure by appropriate cause, and the control can be avoided may is in entirety, if the employer show limited to, that the error did not know existed and it is corrected within 30 days).
How do FAQs Affect premium reimbursement arrangements and Premium Tax Credits?
repeat the FAQs that if a premium refund arrangement is not properly trained and "minimum coverage" is held, then a lower income are employees need between participation in the premium refund Arrangement and receipt of the premium tax credit ,
, an employee will receive a premium tax credit and reimbursement for non-select -Subsidized part of the Health Insurance Plan?
Yes. If the premium refund arrangement is structured such that it does not meet not the definition of "eligible employer-sponsored plan" in Internal Revenue Code (IRC) Section 5000A, then employees can not a premium tax credit received (if otherwise eligible).
What is an eligible employer-sponsored plan
by IRC section 5000A (f) (2):
The term "in question next employer-sponsored plan "means in respect of an employee who reports a group health plan or group health insurance offered by the employer to the employee, the actual
(a) a government plan (as defined in section 2791 (d) (8) of the Public Health service Act) or
(B ) any other plan or offered in the small or large group market coverage within a state.
This term is a Grandfathered include health. Plan in paragraph (1) (D) are offered in a group market
Source: IRC section 5000A
If the arrangement premium refund is designed so that it does not meet the definition of a non-qualified employer-sponsored plan, employees in the participating premium reimbursement arrangement and can simultaneously a premium tax credit received (if otherwise eligible).
It is important to note that when a premium refund arrangement does not meet the definition of an eligible employer-sponsored plan, it is not the employer meet shared responsibility provision (ie employer mandate) the Affordable Care Act. This is an important compromise that employers with 50 or more employees should consider
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