On May 15, the Centers for Medicare & Medicaid Services [CMS] issued the HHS Notice of Benefit and Payment Parameters for 2027, introducing a broad set of changes to the federal ACA Health Insuracne Marketplace. These changes lower marketplace user fees; eliminate the requirement for marketplace insurers to offer standardized plan options; and grant states […]
Increased Federal Scrutiny for ACA Eligibility Read More »
The AI revolution is fueling far-reaching business transformation. These ‘AI & RegTech’ posts have been created by the tech and benefits specialists at BENEFITSCAPE to help employers and everyone in the benefits ecosystem understand better the emerging benefits of AI for ben admin and compliance. In PART 2 we dig deeper into the different types
AI & Regtech for Employee Benefits [Part 2/3] Read More »
Last month’s IRS Revenue Procedure 2026-22 signalled another substantial hike in penalties for non-compliance with the ACA’s Employer Shared Responsibility Provisions [or Employer Mandate]. These penalties fell in TY 2025 but have risen substantially for the current TY 2026 [reporting in 2027]. See ACA-To-Z Blog: Time to Get Ahead of ACA Changes. They are now
ACA Penalties Set To Rise Again in TY27 Read More »
ACA Reporting & Compliance continues to evolve. New reporting requirements, changing penalty rates, and updated affordability thresholds are among the changes for TY 2026 [filing in 2027]. A number of government marketplace subsidies on healthcare are also set to expire, meaning more employees are likely to be considering employer plans. In short, now is the
Time To Get Ahead of ACA Changes for TY26 Read More »
As an active participant in LIMRA’s LDEx standards and technology committee, BENEFITSCAPE is helping shape the future of how data moves across the complex benefits ecosystem. To this end, BENEFITSCAPE Chief Technologist Max Ignatov will be taking part in a key panel discussion at the upcoming LIMRA Workplace Benefits Conference in Tampa, Fl [May 4-6].
BENEFITSCAPE Helping Drive the LDEx Revolution Read More »
Bipartisan legislation giving employees greater control over their employer contributions was introduced on April 15 by two members of the influential House Ways and Means Committee. Below we outline the opportunities unlocked by this proposed legislation — and by BeneSphere’s regtech-enabled orchestration of increasingly complex and dynamic benefits data. _________________________ What is the OPTIONS Act?
The OPTIONS Act & Employee-Directed Benefits Read More »
The AI revolution is fueling exciting and far-reaching business transformation — but also a good deal of hype, misunderstanding and even risk. Unlike other tehnology revolutions, many of the most avid early adopters of AI are the least expert. This can lead to organizations into misapplications, missed opportunities or, far worse, costly pitfalls and even unsafe
AI & RegTech for Employee Benefits [Part 1/3] Read More »
Paid interns can impact ACA Compliance for ALEs by adding to their full-time employee count. If hired to work at least 30 hours per week, paid interns are considered full-time employees for the ACA purposes. Misclassification of short-term employees, such as summer interns, can result in a failure to meet the employer’s requirement under the
ACA FACT CHECK: Should ALEs Offer Paid Interns Medical Coverage? Read More »
On December 23, 2024, President Biden signed new legislation affecting ACA reporting, namely, the Paperwork Burden Reduction Act [PBRA]. This act eases the burden on Applicable Large Employers [ALEs] to furnish their employees with a FORM 1095-B [self-insured employers] and/or FORM 1095-C [both self-insured and fully insured employers]. These are the forms reporting on offers
ACA FACT CHECK: What Are the Eased Demands for FORM 1095 Reporting? Read More »
If you read only one ACA Compliance & Reporting guide this year, make sure it’s this one! There are plenty of ACA guides out there. A lot contain errors, some are plain wrong, and more and more are loosely AI-generated. Most are confusing, to say the least. As if ACA governance, risk management & compliance
ACA TY24: IRS Changes, Tips, & Common Errors Read More »
When passed, the Affordable Care Act [ACA] required individuals to purchase & maintain qualifying health insurance coverage – or face a federal penalty. By reducing these penalties to zero in 2019, the federal Tax Cuts & Jobs Act [TCJA] effectively repealed the ACA individual mandate [as distinct from the ACA employer mandate]. Eleven US states
ACA TY24: State Mandates Guide & Checklist Read More »
The IRS ACA reporting DEADLINES for TY24 [filing in 2025] are as follows: MARCH 3, 2025: Deadline to furnish IRS FORMs 1095-B & C to individual eligible employees. MARCH 31, 2025: Deadline to e-file FORMs 1095-B & C and employer Form 1094-C plus all other required ACA documentation to the IRS. » NOTE: NO MORE
ACA TY24: IRS Deadlines & Penalties Read More »
The annual Dayforce Discover event starts in Vegas on Monday, November 11. BENEFITSCAPE will be participating this year as a Dayforce Consulting Partner for Benefits & Compliance. HCMs DELIVER BEST-IN-CLASS BEN ADMIN. Dayforce’s deep BENEFITSCAPE partnership reflects the industry-leading work BENEFITSCAPE has done pioneering ACA COMPLIANCE and other benefits administration for employers on the major HCMs.
Dayforce Strengthens BENEFITSCAPE Partnership Read More »
The IRS has published the TY2024 ACA Compliance & Reporting templates for employee FORM 1095-B and FORM 1095-C. The TY24 deadlines for distributing these forms to employees and for filing to the IRS are as follows: Forms 1095 Distribution Deadline: March 3, 2025 FORMS 1095 IRS E-Filing Deadline: March 31, 2025 FORMS 1095 & STATE-MANDATED
IRS Publishes Forms 1095-B & C for TY24 Read More »
The TY25 AFFORDABILITY THRESHOLD for calculating employer ACA compliance has been increased to 9.02% of the employee’s household income. This move by the IRS follows three years of decreases — from 9.83% in 2021 down to 8.39% for the current TY 2024. The increased threshold will take some of the budgetary pressure off the health cover
TY25: IRS Sets ACA Affordability at 9.02% Read More »
All Applicable Large Employers [ALEs] are subject to the ACA’s employer shared responsibility [ESR] provisions. They must report on ACA compliance to the IRS. Below is an explanation of how to calculate ALE status. If in any doubt, please contact BENEFITSCAPE, the leading specialist in ACA compliance. It provides an ALE calculation service and can answer any other
ACA TY24: ‘Is My Company an ALE?’ Read More »
This three-part series on AI & REGTECH has been created by the data scientists and benefits specialists at BENEFITSCAPE to provide a high-level framework for understanding how AI can support ben admin and compliance. In this final post, we sum up the key takeaways for employers from Parts 1 & 2. 1. AI comes with
AI & Regtech: The 7 Key Takeaways Read More »
The AI revolution is fueling far-reaching business transformation. This short series of ‘AI & REGTECH’ posts has been created by the data scientists and benefits specialists at BENEFITSCAPE to help employers understand better the emerging benefits of AI for ben admin and compliance. In Part 2 BENEFITSCAPE digs deeper into the different types of AI
AI & Regtech: A Framework for Employers [Part 2] Read More »
We all agree. AI is changing many, many business practices forever. The AI revolution, like the first .com wave, is fueling far-reaching business transformation — but also a fair amount of misguided and misleading hype. In itself, this hype is pretty harmless; no more than window dressing by marketing departments. But it can also lead employers
AI & Regtech: A Framework for Employers [Part 1] Read More »
By BENEFITSCAPE CHAIRMAN Ken Phillips INTRODUCTION Alongside Human Capital Management [HCM] systems, employers typically use specialized ben admin software and services to manage health & welfare benefits. These best-in-class employee ben admin solutions have robust specialized functionality and deep integration with both the benefits supply chain and compliance reporting. HCMs have found it hard to
HCMs Deliver Best-in-Class Ben Admin Read More »
WHAT IS PCORI? PCORI stands for Patient-Centered Outcomes Rsearch Institute. The acronym is used as a short-hand name for the fee imposed by the Affordable Care Act on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans. The revenue generated by this fee helps fund the afore-mentioned Patient-Centered Outcomes Research
PCORI Guide & 30-Second Checklist Read More »
By BENEFITSCAPE CHAIRMAN Ken Phillips ________________________________________________________________ The IRS has invited feedback on the ACA reporting and compliance process — more specifically, on the efficiency and utility of FORMS 1094-C and 1095-C. BENEFITSCAPE’s response is a very practical one. Our focus has always been on developing specialist ACA technology — in conjunction with best-in-class managed services
A Response To IRS Call for ACA Feedback Read More »
You met the IRS reporting deadline. But now it’s time to correct any filing errors. All Applicable Large Employers [ALEs] get one of 6 IRS responses to their Form 1094-C and Form 1095-C ACA submissions. These responses, sent via the IRS AIR e-filing system, do not signal a company’s final ACA compliance status. They are
ACA Filing Errors: What To Do Next Read More »
Now that the April IRS deadline for ACA reporting has come and gone, here three timely tips for employers. 1. NOW’S THE TIME TO SET UP FOR TY24. BENEFITSCAPE recommends all employers process their ACA compliance data month by month — and don’t just wait till year-end. Today is an ideal time to talk to BENEFITSCAPE
Late Filings & Other Timely ACA Tips Read More »
Without much fanfare, a radical data science revolution is taking place inside the Internal Revenue Service [IRS]. And all corporate employers should take note — and take steps not to get caught out by it. From 2010 to 2021, the IRS experienced budget cuts in real terms of 22%, leaving it with outdated technology and a
Regtech Transforming IRS Powers Read More »
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