This Month in Benefits

If you’re old enough, you might remember a great TV show from the 70’s called This Week in Baseball.  I used to watch it religiously every Saturday during the baseball season before the 1:00 games started.  I thought it might be fun to do a little takeoff on that show with this post and call it “This Month in Benefits.”

July was a busy month in the employee benefits world.  Here is a summary of some of the developments.

ACA Affordability Percentages Will Increase

On July 21, the IRS announced that it’s changing the contribution percentage to determine affordability for the ACA for plan years beginning in 2021.  The new benchmark will be 9.83% of the employee’s household income for the year for both the pay or play rules and premium tax credit eligibility.

President Trump Signs Executive Orders Aimed at Lowering Drug Prices

President Trump signed 4 executive orders on July 24:

  1. The Executive Order on Access to Affordable Life-Saving Medications directs federally qualified health centers to pass along discounts on insulin and epinephrine received from drug companies to certain low-income Americans.
  2. The Executive Order on Increasing Drug Importation to Lower Prices For American Patients allows flexibility for states to import drugs.  One example is Florida, where the administration has been working to enable the importation of cheaper Canadian drugs.  This could be a model for other states.
  3. Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen prohibits secret deals between drug manufacturers and pharmacy benefit managers.
  4. The last is meant to ensure that the US will pay the lowest price available in comparable countries for all Medicare Part B drugs.  Currently the US often pays up to 80% more for these drugs than other countries.

Draft Forms for 2020 ACA Reporting Released

On July 13, the IRS released draft 2020 1094-C and 1095-C forms.  They include:

  • A new section to enter the employee’s age on January 1.
  • Additional codes in Code Series 1 related to offers of individual coverage health reimbursement arrangements (ICHRAs).
  • A new section to enter the zip code used to determine affordability for an ICHRA if one was offered.

Supreme Court Upholds ACA Contraceptive Rule Exemptions

On July 8, the US Supreme Court upheld two regulations expanding exemptions from the contraceptive coverage mandate under the ACA.  As a result, employers may now be able to opt out of providing the ACA mandated coverage based on religious or conscientious objections.

If you’d like to discuss these developments or others, feel free to call us at (866) 724-0008 or click the link below.


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