February 5, 2016

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In This Issue
National Member Webinar on Navigating Commissions, Ethics, and Antitrust Laws
White House to Release Cadillac Tax Fix
New Guidance on the HIT/Expatriate Plans
House Fails to Override Presidential Veto; Holds Hearing on Prescription Prices
CMS: 79,000 Agents and Brokers Helped Enroll on HealthCare.gov
Webinar: Understanding the Pros and Cons of Cost Containment Strategies
Compliance Cornered: Coping with COBRA… and Employer Reporting!
It’s Time to Make your Hill Appointments for Capitol Conference
The ShiftShapers Podcast with David Saltzman
HUPAC Roundup
What We’re Reading
Tools
E-mail the Editor
Visit the NAHU Website
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New Guidance on the HIT/Expatriate Plans

On Monday, the Internal Revenue Service (IRS) released Notice 2016-14, which details how expatriate plans impact calculation of the health insurance tax (HIT) by carriers. The guidance is in response to the one-year moratorium of the HIT, passed by Congress in December, and follows up the Expatriate Health Coverage Clarification Act of 2014, for which NAHU advocated to exclude expatriate health plans from the fee for 2015 and later, by noting that a qualified expatriate enrolled in an expatriate health plan is not considered a U.S. health risk. It also included a rule solely applicable for purposes of determining the fee for 2014 and 2015. This guidance notes that for this limited purpose, the definition of expatriate health plan will be the same as provided in the MLR final rule definition.

Covered entities that report direct premiums written for expatriate health plans for 2016 must certify that:

  1. The covered entity (or designated entity, in the case of a controlled group) filed the Supplemental Health Care Exhibit (SHCE) with the National Association of Insurance Commissioners (NAIC) for 2016;
  2. The covered entity is filing the statement pursuant to Notice 2016-14;
  3. The aggregate dollar amount of direct premiums are excluded from direct premiums written reported in the Direct Premiums Written column (f) on the covered entity’s 2016 Form 8963.

Covered entities with premiums for expatriate plans in 2015 not reported on SHCEs for 2016 must exclude direct premiums written for expatriate health plans from the Direct Premiums Written column (f) on its 2016 Form 8963 and attach the reconciliation described in Notice 2016-14, Sec. 5.02. These entities must certify that:

  1. The covered entity is filing the statement pursuant to Notice 2016-14;
  2. The aggregate dollar amount of direct premiums written for expatriate health plans that met the MLR final rule definition, that it excluded from the Direct Premiums Written column (f) on its 2016 Form 8963; and
  3. The source of information that the covered entity has available on request for determining direct premiums written for expatriate health plans for 2016, such as the Accident and Health Policy Experience filed with the NAIC, the MLR Annual Reporting Form filed with the Center for Consumer Information and Insurance Oversight of the Department of Health and Human Services, or any similar statements filed with the NAIC, with any state government, or with the federal government pursuant to applicable state or federal requirements.
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