Author Archives: Eric Walters

Small Business HRA & Special Enrollment Periods.

Special Enrollment Periods and the Small Business HRA

The 21st Century Cures Act reintroduced the stand-alone Health
Reimbursement Arrangement
 (HRA) for small businesses, making it possible for them to offer health benefits they may not have been able to afford otherwise. But implementing this new type of plan, known as the Small Business HRA, can be difficult for businesses whose employees don’t have health coverage.

Because the open enrollment period ended January 31, 2017, businesses that want to start offering the Small Business HRA must consider whether making a change outside an open enrollment period would negatively impact their employees.

Transitioning from a Group Health Policy

If your company is transitioning from group health insurance to the Small Business HRA, your path is simpler. First, you have to cancel your group health. This will trigger a special enrollment period, during which your employees can enroll in individual coverage and immediately begin using the Small Business HRA.

You must also comply with the notice requirements of the 21st Century Cues Act:-(The Small Business HRA allows companies with fewer than 50 employees to reimburse individual health insurance premiums and qualified medical expenses for their employees, as well as their employees’ spouses and dependents. Alongside the benefits of a Small Business HRA come a few responsibilities, howeverincluding a requirement that companies offering the benefit provide a 90-day notice to their employees every year.)
This approach allows all employees to begin taking advantage of the Small Business HRA immediately.

If You Don’t Have a Current Policy

Fewer than half of small businesses offer group health insurance to their employees. If your business doesn’t offer a group health policy, it’s more difficult for the Small Business HRA to deliver immediate value to your employees.

Currently, implementing a Small Business HRA midyear doesn’t qualify employees for a special enrollment period. That means only employees with existing minimal essential coverage, whether through their own individual policy or a spouse’s plan, will be able to access Small Business HRA funds prior to open enrollment.

Employees currently without coverage will need to wait until the next open enrollment period, or another qualifying life event, to buy a policy and begin taking advantage of the Small Business HRA.

Additionally, the individual market doesn’t include new hires among the conditions that trigger a special enrollment period, which means employees hired midyear aren’t permitted to participate in the Small Business HRA until the next open enrollment period.

However, if the new hire is losing group health insurance through their previous employer, they will qualify for a special enrollment period. This means they will be able to enroll in new individual health insurance and begin accessing HRA funds.

Overall, if you’re adopting the Small Business HRA after offering no health benefits, only employees enrolled in prior coverage will immediately benefit from the HRA.


Many factors go into a company’s decision to implement the Small Business HRA. If you’re thinking about making the change outside of an open enrollment period, it’s important to consider how doing so will affect your employees and whether they can take advantage of the benefits right away. In some cases, waiting until all employees are eligible to enroll in coverage under the Small Business HRA may be the better choice.

 Eric Walters – Insurance Services.

Scottsdale, Arizona

Cell: 602-616-660






Can I Still Make Changes to My Individual Health Insurance Plan?

Can I Still Make Changes to My Individual Health Insurance Plan?

We’ve passed the enrollment deadline for coverage beginning January 1, but that doesn’t mean you can’t still choose or change your plan. Open enrollment for individual health insurance on the ACA Marketplace began on November 1, 2016, and continues through January 31, 2017. Signing up in January means your coverage won’t begin until March 1, but that policy will be guaranteed for the remainder of the calendar year.

If you’ve already enrolled in an individual health insurance plan, but are realizing it’s not quite what you expected, you can still switch plans. The final open enrollment deadline also includes making changes to your selection. When doing so, be sure to research whether your doctors and prescriptions are covered. You can do this by clicking on each plan and looking at the formulary and network options.

What Happens If I Miss the Deadline?

If you miss the January 31, 2017, deadline, you won’t be able to sign up for individual health insurance until the next open enrollment unless you qualify for a special enrollment period.

What Is a Special Enrollment Period?

A special enrollment period is a time frame during which a person is allowed to sign up for individual health insurance outside of the designated open enrollment period. To be eligible for special enrollment, you must go through a qualifying life event, such as losing your existing health coverage (such as through being laid off, being fired, or quitting your job), moving, getting married (or divorced), having a baby, or adopting a child.

How Do I Know Which Individual Health Insurance Plan Is Best?

Individual health insurance is not a one-size-fits-all item. Which plan is best for you and your family is dependent upon your unique needs, budget, and health risk.

For example, high-deductible health plans (HDHPs) are often best suited for young people who rarely see the doctor and do not require many prescriptions, as all expenses are paid out of pocket until you’ve met the deductible. These plans typically save you money on monthly premiums and are sometimes referred to as “catastrophic only.”

Health Maintenance Organizations (HMOs) are usually more affordable plans (with fewer out-of-pocket expenses), but frequently come with narrow networks and restrictive formularies. If you are looking for a baseline insurance plan and do not mind switching doctors, this may be a good fit for you.

By contrast, people who would like to keep their doctors, are taking multiple prescriptions, or are managing a chronic health issue may want to choose a Preferred Provider Organization (PPO) or Point of Service (POS) plan. These plans have higher monthly premiums, but generally come with larger networks and formularies than HMOs.


If you still haven’t made a decision about your 2017 individual health insurance, there is still time. In addition, if you would like to change your plan, you may still do so.




Eric Walters – Insurance Services.

Scottsdale, Arizona

Cell: 602-616-660



Tax Time- How to report Small Business Health Insurance.

How to Report Small Business Health Insurance at Tax Time

The Affordable Care Act (ACA) has added some additional paperwork to the tax-filing process. Employers offering small business health insurance are required to provide forms to both employees and the Internal Revenue Service (IRS). Here is an overview of forms required from employers, as well as which forms employees can expect to receive.

For Small Employers: The Small Business Health Insurance Forms You Need

Employers with fewer than 50 full-time-equivalent (FTE) employees are not required to offer small business health insurance. However, if you provide self-funded (or self-insured) coverage, you must fill out Form 1095-B for each employee. It is similar in both content and purpose to Form 1095-C.

You will need to file a copy of these forms with the IRS, as well as Form 1094-C, following the same deadlines as large employers (February 28 or March 31, respectively).

For Large Employers: The Forms You Need

Applicable large employers are required to provide Form 1095-C to employees by March 2, 2017. This form details which members of each employee’s family were included in the group policy for 2016, in which months they were covered, and how much the policy cost them.

These forms (one for each employee) will also need to be filed with the IRS, in addition to Form 1094-C, which provides an overview of the company’s health coverage. If you are filing by mail, this must be completed by February 28. If filing electronically, your deadline is March 31.

For Employees: The Forms You Need at Tax Time

If you purchased health coverage through the ACA Marketplace, you will receive Form 1095-A from your insurance Marketplace. If you received a premium tax credit, you will need to fill out and file Form 8962 when you complete your taxes. It is important to note that premium tax credits prevent you from using Form 1040-EZ. You will need to use the traditional 1040 or 1040-A.

If you have small business health insurance through your employer, you will receive a 1095-B from them by March 2. If your employer has more than 50 FTEs, you will receive a 1095-C.

If this all seems a bit overwhelming, don’t worry—you will not have to fill out the 1095 forms yourself. The 1095s are completed by whoever provides your insurance coverage. If you had more than one type of coverage in 2016, you will receive a 1095 from each employer or insurance company.

Many people like to file their taxes in early February so they receive their returns earlier. The good news is that you do not need to wait to file your taxes until you’ve received these forms—unless you are receiving a subsidy. In that case, you need to wait until you’ve received Form 1095-A from the Marketplace.


While all these forms can seem overwhelming at first, they aren’t overly complicated—but they are time-consuming for employers required to submit them. If you are confused or need assistance, be sure to consult with an accountant, who should be able to get things straightened out for you.

Eric Walters – Insurance Services.

Scottsdale, Arizona

Cell: 602-616-660


ACA Blog:




HRA’s and HSA’s-better together

Better Together: The Benefits of HSAs and HRAs

HSA and HRA. The two acronyms may be almost identical, but they stand for two very different types of plans. With an HSA, the employee owns the account. Money contributed to the HSA is tax-free, and withdrawals must be spent on qualified medical expenses. Since HSAs are owned by the employee, they are also portable. This means they move with the employee from job to job.

Read more: Health Savings Account Overview

In an HRA, the account is owned by the company, and the funds stay with the company if the employee decides to leave. In December 2016, Congress passed legislation that created an HRA specifically for small businesses. The Small Business HRA allows businesses with fewer than 50 employees to reimburse employees for individual health insurance premiums and eligible medical expenses also tax-free. With the Small Business HRA, businesses must offer reimbursements on the same terms to every employee, but they can vary these amounts based on family status.

When businesses offer an HSA in combination with an HRA, they give employees more choices and more control over their own health benefits. The combo appeals to businesses, too, as it allows them to control costs by fixing them through an HSA contribution and setting up an HRA in place of other small business health insurance options.

 How to Make Your HSA “HRA Qualified”

To have both an HSA and an HRA, the HRA must be adjusted to be compatible with HSA regulations. There are many ways to make this work, but two of the simplest are:

  1. Limited purpose HRA: Reduce the scope of what the Small Business HRA can reimburse.

  2. Post-deductible HRA: Reduce the scope of what the Small Business HRA can reimburse, until the HSA deductible has been met. Then reinstate the full list of medical expenses eligible for reimbursement through the HRA.

The expenses which can be reimbursed through the HRA before the HSA deductible has been met are the following: health insurance premiums, preventive services, dental and vision expenses, and long-term care premiums.


Businesses that offer an HRA can give their employees more flexibility, greater freedom of choice, and additional retirement benefits by adding an HSA to their employee benefits program. Once you understand the mechanics of HRAs and HSAs, it’s easy to see why using them together appeals to businesses and employees alike.

Eric Walters – Insurance Services.

Scottsdale, Arizona

Cell: 602-616-660





Health Savings Accounts -hi deductible plans?

Health savings accounts (HSAs) have become a popular option for people who wish to have comprehensive individual health insurance while building up tax-free savings they can roll over from year to year. According to research firm Devenir, more than 16 million people had an HSA in 2015.

An HSA allows individuals to use tax-free funds to pay for medical expenses, doctors’ visits, prescriptions, and other qualified health expenses. In many cases, employers also contribute matching dollars.

Before you can contribute to your HSA, however, you must first be enrolled in a high-deductible health plan (HDHP). As the name indicates, HDHPs have a higher deductible than traditional insurance plans.

When Is an HDHP HSA Qualified?

Just because you have an HDHP, however, does not mean it qualifies for an HSA. In 2016, for example, just 19 percent of the HDHPs available on the federal exchange were HSA eligible.

High deductibles are not the only requirement for an HDHP to be HSA eligible. As defined by the IRS, HSA qualified HDHPs have:

  • A higher deductible than typical individual health insurance plans.
  • A maximum limit on the annual deductible and medical expense costs, including copays and other items.
  • No insurance coverage until the deductible is met, except for the following expenses:
    • Health insurance premiums
    • Wellness and preventive care (e.g., checkups, mammograms, smoking cessation, weight loss)
    • Expenses resulting from accidents
    • Dental expenses
    • Vision expenses

The IRS publishes minimum deductible and maximum medical expense limits annually. The chart below lists the annual HSA contribution limits and the HDHP minimum required deductibles for 2016 and 2017.

Contributions and out-of-pocket limits for HSAs and HDHPs
For 2016 For 2017
HSA contribution limit (employer + employee) Self only: $3,350Family: $6,750 Self only: $3,400Family: $6,750
HSA catch-up contributions (age 55 or older)* $1,000 $1,000
HDHP minimum deductibles Self only: $1,300Family: $2,600 Self only: $1,300Family: $2,600
HDHP maximum out-of-pocket amounts
(deductibles, copayments, and other amounts besides premiums)
Self only: $6,550Family: $13,100 Self only: $6,550Family: $13,100

* Catch-up contributions can be made at any time in the year the participant turns 55.

How to Tell If Your Plan Is HSA Eligible

If you’re new to HDHPs and HSAs, sorting through the various requirements can feel a bit like trying to read a bowl of alphabet soup.

If you’re overwhelmed, keep in mind that insurance carriers will label their plans as HSA eligible.

Other HSA Requirements

In addition to having an HSA-qualified insurance policy, there are several other requirements to contribute to your HSA in a given year:

  • You must be covered under an HDHP.
  • You must have no other health coverage, with the exception of several types of ancillary coverage.
  • You must not be enrolled in Medicare.
  • You cannot be claimed as a dependent on someone else’s tax return.


HSAs are an increasingly popular choice for people looking to manage the rising cost of individual health insurance. Because HSAs offer triple tax advantages, more and more people are likely to participate in the future.

Eric Walters – Insurance Services.

Scottsdale, Arizona

Cell: 602-616-660


ACA Blog:





How a broker can help with an individual health insurance plan

As of spring 2016, more than 11 million people had enrolled in individual health insurance through the Affordable Care Act (ACA) Marketplace, and similar numbers are expected in 2017. With numbers that high, some of these people are bound to feel confused, overwhelmed, and frustrated when shopping for health coverage. The good news is you don’t have to do it alone. Many people don’t realize there are free resources available to them.

Selecting an Individual Health Insurance Plan

Choosing an individual health insurance policy can be a complicated journey. Multiple factors go into the price of a plan—including the size of the provider network, how much the insurance company will cover, and the deductible amount. In an effort to simplify the process, the ACA divided their policies into four different tiers.

The lowest tier (Bronze) comes with the lowest premiums, but the highest out-of-pocket expense share at 40 percent. Silver is the next step up, then Gold. The highest tier is Platinum, which has the highest premiums, but enrollees can expect to pay only 10 percent of the cost of medical care.

Each family’s needs are different, but generally speaking, people who expect to seek little medical attention would be suited for the Bronze tier. If you are treating a chronic illness or require multiple prescriptions, a higher tier may be more suited to you. In addition, if network size is important to you, you may want to look into a PPO plan as opposed to an HMO.

What Does a Broker Do?

Brokers are there to help you make a more informed decision—usually at no charge to you. They can get individual health insurance quotes, compare plans, and help you understand what your options are. They should be able to answer most of your questions, and if not, they’ll have access to people who can.

There are multiple ways to find a broker. If you go to and look for individual health insurance quotes, brokers may call you to offer their assistance. You are welcome to use their services by phone or email—and no, you will not be charged.

Another way to find a healthcare broker is to call a company like Stride Health. They provide many free resources on their website, which means you can do some research ahead of time and ask more informed questions over the phone.

Word to the Wise

You may be wondering, if brokers provide free services, how do they get paid? Brokers are often paid a commission by the insurance company when they sign someone up for a policy. This means that companies offering better incentives to brokers may end up with more enrollees—and the individual health insurance option they recommend may take into account more than just the best option for you and your family.

As always, it is best to do your research and make sure that you understand all of the parameters of your plan before signing up for the year. Don’t be afraid to ask plenty of questions, including “Why are you recommending this plan for my family?

Call:   Eric Walters       Cell: 602-616-1660



Office: Tel: 480-657-8595

FAX: 1-888-739-0796

ACA Individual Statement(1095) extended date!

IRS Extends ACA Individual Statement Deadline (Form 1095) from January 31 to March 2

November 20, 2016

In Notice 2016-70, IRS extends the 2017 deadline from January 31 to March 2 for employers and insurers to furnish individual statements on 2016 health coverage and full-time employee status (Forms 1095-B and 1095-C). The notice also extends 2015 good-faith penalty relief to 2016 for incorrect or incomplete reports due in 2017.

In the Notice, the IRS did not extend the due date for filing the forms with the IRS  February 28 (if filing by paper) or March 31 (if filing electronically).

Please remember that  filers can take advantage of an automatic 30-day extension of the IRS filing deadline  by submitting Form 8809 before the relevant due date.

Lastly, IRS extended the good-faith relief in Notice 2016-70 that applied to in 2015 to 2016. This relief applies to missing and inaccurate taxpayer identification numbers and dates of birth, as well as other information required on the return or statement. To show good faith efforts to qualify for this relief, filers must meet applicable deadlines. However, IRS recognizes that late filers may still be able avoid penalties by showing reasonable cause for missing the due dates.

For a copy of Notice, please click on the link below: 

More information available from:

Eric Walters

CELL: 602-616-1660


Email: OR



ACA/Obamacare- Q & A.

  • Question: What if a consumer files his or her tax return without Form 8962?
    Answer: Tax filers must file their tax return with the IRS Form 8962 to reconcile advance payments of the premium tax credit (APTC).



    Question: Does a consumer’s eligibility for Medicaid, in addition to actually being enrolled in Medicaid, disqualify a consumer from receiving advance payments of the premium tax credit (APTC)?
    Answer: Consumers who are determined eligible for or are enrolled in coverage through Medicaid or CHIP that qualifies as minimum essential coverage (MEC) are ineligible for APTC for themselves, and for income-based cost-sharing reductions (CSRs) to help pay for the cost of their Marketplace coverage.


    Question: Is loss of advance payments of the premium tax credit (APTC) or income-based cost-sharing reductions (CSR) a qualifying event for a special enrollment period (SEP) for consumers to change their Marketplace plan?
    Answer: A consumer may qualify for a Special Enrollment Period if he or she (or anyone in his or her household):
    – Is enrolled in Marketplace coverage and report a change that makes him or her: Newly eligible for help paying for coverage; Ineligible for help paying for coverage; Eligible for a different amount of help paying for out-of-pocket costs, like copayments.
    – Become newly eligible for Marketplace coverage because he or she has become a U.S. citizen, U.S. national, or lawfully present individual.
    – Become newly eligible for Marketplace coverage after being released from incarceration (detention, jail, or prison).
    – Gain or maintain status as a member of a federally recognized tribe or Alaska Native Claim Settlement Act (ANCSA) Corporation shareholders (he or she can change plans once per month).
    – Become newly eligible for help paying for Marketplace coverage because he or she had a change in household income or moved to a different state and he or she was previously both of these: Ineligible for Medicaid coverage because he or she lived in a state that hasn’t expanded Medicaid; Ineligible for help paying for coverage because his or her household income was below 100% of the Federal Poverty Level (FPL).


    Question: How would a consumer become enrolled in both Medicaid/Children’s Health Insurance Program (CHIP) and a Marketplace plan with advance payments of the premium tax credit (APTC) or income-based cost sharing reductions (CSR)?
    Answer: A consumer may experience a life change (e.g., drop in income) making him or her eligible for Medicaid or CHIP, but he or she may fail to end Marketplace coverage with APTC/CSRs after being determined eligible for Medicaid or CHIP. Similarly, consumers who are enrolled in Marketplace coverage with APTC/CSRs may apply for Medicaid or CHIP directly with the state agency and be determined eligible, but fail to end Marketplace coverage with APTC/CSRs. While the Marketplace reinforces in many places the importance of reporting changes directly to the Marketplace and ending Marketplace coverage with APTC/CSRs after being determined eligible for or enrolling in other minimum essential coverage, this notice is a reminder to these consumers who may not have been aware that they need to end their Marketplace coverage with APTC/CSRs after being determined eligible for Medicaid or CHIP.


    Question: Will the process for termination of advance payments of the premium tax credit (APTC) or income-based cost sharing reductions (CSR) be the same for consumers who are enrolled in Medicare?
    Answer: This noticing effort is the first step the Federally-facilitated Marketplace (FFM) is taking to make sure consumers take action to end their Marketplace coverage with APTC because they are receiving Minimum Essential Coverage (MEC) Medicare. The FFM does expect to turn off APTC/CSR for consumers who are found to be dually-enrolled in a Marketplace plan with financial assistance and Medicare once it is operationally feasible.



    Question: If consumers have recently amended their federal income tax returns, how long do they need to wait in to reapply for Marketplace coverage?
    Answer: The Internal Revenue Service (IRS) takes 3-10 weeks to process a tax return based on how it is filed. Consumers should update their application, or reapply for coverage, during the Open Enrollment Period which begins November 1, 2016. After tax filers have filed their tax return, they can attest on the application to having filed their taxes for all past years that they received advance payments of the premium tax credit (APTC). Consumers should update their application and select a plan by Dec 15, 2016 to have coverage effective Jan 1, 2017.


    Question: If a consumer received a final Medicaid/Children’s Health Insurance Program (CHIP) Periodic Data Matching (Medicaid/CHIP PDM) notice, but is not enrolled in Medicaid or CHIP, can he or she appeal the Marketplace’s decision to end advance payments of the premium tax credit (APTC) and income-based cost-sharing reductions (CSRs)?
    Answer: A consumer can appeal the Marketplace’s decision about his or her eligibility for health coverage, including eligibility for APTC and CSRs, within 90 days from the date of the notice. A consumer may appoint an Authorized Representative to help with his or her appeal, or may participate on his or her own. If a consumer requests an appeal, he or she may be able to maintain eligibility for coverage while the appeal is pending. Note that the outcome of an appeal could change the eligibility of other household members on the consumer’s Marketplace account, even if they do not ask for an appeal. Information regarding a consumer’s right to appeal and instructions on how to do so are included in the final notice.


    Question: When were failure to reconcile (FTR) notices sent to consumers?
    Answer: FTR warning notices were sent in May 2016 letting affected consumers and members of their households know they were at risk of losing advance payments of the premium tax credit (APTC) because Internal Revenue Service (IRS) records indicated they did not have a 2014 federal income tax return on file.


    Question: Does simply filing a 2014 federal income tax return automatically count as reconciling advance payments of the premium tax credit (APTC)?
    Answer: Tax filers must file their tax return with the Internal Revenue Service (IRS) Form 8962 to reconcile APTC.

    Have questions?

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  • Insurance Services- Life, Health, Employee benefits ,Retirement and Travel insurance
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Tax Credit or Cost Sharing Reductions- 2016? Check this!

On Exchange healthplan?- did you get Premium Tax Credit and cost sharing reduction payments in 2016?

CMS is re-determining subsidy eligibility for all on-exchange members again this year.

The Marketplace will use the newest income data available to re-determine advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSR). This applies to enrollees who do not return to the Marketplace to update their application information and select a plan by December 15, 2016.

Also in October, CMS will send a Marketplace Open Enrollment Notice (MOEN) to all on-Exchange members.

This notice will contain certain basic information, including: a description of the annual redetermination and renewal process; the requirement to report changes affecting eligibility and the ways for reporting such changes; and the last day members can choose a plan for coverage starting January 1. For enrollees who authorized the Marketplace to request updated tax return information for use in the annual redetermination process and who are receiving APTC or income-based CSRs, this notice will have information on the process the FFM will use to establish APTC and CSR eligibility for 2017 for enrollees who do not actively reenroll.

Again this year, consumers who received subsidies in 2016 but did not file a 2015 federal tax return with Form 8962 to reconcile their APTC will be placed into a federal tax return (FTR) group. This could result in a loss of APTC and CSR eligibility. These consumers will receive a special version of the MOEN from CMS in October indicating that they are at risk for losing APTC in 2017. During Open Enrollment, this group will need to actively renew and include their latest income information or their APTC will be set to $0 for 2017.

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Large employers-<50- ACA reporting data?

In an article published this week, The National Law Review clearly and starkly describes how employers must ensure accuracy and completeness of ACA reporting data in order to avoid billions of dollars in fines. There will be no “good faith” efforts considered for the 2016 reporting year. The message is clear: Penalties and fines will be levied on organizations that fail to carefully attend to the detailed steps, and those fines will be significant.

This no-nonsense checklist explains ten important factors employers should consider in preparation for 2016 ACA reporting (filed in 2017). We recommend that employers with over 50 full-time employees should take the time to read the entire article and prepare their organization in order to mitigate risk.  We have consultants who can provide this level of service for all our clients.

  1. Understand The Big Data Environment. The IRS is using big data analytics to find contradictions within data across multiple forms – contradictions that will lead to audits and fines.
    “…the government projects employer mandate penalties of $228 billion. Thus, there is clear anticipation that revenue will be generated and violations will be ascertained through the information reporting filings.”
  2. Ensure Proper Worker Classifications. This covers more than just identifying full-time versus part-time. For the 2016 reporting year the eligibility threshold has gone from 70% to 95%, placing an additional burden on employers. Relationships with staffing firms and other alternative arrangements further complicate the process of properly classifying employees.
  3. Monitor changes in the applicable guidance. The IRS released draft forms and instructions for filing that included a number of significant changes to codes, some of which could lead to penalties for the employer. There are also proposed regulations regarding how coverage opt-outs should be handled when determining affordability, and how to handle reporting on employees potentially covered by multiple plans offering minimum essential coverage. Familiarity with these changes is vital, but because these are still draft guidelines and proposed regulations, employers will need to be vigilant in staying up-to-date on the information.
  4. Ensure Accurate Names and Social Security Numbers. The article outlines a number of steps that employers should take to ensure that the employee and dependent data is captured accurately and completely. However, it’s not enough to just take the steps outlined – employers will need to systematically track and record steps taken, responses received, and changes made to employee data.
  5. Corrected Returns. The author notes that while employers may be getting ready for 2017 filings, many are still addressing the corrections process for the 2015 forms: “Correcting errors is part of the good faith effort to file accurate and complete information returns.” For those who may have struggled with the 2015 reporting process, showing “good faith” means continuing to try to provide as much accurate information as possible.
  6. Record Retention. An extensive list of employee documentation is outlined in the article, and it’s recommended that employers gather all of this data to provide proof for audits or other issues. Employers should also have a documented process in place for gathering, tracking, and recording the data.
  7. Marketplace Notice and IRS Penalty Notice. For Marketplace Notices issued regarding employees who received a subsidy, “It is especially important for large employers to check records to determine if this employee was offered qualifying coverage, that the employee was properly classified and then to determine if it is necessary to challenge…because this could be a trigger for later receipt of an IRS penalty notice.” The article goes on to explain that employers should prepare to clarify their position and should have an approach for reviewing and responding to subsidy notices.
  8. Corporate Transactions. In terms of mergers and acquisitions, not only should the acquiring organization be aware of the method of reporting used by the organization being acquired, it’s also important to review that reporting to determine if there was inaccurate or incomplete information. Potential penalties could even be factored into purchase prices. “A best practice is to perform a 1095-C and 1094-C audit during the due diligence process.”
  9. Fiduciary Responsibility and Governance. Since health and welfare plans are subject to ERISA, care should be taken to ensure that they are in compliance. Employers are urged to enact enhanced fiduciary governance procedures.
  10. Establish an ACA Information Reporting Team. As the author notes, “ACA compliance has many facets, and information reporting is a complex requirement.” Data collection and integrity, quality control, data privacy, and accuracy auditing are all items that this team should handle to determine the cause of the errors and address them. Without this level of attentiveness, fines are an inescapable outcome.

What to do?

Partnering with an ACA expert ( we have the names for you) will relieve this pressure on your organization providing turnkey support including:

  • An ACA-certified partner who will manage your program and provide regular communication
  • Meticulous data collection, analysis and tracking
  • Proactive monitoring and alerts regarding updates and changes in the guidelines
  • Remediation to ensure your organization achieves ACA compliance success
  • Insurance Services- Life, Health, Retirement,Travel and employee benefits
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FSA 2017 Contributions- inflation adjustments!

On Tuesday, Oct. 26, 2016, the Internal Revenue Service (IRS) announced 2017 inflation adjustments for several tax provisions, including flexible spending accounts (FSA) and transportation services.

New limits are provided for plan years beginning on or after Jan. 1, 2017. Employers should ensure their FSA plan document accurately reflects their plans allowable annual election. 

Contribution Limits for FSAs
For 2016 For 2017 Change
Healthcare FSA(full and limited purpose) $2,550 $2,600* +$50
Dependent Care FSA $5,000 $5,000* No change
Transportation (parking and transit) $255/month $255/month No change


*This is the maximum annual election allowed by the IRS. An employer may choose to limit their plan to an amount less than the IRS maximum.


  • Insurance Services- Life, Health, Retirement,Travel and employee benefits
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  •                                      Cell:602-616-1660
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Remember the Individual Mandate? Obamacare health insurance?

The Individual Mandate and the Affordable Care Act

What is the Obamacare Individual Mandate?

Under the Affordable Care Act’s Individual Mandate, most Americans are required to have health insurance, or pay a tax penalty if they don’t. This Obamacare rule is called the “Individual Mandate” or “Individual Shared Responsibility Fee” and started in 2014.

Coverage can include job-based health insurance, individual health insurance, or insurance through a government program such as Medicaid or Medicare.

Is there a penalty for not having health insurance?

Yes. The penalty for not having “minimum essential coverage” is either a flat fee or a percentage of household income, whichever is greater.

As the chart shows below, the penalty increases each year.


Year: Pay the Greater of: Flat Fee        OR                           Percentage of Income


        $695 per adult,$347.50                       OR                 2.5% of family income

per child, up to $2,085                                                minus federal tax filing

per family.                                                                    threshold

2017                                                    OR                   Adjusted Annually

Adjusted Annually




Individual Mandate Tax Penalty – Example

Beth is single and earns an annual income of $40,000/year. Beth went uninsured in 2015. At tax time, Beth is required to pay an Individual Shared Responsibility Fee.

Beth will pay either 2% of income (minus the federal tax filing threshold) or $325, whichever is greater.

Beth’s annual income ($40,000) minus the federal tax filing threshold ($10,150) is $29,850. Two percent (2%) of $29,850 is $597.

Since this amount is greater than $325, Beth will pay a $597 tax penalty.

How can I avoid the tax penalty?

You may not have to pay the Individual Mandate tax penalty if you are uninsured, and:

Are required to pay more than 8% of your household income for the lowest cost bronze plan.
Are not a U.S. citizen, a U.S. national, or a resident alien lawfully present in the U.S.
Had one gap in coverage for less than three consecutive months during the year.
Won’t file a tax return because your income is below the tax filing threshold. In 2013, the tax filing threshold was $10,000 for individuals and $20,000 for a couple.
Are unable to qualify for Medicaid because your state has chosen not to expand the program.
Participate in a health care sharing ministry or are a member of a recognized religious sect with objections to health insurance.
Are a member of a federally recognized Indian tribe.
Are incarcerated.
Qualify for a hardship exemption

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Insurance Services- Life, Health, Retirement, employee benefits and Travel.

The Health Insurance Marketplace- know your rights!


Enrolling in a Marketplace QHP ( Qualified Health Plan)?

Understand your rights when enrolling in a Marketplace QHP, including how to get easy-to-understand information about what the plan covers, out-of-pocket costs, drug coverage, and more by reviewing The Health Insurance Marketplace: Know Your Rights.

Being informed is a consumer’s best protection against fraud when enrolling in coverage through the Health Insurance Marketplace. Help yourself by reviewing and sharing the Protect Yourself from Fraud resource.

We can help you avoid unnecessary delays in completing enrollment by using the Marketplace Application Checklist to help you gather the information needed to apply for or renew coverage.

Spotlight on Eligibility and Enrollment

1)-  Medicare PDM Update: Sending Notices to Consumers


The Marketplace has begun mailing paper notices to the household points of contact of consumers who may be enrolled in a Marketplace plan with APTC and also enrolled in Medicare coverage that qualifies as minimum essential coverage (MEC). The notices include instructions on what to do to resolve this dual enrollment.



We can help consumers determined eligible for MEC Medicare, and who are consequently not eligible for a Marketplace plan with APTC (Advanced Payment Tax Credit) or income-based cost-sharing reductions.

2)- Married victims of domestic violence or spousal abandonment who are applying for coverage separately from their spouse and filing taxes separately may be determined eligible for financial assistance paying for their Marketplace plan.

3)- We can assist a consumer who is currently enrolled in health coverage through the Marketplace, but who needs to decide if an offer of employer-sponsored coverage is a better deal.

We can help. Contact me:  Eric Walters ( Cell- 602-616-1660)

  • Insurance Services- Life, Health, Employee benefits ,Retirement ,Income Protection, Dental, Vision, etc and Travel insurance
  •                                 TEL:(480)-657-8595/FAX:(888)-739-0796/Cell:602-616-1660
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2015 Tax return?-Tax Credit as well?


If you used premium tax credits in 2015, you must file a 2015 tax return and reconcile your health insurance tax credit on your return. See what that means and how to do it.

You have just one week left until the April 18th deadline to file your 2015 federal income taxes. Don’t wait!


Get more help : here!


.Further information ( at no cost or obligation to you) –  ERIC WALTERS Cell:602-616-1660

-ERIC WALTERS Insurance Services

Health insurance including ACA plans for individuals and families and

·         Employee Benefits for employer groups of all sizes

·         PLUS income protection, Dental, Vision, Life Pensions and Annuity, etc.

 Office :(480)-657-8595/FAX:(888)-739-0796


Form 1095??

In response to inquiries about how and when covered individuals will obtain Form 1095, the following information provides clarification of filing deadlines and resources available to aid plan sponsors (employers).

The IRS extended the deadlines for 6055 and 6056 reporting requirements. Plan sponsors of self-funded health benefit plans, and large employers (50 or more employees and their equivalents), must provide a statement (Form 1095) to full-time employees by March 31, 2016. Paper Forms 1094 and 1095 must be filed with the IRS by May 31, 2016, or electronically filed by June 30, 2016.

Plan sponsor of a self-funded health benefit plan, can review articles regarding the 6055 and 6056 reporting on this blog.

Further assistance regarding form 1095 can be found on the site:

Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

For further information:-  ERIC WALTERS

Insurance Services-Individuals/families, Employee Benefits, Life, Health & Annuity

 Scottsdale,AZ 85260

TeL: (480)-657-8595/FAX: (888)-739-0796/CELL: (602)-616-16