Learn more about IRS Finalizing Deadline Extensions and Price Comparison Tool for Health Plans:
IRS FINALIZES DEADLINE EXTENSION FOR FURNISHING ACA STATEMENTS
On Dec. 12, 2022, the IRS released a final
rule that extends the annual furnishing
deadlines for Sections 6055 and 6056
reporting under the Affordable Care Act
(ACA). This rule finalizes guidance that was
proposed by the IRS in December 2021 with
minor clarifications. Specifically, the rule:
• Finalizes the 30-day automatic extension
to the due date for furnishing
statements to individuals under Sections
6055 and 6056.
• Confirms the availability of an alternate
method for furnishing statements to
individuals under Section 6055 for every
year in which the individual mandate
penalty is zero.
The due date for filing forms with the IRS
under Sections 6055 and 6056 remains
unchanged. This means that forms must
generally be filed with the IRS each year by
Feb. 28 (or March 31, if filing electronically).
Due to the 30-day automatic extension,
employers have until March 2 (or March 1
in a leap year) to furnish ACA statements.
The deadline for furnishing statements for
the 2022 calendar year is March 2, 2023
.
Also, because the individual mandate
penalty is zero, employers with self-insured
plans that are subject to reporting under
Section 6055 may use the alternate method
of furnishing statements to individuals.
With this method, an employer must post a
clear and conspicuous notice on its website
stating that responsible individuals may
receive a copy of their statement upon
request. Employers must furnish
statements within 30 days of when they are
requested. For 2022 statements, this
website notice must be posted by March 2,
2023, and must generally remain posted
through Oct. 17, 2023.
HEALTH PLANS MUST PROVIDE PRICE COMPARISON TOOL FOR 2023
Beginning in 2023, group health plans and
health insurance issuers must make an
internet-based price comparison tool
available to participants. The purpose of
this tool is to provide consumers with real-time estimates of their cost-sharing liability
from different providers for covered items
and services, including prescription drugs,
so they can shop and compare prices before
receiving care. Upon request, plans and
issuers must also provide this information
in paper form or over the telephone.
For plan years beginning on or after Jan. 1,
2023, plans and issuers must make price
comparison information available for 500
shoppable items, services and drugs. For
plan years beginning on or after Jan. 1,
2024, price comparison information must
be available for all covered items, services
and drugs.
Most employers will rely on their issuers or
third-party administrators (TPAs) to provide
this tool and provide related disclosures on
paper or over the phone upon request.
Employers should confirm that their issuers
and TPAs will comply with the price
comparison tool requirements beginning
with the 2023 plan year and ensure this
compliance responsibility is reflected in a
written agreement. In addition, self-insured
employers should monitor their TPAs’
compliance with this requirement, as the
legal responsibility stays with the employer.
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