7KH3DWLHQW3URWHFWLRQDQG$IIRUGDEOH&DUH$FW³33$&$´DPHQGHGWKH,QWHUQDO5HYHQXH&RGHWR UHTXLUHWKDWHPSOR\HUVUHSRUWWKHDJJUHJDWHFRVWRI³DSSOLFDEOHHPSOR\HUVSRQVRUHGFRYHUDJH´RQ HPSOR\HH)RUP:VLQ%R[XVLQJD''FRGH7RDVVLVWHPSOR\HUVLQIXOILOOLQJWKLVREOLJDWLRQWKH ,56LVVXHG1RWLFHRQ0DUFKDQGVXEVHTXHQWO\SRVWHG)$4VRQWKH,56ZHEVLWH2Q -DQXDU\WKH,56LVVXHG1RWLFHWRFODULI\JXLGDQFHLVVXHGLQ1RWLFHDQGWR SURYLGHHLJKWDGGLWLRQDO4 $VLQOLJKWRIFRPPHQWVUHFHLYHGLQUHVSRQVHWR1RWLFH&OLFNKHUH IRUDOLQNWR1RWLFH (PSOR\HUVDUHFDXWLRQHGWKDWVHYHUDOLWHPVDUH³WUDQVLWLRQDOUHOLHI´DQGWKH1RWLFHVWDWHVWKDWWKHUXOHV PD\FKDQJHZLWKIXWXUHJXLGDQFH+RZHYHUDQ\FKDQJHVZLOOEHHIIHFWLYHSURVSHFWLYHO\DQGZLOOQRW DSSO\HDUOLHUWKDQ-DQXDU\VWRIWKHFDOHQGDU\HDUEHJLQQLQJDWOHDVWVL[PRQWKVDIWHUWKHJXLGDQFHLV LVVXHG Who Must Report? $OPRVWDOOHPSOR\HUVZLOOEHUHTXLUHGWRUHSRUWWKHDJJUHJDWHFRVWRIHPSOR\HUVSRQVRUHGFRYHUDJH± LQFOXGLQJSULYDWHHPSOR\HUVIHGHUDOVWDWHDQGORFDOJRYHUQPHQWVDQGFKXUFKHVDQGRWKHUUHOLJLRXV RUJDQL]DWLRQV7KHUHTXLUHPHQWJHQHUDOO\DSSOLHVWRERWKLQVXUHGDQGVHOIIXQGHGKHDOWKFDUHFRYHUDJH DQGWKHUHLVQRH[FHSWLRQIRUJUDQGIDWKHUHGSODQV7KHUHSRUWLQJUHTXLUHPHQWKRZHYHUGRHVQRWDSSO\WR x &RYHUDJHSURYLGHGE\IHGHUDOO\UHFRJQL]HG,QGLDQWULEDOJRYHUQPHQWV x &RYHUDJHSURYLGHGE\WULEDOO\FKDUWHUHGFRUSRUDWLRQVWKDWDUHZKROO\RZQHGE\D)HGHUDOO\ UHFRJQL]HG,QGLDQWULEDOJRYHUQPHQWuntil further guidance is issued x *RYHUQPHQWSODQVWKDWDUHPDLQWDLQHGSULPDULO\IRUPLOLWDU\DQGWKHLUIDPLOLHV x 7KLUGSDUW\VLFNSD\HUVZKRLVVXH)RUP:V x (PSOR\HUVSRQVRUHGVHOILQVXUHGKHDOWKSODQVWKDWDUHQRWVXEMHFWWRIHGHUDO&2%5$HJVHOI IXQGHGFKXUFKSODQVuntil further guidance is issued. )RUH[DPSOHDFKXUFKSODQQRWVXEMHFW WRIHGHUDO&2%5$EXWUHTXLUHGWRSURYLGHFRQWLQXDWLRQFRYHUDJHXQGHUDVWDWHFRYHUDJH FRQWLQXDWLRQODZZRXOGQRWEHUHTXLUHGWRUHSRUW Employers who provide insured health plans are required to report health care coverage costs even if they are not subject to federal COBRA requirements. x &RYHUDJHWKURXJKDQHPSOR\HUFRQWULEXWRU\PXOWLHPSOR\HUSODQHJEDVHGRQHPSOR\HU FRQWULEXWLRQVRIFHQWVRUGROODUVSHUKRXUuntil further guidance is issued. However, if the March 2012 P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 2 | © Gallagher Benefit Services, Inc. 2012 employer provides other coverage (i.e., not through the multiemployer plan), the cost of that coverage must be reported. x &RYHUDJHSURYLGHGE\HPSOR\HUVZKRLVVXHIHZHUWKDQ)RUP:VIRUDFDOHQGDU\HDU 7KHUHLVDGHOD\LQWKHUHSRUWLQJUHTXLUHPHQWIRUVRPHHPSOR\HUVVXFKDVWKRVHZKRLVVXHIHZHU WKDQ:IRUPVIRUDFDOHQGDU\HDUVHH³7UDQVLWLRQ5HOLHI´RQSDJH The health care coverage reporting requirement does not create a requirement to provide Form W- 2s to any individual who would not otherwise receive a Form W-2)RUH[DPSOHDQRUJDQL]DWLRQ ZRXOGQRWEHUHTXLUHGWRSURYLGHD)RUP:WRUHWLUHHVMXVWWRUHSRUWWKHDJJUHJDWHFRVWRIWKHLUUHWLUHH KHDOWKFRYHUDJH Special Situations 6SHFLDOVLWXDWLRQVDULVHZKHQDQHPSOR\HHKDVPXOWLSOHUHODWHGHPSOR\HUVGXULQJDVLQJOHFDOHQGDU\HDU )LUVWZKHUHDQHPSOR\HHKDVPXOWLSOHHPSOR\HUVGXULQJDFDOHQGDU\HDUHDFKRIWKRVHHPSOR\HUVPXVW UHSRUWWKHFRVWRIFRYHUDJHLWSURYLGHVXQOHVVWKHWZRHPSOR\HUVDUHUHODWHGKDYHDFRPPRQ³SD\PDVWHU´ )RUH[DPSOHDQHPSOR\HHZRUNVIRUWZRUHODWHGHPSOR\HUVDWWKHVDPHWLPHDQGRQHRIWKHWZR HPSOR\HUVLVVXHVSD\FKHFNVFRYHULQJVHUYLFHVIRUERWKHPSOR\HUV8QGHUWKHLQLWLDO,56)RUP: UHSRUWLQJJXLGDQFHDFRPPRQSD\PDVWHUDPRQJDJURXSRIUHODWHGHPSOR\HUVZLWKLQWKHPHDQLQJRI,56 &RGH6HFWLRQVZRXOGEHUHTXLUHGWRDJJUHJDWHUHSRUWDEOHFRVWRIFRYHUDJHSURYLGHGWRDQ HPSOR\HHE\DOORIWKHHPSOR\HUVIRUZKRPWKHRUJDQL]DWLRQVHUYHGDVWKHFRPPRQSD\PDVWHU ,561RWLFHFODULILHVWKDWLIHPSOR\HUVDUHDPRQJDJURXSRIUHODWHGHPSOR\HUVZLWKLQWKHPHDQLQJ RI6HFWLRQVEXWGRQRWFRPSHQVDWHDQHPSOR\HHWKDWLVFRQFXUUHQWO\HPSOR\HGE\DJURXSRI UHODWHGHPSOR\HUVWKURXJKDFRPPRQSD\PDVWHUWKHQWKHUHODWHGHPSOR\HUVPD\HLWKHUUHSRUWWKHHQWLUH DJJUHJDWHFRVWRQRQHRIWKH)RUP:VSURYLGHGWRWKHHPSOR\HHRUWKH\PD\DOORFDWHWKHDJJUHJDWH UHSRUWDEOHFRVWDPRQJWKHHPSOR\HUVFRQFXUUHQWO\HPSOR\LQJWKHLQGLYLGXDOXVLQJDQ\UHDVRQDEOH DOORFDWLRQPHWKRG,QRWKHUZRUGVLIWKHJURXSGRHVQRWXVHDFRPPRQSD\PDVWHUDQGWKXVPXVWSURYLGH PXOWLSOH)RUP:VWRDQLQGLYLGXDOWKHDJJUHJDWHFDQHLWKHUEHUHSRUWHGRQRQH)RUP:RQEHKDOIRI WKHZKROHJURXSRIUHODWHGHPSOR\HUVRUHDFKHPSOR\HULQWKHJURXSPD\UHSRUWDQDOORFDWHGDPRXQWRQ WKH)RUP:WKDWHPSOR\HUSURYLGHVWRWKHLQGLYLGXDO 6HFRQGLIDQHPSOR\HHWUDQVIHUVWRDQHPSOR\HUWKDWTXDOLILHVDVDVXFFHVVRUHPSOR\HUWKHSUHGHFHVVRU DQGVXFFHVVRUHPSOR\HUVZLOOHDFKUHSRUWVHSDUDWHO\WKHFRVWRIFRYHUDJHRQWKHLUUHVSHFWLYH:V +RZHYHUWKHVXFFHVVRUHPSOR\HUPD\IROORZLQJ,56JXLGHOLQHVUHSRUWWKHDJJUHJDWHFRVWRIFRYHUDJH IRUERWK,IWKHVXFFHVVRUUHSRUWVWKHDJJUHJDWHFRYHUDJHIRUERWKWKHSUHGHFHVVRUHPSOR\HUPXVWQRW UHSRUWWKHFRVWRIFRYHUDJH Where Should the Aggregate Cost be Reported? Box 12 Versus Box 1 7KHDJJUHJDWHFRVWRIKHDOWKFRYHUDJHLVUHSRUWDEOHEXWXQOHVVLWLVDOVRWD[DEOHWKHDPRXQWUHSRUWHGLQ %R[VKRXOGQRWEHLQFOXGHGLQ%R[)RUH[DPSOHFRYHUDJHSURYLGHGWRGRPHVWLFSDUWQHUVLVRIWHQ WD[DEOH7KXVDQHPSOR\HUZRXOGLQFOXGHWKHDJJUHJDWHFRVWRIFRYHUDJHLQFOXGLQJWKHFRVWRIDOO GRPHVWLFSDUWQHUFRYHUDJHLQ%R[EXWRQO\WKHYDOXHRIWKHWD[DEOHGRPHVWLFSDUWQHUFRYHUDJHZRXOG EHLQFOXGHGDVWD[DEOHLQFRPHLQ%R[RIWKH)RUP: P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 3 | © Gallagher Benefit Services, Inc. 2012 What Must be Reported? Health Coverage that Must be Included in “Aggregate Cost” 0RVWHPSOR\HUSURYLGHGKHDOWKFRYHUDJHPXVWEHLQFOXGHGZKHQUHSRUWLQJWKHFRVWRIKHDOWKFDUH FRYHUDJHLQ%R[XVLQJ&RGH''7\SHVRIFRYHUDJHWKDWDUHLQFOXGDEOH x 0HGLFDO x 3UHVFULSWLRQGUXJ x 'HQWDOLIQRW³+,3$$H[FHSWHG´ x 9LVLRQLIQRW³+,3$$H[FHSWHG´ x +HDULQJ x (PSOR\HH$VVLVWDQFH3ODQH[FHSWUHIHUUDORQO\ LIHPSOR\HUFKDUJHV&2%5$SUHPLXPIRU FRQWLQXDWLRQRIEHQHILW x 2QVLWHPHGLFDOFOLQLFVLIHPSOR\HUFKDUJHVD&2%5$SUHPLXPIRUFRQWLQXDWLRQRIEHQHILW x +HDOWKFDUHIOH[LEOHVSHQGLQJDFFRXQWFRQWULEXWLRQVin excess of employee’s cafeteria plan salary reduction amounts x 6SHFLILHGGLVHDVHRUKRVSLWDOLQGHPQLW\LQVXUDQFHXQOHVVWKHHPSOR\eeSD\VWKHIXOOFRVWDIWHU WD[ x ([HFXWLYHPHGLFDOFRYHUDJHLQVXUHGRUVHOIIXQGHG,QFOXGHVH[HFXWLYHSK\VLFDODQGVFUHHQLQJV DVZHOODVDQ\VXSSOHPHQWDOFRYHUDJH x :HOOQHVVEHQHILWVLIWKHZHOOQHVVSURJUDPTXDOLILHVDVDKHDOWKEHQHILWDQGLIHPSOR\HUFKDUJHV &2%5$SUHPLXPIRUFRQWLQXDWLRQRIEHQHILW x 0HGLFDUHVXSSOHPHQWFRYHUDJH x 'RPHVWLFSDUWQHUFRYHUDJHLQFOXGHGLQHPSOR\HH¶VJURVVLQFRPH Special Rules for Healthcare Flexible Spending Arrangements 7KH)RUP:UHSRUWLQJUHTXLUHPHQWGRHVQRWDSSO\WRFRYHUDJHXQGHUDKHDOWKFDUH)OH[LEOH6SHQGLQJ $UUDQJHPHQW³KHDOWK)6$´LIFRQWULEXWLRQVGRQRWH[FHHGWKHHPSOR\HH¶VVDODU\UHGXFWLRQHOHFWLRQ)RU H[DPSOHLIDQHPSOR\HHHOHFWVDVDODU\UHGXFWLRQWRPDNHFRQWULEXWLRQVWRDKHDOWK)6$DQGWKH WRWDODPRXQWRIWKH)6$HOHFWLRQLVWKHLVQRWLQFOXGHGLQWKHDPRXQWUHSRUWHGDVWKH (PSOR\HHDVVLVWDQFHSODQV($3VWKDWSURYLGHRQO\UHIHUUDOVHUYLFHVSUREDEO\GRQRWVDWLVI\WKHGHILQLWLRQRID KHDOWKSODQ($3VWKDWDOVRSURYLGHFRXQVHOLQJDQGRUWUHDWPHQWXVXDOO\TXDOLI\DVKHDOWKSODQVDQGWKXVPXVWEH LQFOXGHGLQWKHDJJUHJDWHFRVWFDOFXODWLRQ :KHWKHUDZHOOQHVVSODQVDWLVILHVWKHGHILQLWLRQRIDKHDOWKSODQGHSHQGVRQWKHIDFWVDQGFLUFXPVWDQFHV$ ZHOOQHVVSODQWKDWSURYLGHVDUHZDUGIRUFRPSOHWLQJD+HDOWK5LVN$VVHVVPHQWTXHVWLRQQDLUHZRXOGnotTXDOLI\DVD KHDOWKSODQ$ZHOOQHVVSODQWKDWSURYLGHVIOXVKRWVRULQFOXGHVGLDJQRVWLFWHVWVRUELRPHWULFVFUHHQLQJPD\TXDOLI\ DVDKHDOWKSODQ /LPLWHGWRHPSOR\HUVZLWKIHZHUWKDQHPSOR\HHVEHFDXVHRIWKH0HGLFDUH6HFRQGDU\3D\HUUXOHV P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 4 | © Gallagher Benefit Services, Inc. 2012 DJJUHJDWHUHSRUWDEOHFRVW6RPHHPSOR\HUVPDLQWDLQKHDOWKFDUHIOH[LEOHVSHQGLQJDFFRXQWVWKDWDUHQRW IXQGHGVROHO\E\VDODU\UHGXFWLRQV±XVXDOO\LQWKHIRUPRIDQHPSOR\HU³VHHG´RUPDWFKLQJFRQWULEXWLRQ ,IWKHHPSOR\HUSURYLGHVDVHHGRUPDWFKLQJFRQWULEXWLRQWKHDPRXQWRIWKHHPSOR\HU¶VFRQWULEXWLRQLV LQFOXGDEOH$VSHFLDOFDOFXODWLRQPHWKRGDSSOLHVZKHQDFDIHWHULDSODQXVHVDFUHGLWPHWKRGRORJ\VHH ³+RZLVWKH&RVWRI&RYHUDJH&DOFXODWHG"´EHORZ Excluded Coverages 7KHUHDUHVRPHW\SHVRIKHDOWKFDUHFRYHUDJHWKDWDUHQRWLQFOXGDEOHZKHQUHSRUWLQJXVLQJ&RGH'' 5HSRUWLQJLVQRWUHTXLUHGIRU x 6SHFLILHGGLVHDVHRUKRVSLWDOLQGHPQLW\LQVXUDQFHLIWKHHPSOR\eeSD\VRIWKHFRVWRQDQ DIWHUWD[EDVLV x +HDOWKVDYLQJVDFFRXQWVUHSRUWDEOHXVLQJ&RGH: x $UFKHU0HGLFDO6DYLQJV$FFRXQWVUHSRUWDEOHXVLQJ&RGH5 x 6HOIIXQGHGFRYHUDJHQRWVXEMHFWWRIHGHUDO&2%5$FRQWLQXDWLRQ x 6DODU\UHGXFWLRQFRQWULEXWLRQVWRDKHDOWKFDUHIOH[LEOHVSHQGLQJDFFRXQW x +HDOWKUHLPEXUVHPHQWDUUDQJHPHQWV x &HUWDLQ+,3$$³H[FHSWHG´FRYHUDJH o 6WDQGDORQHGHQWDODQGYLVLRQLQVXUHGRUVHOIIXQGHG o $FFLGHQWRUGLVDELOLW\RQO\FRYHUDJH o :RUNHUV¶FRPSHQVDWLRQ o /LDELOLW\LQVXUDQFH o 6XSSOHPHQWWROLDELOLW\LQVXUDQFH o &UHGLWRQO\LQVXUDQFH o $XWRPRELOHPHGLFDOSD\PHQWLQVXUDQFH x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³7UDQVLWLRQ5HOLHI´RQSDJH 6HHIRRWQRWH*HQHUDOO\GHQWDORUYLVLRQEHQHILWVDUH+,3$$H[FHSWHGEHQHILWVLIWKH\DUHHLWKHURIIHUHG XQGHUDVHSDUDWHSROLF\FHUWLILFDWHRUFRQWUDFWRILQVXUDQFHRUSDUWLFLSDQWVPXVWKDYHWKHULJKWQRWWRHOHFWWKH GHQWDORUYLVLRQEHQHILWVDQGLIWKH\GRHOHFWWKHGHQWDORUYLVLRQEHQHILWVWKH\PXVWSD\DQDGGLWLRQDOSUHPLXPRU FRQWULEXWLRQIRUWKDWFRYHUDJH P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 5 | © Gallagher Benefit Services, Inc. 2012 x +HDOWKLQVXUDQFHFRVWVIRUVHOIHPSOR\HGLQGLYLGXDOV x +HDOWKLQVXUDQFHFRVWVIRUDRUJUHDWHUVKDUHKROGHUHPSOR\HHRIDQ6FRUSRUDWLRQGRQRWKDYH WREHUHSRUWHGRQ)RUP:ifWKHLQGLYLGXDOLVUHTXLUHGWRLQFOXGHWKHSUHPLXPSD\PHQWVLQKLV RUKHUJURVVLQFRPH x ([FHVVUHLPEXUVHPHQWVIRUKLJKO\FRPSHQVDWHGLQGLYLGXDOVUHTXLUHGWREHLQFOXGHGLQWKRVH LQGLYLGXDOV¶JURVVLQFRPHDVDUHVXOW6HFWLRQKRIWKH,QWHUQDO5HYHQXH&RGH How is the Cost of Coverage Calculated? 7KHUHSRUWDEOHFRVWLVWKHDJJUHJDWHFRVWIRULQFOXGLEOHFRYHUDJH±HPSOR\HUFRQWULEXWLRQVHPSOR\HHSUH WD[FRQWULEXWLRQVDQGHPSOR\HHDIWHUWD[FRQWULEXWLRQVDVDSSOLFDEOH,WPXVWLQFOXGHWKHFRVWIRU FRYHUDJHZKHUHWKHFRVWRIFRYHUDJHLVWD[DEOHWRWKHHPSOR\HHVXFKDVWKHFRVWRIFRYHUDJHIRUDQROGHU FKLOGRUGRPHVWLFSDUWQHUZKRLVQRWWKHHPSOR\HH¶VWD[GHSHQGHQW)RUH[DPSOHLIWKHFRVWRIVLQJOH FRYHUDJHLVDQGWKHFRVWRIFRYHUDJHIRUDQHPSOR\HHSOXVDGRPHVWLFSDUWQHULVDQGWKH GRPHVWLFSDUWQHULVQRWWKHHPSOR\HH¶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pecial Rule Where Employer Subsidizes COBRA Cost $QHPSOR\HUPD\XVHDPRGLILHG&2%5$SUHPLXPPHWKRGLIWKHHPSOR\HUVXEVLGL]HVRUXVHVWKHSULRU \HDU¶VFRVWZKHQFKDUJLQJ&2%5$SUHPLXPV,561RWLFHLQFOXGHVWKUHHKHOSIXOH[DPSOHV Example #1±DQHPSOR\HUGLGQRWFDOFXODWHWKHDFWXDULDOFRVWIRUFRYHUDJHIRU,QVWHDGWKH HPSOR\HUXVHGDJRRGIDLWKUHDVRQDEOHHVWLPDWHRISHUPRQWKIRUVLQJOHFRYHUDJH7KH HPSOR\HUVXEVLGL]HGWKH&2%5$FRVWE\FKDUJLQJ&2%5$SDUWLFLSDQWVRQO\SHUPRQWKIRU FRQWLQXDWLRQFRYHUDJH7KHHPSOR\HUPXVWXVHWKHSHUPRQWKJRRGIDLWKHVWLPDWHWRUHSRUW WKHDJJUHJDWHFRVWIRUFRYHUDJHIRU Example #2±DQHPSOR\HUGHWHUPLQHGWKDWWKH&2%5$FRVWIRUVLQJOHFRYHUDJHLQFDOHQGDU\HDU ZDVSHUPRQWKDQGFKDUJHGWKHIXOO&2%5$SUHPLXPRI[7KH HPSOR\HUNQRZVWKDWWKHFRVWIRU&2%5$FRYHUDJHIRULVQRWOHVVWKDQWKHDPRXQWDQG GHFLGHVWRFKDUJHWKH&2%5$UDWHRISHUPRQWKLQUDWKHUWKDQFDOFXODWHWKH &2%5$UDWH7KHHPSOR\HUPXVWXVHPLQXVWKHDGPLQLVWUDWLYHFKDUJHWR FDOFXODWHWKHDPRXQWUHSRUWDEOHIRUFDOHQGDU\HDU Example #3±DQHPSOR\HUPDNHVDJRRGIDLWKHVWLPDWHRIWKH&2%5$SUHPLXPIRUVLQJOH FRYHUDJHRISHUPRQWKIRUFDOHQGDU\HDU7KHHPSOR\HUGHFLGHVWRFKDUJHSHU PRQWKWRHQVXUHWKDWLWLVFRPSOLDQFHZLWK&2%5$UHTXLUHPHQWVGHVSLWHQRWFDOFXODWLQJWKH DFWXDO&2%5$SUHPLXPIRU7KHHPSOR\HUPXVWXVHSHUPRQWKWRFDOFXODWHWKH DPRXQWUHSRUWDEOHIRU P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 6 | © Gallagher Benefit Services, Inc. 2012 Special Rule for Cafeteria Plans with Credits ,561RWLFHFODULILHVWKDWWKH)RUP:UHSRUWLQJUHTXLUHPHQWGRHVQRWDSSO\WRFRYHUDJHXQGHUD KHDOWKFDUH)OH[LEOH6SHQGLQJ$UUDQJHPHQW³KHDOWK)6$´LIFRQWULEXWLRQVDUHPDGHonlyWKURXJK HPSOR\HHVDODU\UHGXFWLRQHOHFWLRQV)RUH[DPSOHLIDQHPSOR\HHHOHFWVDVDODU\UHGXFWLRQWR PDNHFRQWULEXWLRQVWRDKHDOWK)6$DQGWKHWRWDODPRXQWRIWKH)6$HOHFWLRQLVWKHLVQRW LQFOXGHGLQWKHDPRXQWUHSRUWHGDVWKHDJJUHJDWHUHSRUWDEOHKHDOWKFDUHFRVW &DOFXODWLQJWKHLQFOXGLEOHDPRXQWIRUDKHDOWKFDUHVSHQGLQJDFFRXQWXQGHUDFDIHWHULDSODQWKDWXVHVD FUHGLWPHWKRGRORJ\LQYROYHVDQDGGLWLRQDOVWHS,QJHQHUDOZKHUHERWKHPSOR\HHVDODU\UHGXFWLRQ DPRXQWVDQGIOH[FUHGLWVDUHFRQWULEXWHGWRDKHDOWKFDUH)6$WKHDPRXQWWKDWLVLQFOXGDEOHLVWKHWRWDO HOHFWLRQPLQXVWKHDPRXQWRIWKHVDODU\UHGXFWLRQ5HJXODWLRQVLQFOXGHWKUHHVDPSOHFDOFXODWLRQV Example #1±WKHFDIHWHULDSODQRQO\DOORZVFRQWULEXWLRQVWKURXJKHPSOR\HHVDODU\UHGXFWLRQV DQGWKHHPSOR\HUGRHVQRWRIIHUDQ\IOH[FUHGLWV$QHPSOR\HHHOHFWVDVDODU\UHGXFWLRQ IRUVHYHUDOTXDOLILHGEHQHILWVLQFOXGLQJDQHOHFWLRQRIIRUDKHDOWKFDUH)6$)RU UHSRUWLQJSXUSRVHVQRQHRIWKHFRQWULEXWLRQWRWKHKHDOWKFDUH)6$LVLQFOXGHGLQWKH³DJJUHJDWH UHSRUWDEOHFRVW´ Example #2 ±DQHPSOR\HUSURYLGHVRIIOH[FUHGLWVXQGHUDFDIHWHULDSODQ$QHPSOR\HH HOHFWVTXDOLILHGEHQHILWVWKDWFRVW±LQFOXGLQJDKHDOWKFDUH)6$HOHFWLRQ±DQG PDNHVDVDODU\UHGXFWLRQRI7KHDPRXQWWKDWPXVWEHLQFOXGHGRQWKLVHPSOR\HH¶V: IRUPLVEHFDXVHKLVWRWDOVDODU\UHGXFWLRQDPRXQWLVJUHDWHUWKDQWKH)6$HOHFWLRQ (While not specified in the IRS example, the employee’s election of $3,000 of qualified benefits could be a combination such as $1,200 medical + $200 dental + $100 vision + $1,500 health care FSA = $3,000 qualified benefits.) Example #3±WKHHPSOR\HHPDNHVDVDODU\UHGXFWLRQHOHFWLRQIRUDKHDOWK)6$7KH HPSOR\HUSURYLGHVDPDWFKLQJDPRXQWZKLFKJLYHVWKHHPSOR\HHDWRWDOKHDOWK)6$ HOHFWLRQRI7KHDPRXQWWKDWPXVWEHLQFOXGHGRQWKLVHPSOR\HH¶V:IRUPLV WRWDO)6$HOHFWLRQPLQXVVDODU\UHGXFWLRQDPRXQW Special Rule for EAPs, Wellness Programs and On-site Clinics ,561RWLFHVWDWHVWKDWWKHFRVWRIFRYHUDJHSURYLGHGXQGHUDQ(PSOR\HH$VVLVWDQFH3URJUDP ³($3´ZHOOQHVVSURJUDPRURQVLWHPHGLFDOFOLQLFWKDWTXDOLILHVDVDJURXSKHDOWKSODQGRHVQRWKDYHWR EHLQFOXGHGLQWKHDJJUHJDWHUHSRUWDEOHFRVWif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anyHPSOR\HHV RIDQ($3ZHOOQHVVSURJUDPRURQ-VLWHPHGLFDOFOLQLFLIWKRVHEHQHILWVDUHSURYLGHGWRTXDOLI\LQJ EHQHILFLDULHVUHFHLYLQJ&2%5$ZLWKRXWFRVW%XWLIDQHPSOR\HUFKDUJHVD&2%5$SUHPLXPWKH HPSOR\HUPXVWLQFOXGHWKHSUHPLXPLQWKHDJJUHJDWHUHSRUWDEOHFRVWRQWKH)RUP:- P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 7 | © Gallagher Benefit Services, Inc. 2012 $GGLWLRQDOO\WKHUHFHQWJXLGDQFHSURYLGHVUHOLHIWRDQ\HPSOR\HUWKDWLVQRWVXEMHFWWRDQ\IHGHUDO FRQWLQXDWLRQFRYHUDJHUHTXLUHPHQWVLH(5,6$3XEOLF+HDOWK6HUYLFH$FWRUWKH)HGHUDO(PSOR\HHV +HDOWK%HQHILWV3URJUDP6SHFLILFDOO\DQHPSOR\HUWKDWLVQRWVXEMHFWWRDQ\IHGHUDOFRQWLQXDWLRQ FRYHUDJHUHTXLUHPHQWHJDFKXUFKSODQGRHVQRWKDYHWRUHSRUWWKHFRVWRIFRYHUDJHSURYLGHGXQGHUDQ ($3ZHOOQHVVSURJUDPRURQVLWHPHGLFDOFOLQLFHYHQLIWKHFRYHUDJHTXDOLILHVDVDJURXSKHDOWKSODQ Special Rule for Incidental Group Health Plan Benefits *URXSKHDOWKSODQFRYHUDJHSURYLGHGDVDQDGGRQRUYDOXHDGGHGSURJUDPHJDQ($3SURYLGHG³IUHH´ E\DORQJWHUPGLVDELOLW\FDUULHUGRHVQRWKDYHWREHUHSRUWHGLIWKHSRUWLRQRIWKHSURJUDPSURYLGLQJWKH KHDOWKEHQHILWVLVRQO\LQFLGHQWDOLQFRPSDULVRQWRWKHSRUWLRQRIWKHSURJUDPSURYLGLQJWKHRWKHUEHQHILWV ,IWKHYDOXHDGGHGSURJUDPLVQRW³LQFLGHQWDO´WKHFRVWPXVWEHDOORFDWHGDQGWKHKHDOWKFDUHFRYHUDJH SRUWLRQRIWKHFRVWLQFOXGHG Special Rule for Hospital or Other Fixed Indemnity Insurance or Specified Illness Insurance ,IWKHHPSOR\HUPDNHVDQ\FRQWULEXWLRQWRZDUGVWKHFRVWRIWKHIL[HGLQGHPQLW\RUVSHFLILHGLOOQHVV LQVXUDQFHRUDOORZVHPSOR\HHVWRSXUFKDVHWKHFRYHUDJHRQDSUHWD[EDVLVXQGHUD6HFWLRQ FDIHWHULDSODQWKHQWKHFRVWPXVWEHLQFOXGHGLQWKHDJJUHJDWHUHSRUWDEOHFRVW 7KHFRVWRIKRVSLWDOLQGHPQLW\RURWKHUIL[HGLQGHPQLW\LQVXUDQFHRUVSHFLILHGLOOQHVVFRYHUDJH GRHVQRWKDYHWREHUHSRUWHGRQ)RUP:LIWKHHPSOR\HUPHUHO\SURYLGHVWKHRSSRUWXQLW\IRUHPSOR\HHV WRSXUFKDVHWKHFRYHUDJHDQGWKHHPSOR\HHSD\VWKHIXOODPRXQWRIWKHSUHPLXPZLWKDIWHUWD[GROODUV Special Rules for S-Corporations & Excess Reimbursements for Highly Compensated Individuals 7KHVWDWXVRIFRYHUDJHIRURUJUHDWHUVKDUHKROGHUHPSOR\HHVRI6&RUSRUDWLRQVZDVXQFOHDULQWKH RULJLQDO,56JXLGDQFH8QGHUWKHODWHVWJXLGDQFHSD\PHQWVRUUHLPEXUVHPHQWVRIKHDOWKLQVXUDQFH SUHPLXPVIRUDRUJUHDWHUVKDUHKROGHUHPSOR\HHRIDQ6FRUSRUDWLRQGRQRWKDYHWREHUHSRUWHGRQ )RUP:ifWKHLQGLYLGXDOLVUHTXLUHGWRLQFOXGHWKHSUHPLXPSD\PHQWVLQKLVRUKHUJURVVLQFRPH 7KH,56*XLGDQFHVWDWHGWKDWWKHDJJUHJDWHFRVWRIHPSOR\HUVSRQVRUHGKHDOWKFRYHUDJHZRXOG LQFOXGHH[FHVVUHLPEXUVHPHQWVIRUKLJKO\FRPSHQVDWHGLQGLYLGXDOVUHTXLUHGWREHLQFOXGHGLQWKRVH LQGLYLGXDOV¶JURVVLQFRPHDVDUHVXOW6HFWLRQKRIWKH,QWHUQDO5HYHQXH&RGH8QGHUWKHODWHVW JXLGDQFHH[FHVVUHLPEXUVHPHQWVWKDWDUHLQFOXGDEOHLQLQFRPHPXVWEHH[FOXGHGIURPWKHDJJUHJDWH UHSRUWDEOHFRVW Special Rule for Composite Rates 1RWLFHDOVRSURYLGHVFODULILFDWLRQIRUHPSOR\HUVWKDWFKDUJHD³FRPSRVLWHUDWH´$QHPSOR\HULV FRQVLGHUHGWREHFKDUJLQJD³FRPSRVLWHUDWH´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raphics\GBS\Healthcare\Healthcare Reform Template.doc Page 8 | © Gallagher Benefit Services, Inc. 2012 RQWKH)RUP:-EXWLWPXVWXVHWKHVDPHPHWKRGFRQVLVWHQWO\IRUDOODFWLYHHPSOR\HHVDQGIRUDOO TXDOLI\LQJEHQHILFLDULHV How is the Cost of Coverage Reported? $OOFRVWVPXVWEHUHSRUWHGRQDFDOHQGDU\HDUEDVLVUHJDUGOHVVRIWKHHPSOR\HU¶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¶VFRVWFKDQJHVGXULQJWKH\HDUDVWKHUHVXOWRIDVWDWXVFKDQJHHJFRYHUDJHFKDQJHVIURP VLQJOHWRIDPLO\WKHFRVWRQWKH:PXVWUHIOHFWWKHFKDQJH,56JXLGDQFHSURYLGHVWKUHHH[DPSOHV Example #1±DQHPSOR\HUZLWKDQ2FWREHUWKURXJK6HSWHPEHUSODQ\HDUKDVDPRQWKO\UDWH IRUVHOIRQO\FRYHUDJHRIIRUWKHSHULRG2FWREHUWKURXJK6HSWHPEHUDQGD UDWHRIIRUWKHSHULRG2FWREHUWKURXJK6HSWHPEHU7KHFRVWIRUVHOIRQO\ FRYHUDJHIRUFDOHQGDU\HDUPXVWEHUHSRUWHGDV[PRQWKVIRU PRQWKV Example #2±WKHFRVWIRUFRYHUDJHXQGHUDQHPSOR\HU¶VSODQLVSHUPRQWKIRUVHOIRQO\ FRYHUDJHDQGSHUPRQWKIRUHPSOR\HHSOXVVSRXVHFRYHUDJH$QHPSOR\HHKDVVHOIRQO\ FRYHUDJHIRU-DQXDU\WKURXJK-XQHDQGHPSOR\HHSOXVVSRXVHFRYHUDJHIRU-XO\WKURXJK 'HFHPEHU7KHHPSOR\HUPXVWUHSRUWDFRVWRIIRUWKHFDOHQGDU\HDU[PRQWKV [PRQWKV Example #3±WKHPRQWKO\FRVWIRUVHOIRQO\FRYHUDJHLV$QHZO\KLUHGHPSOR\HHEHJLQV FRYHUDJHRQ0DUFKDQGPDLQWDLQVVHOIRQO\FRYHUDJHIURP0DUFKWKURXJKWKHHQGRI WKHFDOHQGDU\HDU7KHHPSOR\HUPD\XVHDSURUDWHGDPRXQWRI[òIRU0DUFK DQGFDOFXODWHWKHWRWDOFRVWIRUWKLVHPSOR\HHDV[òPRQWK[PRQWKV±DV ORQJDVWKHHPSOR\HHXVHVWKHVDPHFDOFXODWLRQPHWKRGIRUDOOHPSOR\HHV Impact of Status Changes after the End of the Reporting Year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¶VELUWKGD\WKHHPSOR\HUQHHGRQO\UHSRUWKHUDJJUHJDWHUHSRUWDEOHFRVWEDVHGXSRQHPSOR\HHSOXV P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 9 | © Gallagher Benefit Services, Inc. 2012 VSRXVHFRYHUDJHIRUWKHHQWLUH\HDUEHFDXVHWKDWZDVWKHVWDWHRIWKHLQIRUPDWLRQLWKDGRQ'HFHPEHU 7KH1RWLFHDOVRSURYLGHVWKDWD)RUP:-FQHHGQRWEHIXUQLVKHGLID)RUP:-KDVDOUHDG\EHHQ SURYLGHGIRUDFDOHQGDU\HDUEHIRUHWKHHOHFWLRQRUQRWLILFDWLRQ Special Rule for Midyear Terminations $VSHFLDOUXOHPD\EHXVHGIRUUHSRUWLQJWKHFRVWRIFRYHUDJHIRUHPSOR\HHVZKRWHUPLQDWHHPSOR\PHQW GXULQJWKHFDOHQGDU\HDU7KHHPSOR\HUPD\LQFOXGHRUH[FOXGHWKHFRVWRI&2%5$FRYHUDJHDVORQJDV DOOIRUPHUHPSOR\HHVDUHWUHDWHGWKHVDPH,56JXLGDQFHSURYLGHVDQH[DPSOHRIWZRDFFHSWDEOH PHWKRGV8QGHUERWKPHWKRGVWKHFRVWRIWKHHPSOR\HH¶VFRYHUDJHLVSHUPRQWKWKHHPSOR\HHLV DFWLYHIRU-DQXDU\WKURXJK$SULODFWLYHFRYHUDJHFRQWLQXHVXQWLOWKHHQGRI$SULODQGWKHHPSOR\HH SD\VSHUPRQWKWKHSHUPLVVLEOHDGPLQLVWUDWLYHFKDUJHLVQRWLQFOXGHGLQWKHH[DPSOHIRU &2%5$FRYHUDJHIRU0D\WKURXJK2FWREHULHVL[PRQWKV Method #1 – 7KHHPSOR\HULQFOXGHVRQO\WKHFRVWRIDFWLYHFRYHUDJHRUIRUIRXUPRQWKV RQQRQ&2%5$FRYHUDJHGXULQJWKHFDOHQGDU\HDUSHUPRQWK[PRQWKV Method #2±7KHHPSOR\HULQFOXGHVWKHFRVWRIERWKDFWLYHDQG&2%5$FRYHUDJHH[FOXGLQJWKH DGPLQLVWUDWLYHIHHRUIRUIRXUPRQWKVRIDFWLYHQRQ&2%5$FRYHUDJHSOXVPRQWKV RI&2%5$FRYHUDJHSHUPRQWK[PRQWKV (LWKHUPHWKRGPD\EHXVHGDVORQJDVWKHHPSOR\HUXVHVWKHVDPHPHWKRGIRUDOOHPSOR\HHV Special Rule for Retirees $VSHFLDOUXOHPD\EHXVHGIRUUHSRUWLQJWKHFRVWRIFRYHUDJHIRUHPSOR\HHVZKRUHWLUHPLG\HDUDQG PRYHIURPDFWLYHWRUHWLUHHKHDOWKSODQ'XULQJWKH\HDURIUHWLUHPHQWRQO\WKHHPSOR\HUPD\XVHWKH VDPHDSSURDFKDVQRWHGIRUHPSOR\HHVZKRWHUPLQDWHPLG\HDUDQGEHJLQ&2%5$FRQWLQXDWLRQFRYHUDJH 7KHHPSOR\HUPD\LQFOXGHRUH[FOXGHWKHFRVWRIUHWLUHHFRYHUDJHVRORQJDVDOOUHWLUHHVDUHWUHDWHGWKH VDPH1RWH)RUDQ\\HDUWKDWWKHHPSOR\HUSURYLGHVD)RUP:WRDUHWLUHHDIWHUWKH\HDURIUHWLUHPHQW WKHHPSOR\HUPXVWLQFOXGHWKHFRVWRIUHWLUHHKHDOWKFRYHUDJHLQWKH³DJJUHJDWHUHSRUWDEOHFRVW´IRUWKDW UHWLUHH)RUH[DPSOHLIWKHUHWLUHHLVGXHD)RUP:IRUSDUWWLPHZRUNRUIRUWKHSXUSRVHRIUHSRUWLQJ JURXSWHUPOLIHLQVXUDQFHWKHQWKHDJJUHJDWHFRVWRIWKHUHWLUHHFRYHUDJHPXVWEHUHSRUWHGRQWKHUHWLUHH¶V )RUP:+RZHYHUWKHHPSOR\HULVQRWUHTXLUHGWRUHSRUWWKHFRVWRIUHWLUHHFRYHUDJHLIWKHUHWLUHH UHFHLYHVD)RUPRU)RUP5LQVWHDGRID)RUP: Payroll Deductions that Span Two Taxable Years 0DQ\HPSOR\HUVPDNHSD\UROOGHGXFWLRQV±DVSHUPLWWHGE\WKHFDIHWHULDSODQUHJXODWLRQV±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raphics\GBS\Healthcare\Healthcare Reform Template.doc Page 10 | © Gallagher Benefit Services, Inc. 2012 Third Party Sick Pay Provider 8QGHU1RWLFHWKLUGSDUW\VLFNSD\SURYLGHUVZKRIXUQLVK)RUPV:-WRHPSOR\HHVDUHQRW UHTXLUHGWRUHSRUWWKHDJJUHJDWHUHSRUWDEOHFRVWRIHPSOR\HUVSRQVRUHGJURXSKHDOWKSODQ FRYHUDJH+RZHYHUD)RUP:-IXUQLVKHGE\DQHPSOR\HUPXVWLQFOXGHWKHDJJUHJDWHUHSRUWDEOHFRVW HYHQLIWKDW)RUP:-LQFOXGHVVLFNSD\RULIDWKLUGSDUW\SURYLGHULVIXUQLVKLQJDVHSDUDWH)RUP:- UHSRUWLQJWKHVLFNSD\ Is Voluntary Reporting of Coverage Permissible? $QHPSOR\HUPD\YROXQWDULO\UHSRUWRQ)RUP:-WKHFRVWRIFRYHUDJHWKDWLVQRWUHTXLUHGWREHLQFOXGHG LQWKHDJJUHJDWHUHSRUWDEOHFRVWXQGHUDSSOLFDEOHLQWHULPUHOLHILQFOXGLQJFRYHUDJHXQGHUD+HDOWK 5HLPEXUVHPHQW$UUDQJHPHQW+5$DPXOWLHPSOR\HUSODQD+,3$$H[FHSWHGGHQWDORUYLVLRQSODQDQ ($3DZHOOQHVVSURJUDPRURQ-VLWHPHGLFDOFOLQLFSURYLGHGVXFKFRYHUDJHFRQVWLWXWHVDSSOLFDEOH HPSOR\HU-VSRQVRUHGFRYHUDJHDQGLVFDOFXODWHGXVLQJDSHUPLVVLEOHPHWKRGXQGHUWKH,56*XLGDQFH What Transition Relief is Available? 7UDQVLWLRQUHOLHILVDYDLODEOHIRUWKHIROORZLQJHPSOR\HUVRUSODQV x (PSOR\HUVWKDWILOHGIHZHUWKDQ)RUP:IRUWKHSUHYLRXVFDOHQGDU\HDU)RUH[DPSOHDQ HPSOR\HUWKDWILOHGIHZHUWKDQ)RUP:LQFDOHQGDU\HDUZRXOGQRWEHUHTXLUHGWR UHSRUWRQ)RUP:VIRUFDOHQGDU\HDU7KHFRQWUROOHGJURXSUXOHVGRQRWDSSO\LQ GHWHUPLQLQJZKHWKHUDQHPSOR\HUUHDFKHVWKH)RUP:WKUHVKROG x (PSOR\HUVIXUQLVKLQJD:IRUPWRHPSOR\HHVZKRWHUPLQDWHEHIRUHWKHHQGRIWKHFDOHQGDU \HDUDQGUHTXHVWD)RUP:EHIRUHWKHHQGRIWKDWFDOHQGDU\HDU*HQHUDOO\DQHPSOR\HULV UHTXLUHGWRSURYLGHD:IRUPWRDWHUPLQDWHGHPSOR\HHZLWKLQGD\VDIWHUUHFHLSWRIDZULWWHQ UHTXHVW7KLVUHOLHIGRHVQRWDSSO\WRHPSOR\HUVZKRDXWRPDWLFDOO\SURYLGHD)RUP:XSRQ WHUPLQDWLRQ x +,3$$H[FHSWHGGHQWDODQGYLVLRQEHQHILWV x 6HOIIXQGHGSODQVRIHPSOR\HUVQRWVXEMHFWWR&2%5$ x +HDOWKUHLPEXUVHPHQWDUUDQJHPHQWVDQG x 0XOWLHPSOR\HUSODQV Employers Providing Fewer than 250 Form W-2s in Prior Year 8QGHU,561RWLFHHPSOR\HUVWKDWILOHGIHZHUWKDQ)RUP:VIRUWKHSUHYLRXVFDOHQGDU \HDUZHUHH[HPSWHGIURPUHSRUWLQJWKHDJJUHJDWHRIHPSOR\HUVSRQVRUHGKHDOWKFRYHUDJHRQ)RUP: IRUWKHFXUUHQWFDOHQGDU\HDU)RUH[DPSOHDQHPSOR\HUWKDWILOHGIHZHUWKDQ)RUP:VLQFDOHQGDU \HDUZRXOGQRWEHUHTXLUHGWRUHSRUWWKHDJJUHJDWHUHSRUWDEOHFRVWRQ)RUP:VIRUFDOHQGDU\HDU 7KLVUXOHLVEDVHGRQWKHH[HPSWLRQIURPILOLQJ)RUP:UHWXUQVHOHFWURQLFDOO\IRUHPSOR\HUVWKDW ILOHIHZHUWKDQ)RUP:V ,561RWLFHFODULILHGWKDWZKHQGHWHUPLQLQJKRZPDQ\)RUP:VDQHPSOR\HUILOHGLQWKHSULRU \HDUWKHHPSOR\HULVRQO\UHTXLUHGWRFRXQWWKH)RUP:VLWZRXOGEHUHTXLUHGWRILOHZLWKRXWUHJDUGWR P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 11 | © Gallagher Benefit Services, Inc. 2012 WKHXVHRIDQDJHQWXQGHU6HFWLRQ$QHPSOR\HUPD\DSSRLQWDQDJHQWXQGHU6HFWLRQRIWKH ,QWHUQDO5HYHQXH&RGHWRSHUIRUPDFWVVXFKDVZLWKKROGLQJUHSRUWLQJDQGSD\LQJIHGHUDOHPSOR\PHQW WD[HVZLWKUHJDUGWRZDJHVSDLGE\WKHDJHQWIRUWKHHPSOR\HUDVZHOODVWKHDJHQW¶VRZQHPSOR\HHV %DVHGXSRQLQIRUPDO,56FRPPHQWVWKHH[FHSWLRQIRUHPSOR\HUVILOLQJIHZHUWKDQ)RUP:VLV EDVHGXSRQ,QWHUQDO5HYHQXH&RGH6HFWLRQZKLFKUHODWHVWRZKLFKHPSOR\HUVDUHUHTXLUHGWRILOH )RUP:VHOHFWURQLFDOO\ZLWKWKH,56$OVREDVHGXSRQLQIRUPDO,56FRPPHQWVWKHGHWHUPLQDWLRQRI ZKHWKHUDQHPSOR\HUH[FHHGVWKH)RUP:WKUHVKROGGRHVQRWDSSO\RQDFRQWUROOHGJURXSEDVLV 7KXVHPSOR\HUVDUHQRWUHTXLUHGWRFRXQWDOO)RUP:VDFURVVWKHLUFRQWUROOHGJURXSZKHQGHFLGLQJLI WKH\PXVWUHSRUWWKHDJJUHJDWHUHSRUWDEOHFRVWVRQHPSOR\HH)RUP:V Employee Terminating in Mid-Year (PSOR\HUVIXUQLVKLQJD)RUP:WRHPSOR\HHVZKRWHUPLQDWHEHIRUHWKHHQGRIWKHFDOHQGDU\HDUDQG UHTXHVWD)RUP:EHIRUHWKHHQGRIWKDWFDOHQGDU\HDULIWKHHPSOR\HUQRUPDOO\SURYLGHD)RUP:LQ -DQXDU\*HQHUDOO\DQHPSOR\HULVUHTXLUHGWRSURYLGHD)RUP:WRDWHUPLQDWHGHPSOR\HHZLWKLQ GD\VDIWHUUHFHLSWRIDZULWWHQUHTXHVW7KHH[HPSWLRQIRUPLG\HDU)RUP:VLVRQO\IRUDVLWXDWLRQLQ ZKLFKD)RUP:LVSURYLGHGXSRQDQHPSOR\HH¶VUHTXHVW HIPAA Excepted Dental and Vision Benefits 8QGHUWKH,56JXLGDQFHHPSOR\HUVZHUHUHTXLUHGWRLQFOXGHWKHFRVWVRIGHQWDODQGYLVLRQFRYHUDJH LIWKH\ZHUH³LQWHJUDWHG´ZLWKPHGLFDOFRYHUDJH7KHUHFHQWJXLGDQFHFODULILHVWKDWWKHFRVWRIGHQWDODQG YLVLRQEHQHILWVWKDWDUH+,3$$³H[FHSWHGEHQHILWV´GRQRWKDYHWREHUHSRUWHGRQ)RUP:*HQHUDOO\ GHQWDORUYLVLRQEHQHILWVDUH+,3$$H[FHSWHGEHQHILWVLIWKH\DUHHLWKHU RIIHUHGXQGHUDVHSDUDWHSROLF\FHUWLILFDWHRUFRQWUDFWRILQVXUDQFHRU SDUWLFLSDQWVPXVWKDYHWKHULJKWQRWWRHOHFWWKHGHQWDORUYLVLRQEHQHILWVDQGLIWKH\GRHOHFW WKHGHQWDORUYLVLRQEHQHILWVWKH\PXVWSD\DQDGGLWLRQDOSUHPLXPRUFRQWULEXWLRQIRUWKDW FRYHUDJH 7KHH[FHSWLRQIRU+,3$$H[FHSWHGEHQHILWVIRUIXOO\LQVXUHGSODQVLVFRQWDLQHGLQWKHVWDWXWH+RZHYHU WKH,56H[WHQGHGWKHH[FHSWLRQWRVHOIIXQGHGSODQVXQGHU7UDQVLWLRQ5HOLHI Self-Funded Plans of Employers Not Subject To Federal Continuation (PSOR\HUVDUHQRWUHTXLUHGWRUHSRUWFRYHUDJHSURYLGHGXQGHUDVHOIIXQGHGSODQLIWKHHPSOR\HULVQRW VXEMHFWWRIHGHUDOFRQWLQXDWLRQFRYHUDJHUHTXLUHPHQWV)HGHUDOFRQWLQXDWLRQFRYHUDJHUHTXLUHPHQWV LQFOXGHWKH&2%5$UHTXLUHPHQWVXQGHUWKH&RGHWKH(PSOR\HH5HWLUHPHQW,QFRPH6HFXULW\$FWRI RUWKH3XEOLF+HDOWK6HUYLFH$FWDQGWKHWHPSRUDU\FRQWLQXDWLRQFRYHUDJHUHTXLUHPHQWXQGHUWKH)HGHUDO (PSOR\HHV+HDOWK%HQHILWV3URJUDP Health Reimbursement Arrangements 0DQ\+5$VSURYLGHUHLPEXUVHPHQWRQO\IRUFRVWVQRWFRYHUHGXQGHUWKHHPSOR\HU¶VPDMRUPHGLFDOSODQ ±VXFKDVGHGXFWLEOHVFRSD\VDQGFRLQVXUDQFH6RPH+5$VDOVRSHUPLWUHLPEXUVHPHQWRISUHPLXP SD\PHQWVXQGHUDQRWKHUSODQVXFKDVDQLQGLYLGXDOLQVXUDQFHSROLF\RUDVSRXVH¶VHPSOR\HU¶VSODQ2QH TXHVWLRQQRWDGGUHVVHGDWOHDVWQRW\HWE\WKH,56LVWKHVWDWXVRI+5$VWKDWDOVRUHLPEXUVHHPSOR\HHV P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 12 | © Gallagher Benefit Services, Inc. 2012 IRUWKHFRVWRILQGLYLGXDOKHDOWKLQVXUDQFH 7KHFRVWRIFRYHUDJHIRUEHQHILWVVXFKDVUHLPEXUVHPHQWRI FRLQVXUDQFHXQGHUDQ+5$LVFOHDUO\H[FOXGDEOHIURPWKH)RUP:DJJUHJDWHFRVWFDOFXODWLRQ%XWZKDW DERXWWKHFRVWRIWKHLQGLYLGXDOKHDOWKSUHPLXP",QWKHDEVHQFHRIDGGLWLRQDOJXLGDQFHLWDSSHDUVWKDW HPSOR\HUVPD\DOVRH[FOXGHWKHLQGLYLGXDOSUHPLXPFRVW Multiemployer Plans $QHPSOR\HUWKDWFRQWULEXWHVWRDPXOWLHPSOR\HUSODQLVQRWUHTXLUHGWRLQFOXGHWKHFRVWRIFRYHUDJH SURYLGHGWRDQHPSOR\HHXQGHUWKDWPXOWLHPSOR\HUSODQ,IWKHRQO\DSSOLFDEOHHPSOR\HUVSRQVRUHG FRYHUDJHSURYLGHGWRDQHPSOR\HHLVSURYLGHGXQGHUDPXOWLHPSOR\HUSODQWKHHPSOR\HULVQRWUHTXLUHG WRUHSRUWDQ\DPRXQWXQGHUDRQWKH)RUP:IRUWKDWHPSOR\HH+RZHYHULIWKHHPSOR\HU SURYLGHVRWKHUUHSRUWDEOHFRYHUDJHWKDWFRYHUDJHPXVWEHLQFOXGHG What will be the Impact of Future Guidance? 7KH,56VWDWHGLQ1RWLFHWKDWDQ\FKDQJHPDGHE\IXWXUHJXLGDQFHZLOOEHRQDSURVSHFWLYHEDVLV 1HZFKDQJHVZLOOQRWDSSO\IRUIXWXUHFDOHQGDU\HDUVXQWLOWKH,56SXEOLVKHVJXLGDQFHJLYLQJDWOHDVWVL[ PRQWKVRIDGYDQFHQRWLFHRIDQ\FKDQJHWRWKHWUDQVLWLRQUHOLHI)RUH[DPSOHLIWKH,56PRGLILHGWKLV WUDQVLWLRQJXLGDQFHLQ6HSWHPEHUWKHQHZJXLGDQFHZRXOGQRWDSSO\XQWLO What are the Penalties for Failure to Comply? *HQHUDOO\WKHSHQDOW\LVSHU)RUP:IRUIDLOXUHWRILOHDFRUUHFW)RUP:ZLWKDPD[LPXP SHQDOW\RIPLOOLRQIRUFHUWDLQVPDOOEXVLQHVVHV7KHUHDUHVRPHOLPLWHGH[FHSWLRQVVXFK DVZKHUHWKHIDLOXUHZDVGXHWRUHDVRQDEOHFDXVHDQGQRWWRZLOOIXOQHJOHFWDQGDde minimisUXOHIRU FRUUHFWLRQV7KHUHLVDOVRWKHSRWHQWLDOIRUDQLQFUHDVHGSHQDOW\SHU)RUP:LIWKHIDLOXUHWRILOH DFRUUHFW)RUP:LVGXHWRLQWHQWLRQDOGLVUHJDUGRIWKHILOLQJUHTXLUHPHQWV7KHVHDUHWKHFXUUHQW SHQDOWLHVWKH\GRQRWUHSUHVHQWQHZSHQDOWLHVRUFKDQJHVWRWKHH[LVWLQJSHQDOWLHV How do We get More Information? ,QIRUPDWLRQWKDWLVPRUHGHWDLOHGLVDYDLODEOHLQ,561RWLFHDQGLQWKH)$4VSRVWHGRQWKH,56 ZHEVLWH IRS Notice 2012-9KWWSZZZLUVJRYSXELUVGURSQSGI GBS Materials: x )$4V KWWSDMJDGREHFRQQHFWFRPZBF x :5HSRUWLQJ4XHVWLRQVWR&RQVLGHU&KHFNOLVWIRU,PSOHPHQWDWLRQ KWWSDMJDGREHFRQQHFWFRPKFUBE x 4XLFN5HIHUHQFH7RRO KWWSDMJDGREHFRQQHFWFRPKFUBD +5$VVKRXOGQRWEHOLPLWHGWRUHLPEXUVHPHQWRILQGLYLGXDOKHDOWKLQVXUDQFHSUHPLXPVVLQFHWKLVW\SHRISODQ GHVLJQLVXQOLNHO\WRFRPSO\ZLWKDQXPEHURIIHGHUDOODZVLQFOXGLQJ+,3$$SRUWDELOLW\DQG&2%5$ P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 13 | © Gallagher Benefit Services, Inc. 2012 x Sample Employee Communication with Instructions: http://ajg.adobeconnect.com/w-2_1112/ Action Steps The cost of health care coverage is generally not reportable until January 2013 (January 2014 for employers who issue fewer than 250 Form W-2s for 2011). Nevertheless, employers must be able to track the cost of includable coverage beginning in 2012 in order to be certain to have the information that must be included on Form W-2s in 2013, and employers who automatically provide Form W-2s to employees who terminate mid-year, must include the aggregate reportable cost of coverage in Box 12, using Code DD. Employers should be taking steps now in order to be ready by 2013. Steps employers may want to take include: x Consult with your tax advisor at an early date to ensure that you will be able to complete needed action steps on a timely basis. x Identify what information on health coverage is currently being collected and transmitted to payroll. x Determine if any self-funded health plans need to be valued before they can be reported. For example, a wellness program that provides biometric screening or annual executive physicals that include biometric screening and for which the employer charges a COBRA premium. x Determine what additional information (if any) the employer should begin tracking. When reviewing what should be provided to payroll, employers may also want to consider the type of reporting that may be required for the “cadillac” tax beginning in 2018. While similar, there are differences such as the type of health coverage that must be included. For example, salary reduction contributions to a health care FSA, health savings account contributions, and Archer medical savings account contributions are not includible using Code DD for W-2 reporting, but must be included when determining if the “cadillac” tax applies and if it applies how much tax will be owed. x Decide how to handle special situations such as reporting for situations where coverage is part active and part COBRA or part retiree coverage because an employee terminated or retired midyear. x Coordinate with payroll – whether an internal department or an external vendor – to ensure that the appropriate information is tracked, transmitted to payroll and included correctly. x Make any needed systems or recordkeeping changes and test the system(s) before the employer needs to begin producing Form W-2s. x Develop communications that will explain briefly the new reporting requirement and reassure employees that this does not affect the tax status of their coverage. Employers may want to use this as opportunity to let employees the true cost of their health care benefits. Many employees who inquire about COBRA coverage and receive an election notice with the full rates experience “sticker shock.” Letting employees know the real cost may increase their appreciation for the P:\Graphics\GBS\Healthcare\Healthcare Reform Template.doc Page 14 | © Gallagher Benefit Services, Inc. 2012 HPSOR\HUSURYLGHGEHQHILWVDQGUHGXFHWKHSRWHQWLDOIRUFDOOVWR+5ZKHQDWHUPLQDWHGHPSOR\HH RUGHSHQGHQWRIWKHHPSOR\HHH[SHULHQFHVWKDW&2%5$VWLFNHUVKRFN x 'HWHUPLQHLIWKHHPSOR\HUZDQWVWREHJLQLQFOXGLQJWKHPRQWKO\FRVWRQDQLQIRUPDWLRQDOEDVLVRQ HPSOR\HHSD\VWXEVDVVXPLQJLW¶VIHDVLEOHWRDGGWKLVLQIRUPDWLRQ x 'HWHUPLQHZKHWKHUGHQWDODQGRUYLVLRQFRYHUDJHTXDOLI\DV+,3$$H[FHSWHGEHQHILWV x 'HWHUPLQHZKHWKHUUHSRUWLQJIRUHPSOR\HUVSRQVRUHG($3VZHOOQHVVSURJUDPVRURQVLWHFOLQLFV LVUHTXLUHG x 'HWHUPLQHZKHWKHUYROXQWDU\UHSRUWLQJRIDQ\EHQHILWVLVGHVLUDEOH x &RQILUPWKDWDQ\KHDOWKEHQHILWVSURYLGHGXQGHUDQ/7'SROLF\DUHLQFLGHQWDO x &RQILUPWKDWH[FHVVUHLPEXUVHPHQWVXQGHU&RGH6HFWLRQKWKDWDUHLQFOXGHGLQJURVVLQFRPH ZLOOQRWEHLQFOXGHGLQ³DSSOLFDEOHHPSOR\HUVSRQVRUHGFRYHUDJH´ x 6WD\WXQHGIRUIXUWKHUGHYHORSPHQWVDQGDGGLWLRQDO,56JXLGDQFH *DOODJKHU%HQHILW6HUYLFHVWKURXJKLWVFRPSOLDQFHH[SHUWVDQGFRQVXOWDQWVZLOOFRQWLQXHWRPRQLWRU GHYHORSPHQWVRQKHDOWKFDUHUHIRUPOHJLVODWLRQDQGZLOOSURYLGH\RXZLWKUHOHYDQWXSGDWHGLQIRUPDWLRQDV LWEHFRPHVDYDLODEOH,QWKHLQWHULPSOHDVHFRQWDFW\RXU*DOODJKHU%HQHILW6HUYLFHV5HSUHVHQWDWLYHZLWK DQ\TXHVWLRQVWKDW\RXPD\KDYH The intent of this analysis is to provide general information regarding the provisions of current healthcare reform legislation. It does not necessarily fully address all your organization’s specific issues. It should not be construed as, nor is it intended to provide, legal advice. Your organization’s general counsel or an attorney who specializes in this practice area should address questions regarding specific issues.