Quickfinder Health Care Reform Handbook

Your trusted tax quick reference health care reform guide

Health Care Reform has wide-ranging implications for individuals and employers. Employer mandates to provide insurance coverage, credits and subsidies to help individuals purchase coverage, marketplaces for acquiring coverage and reporting requirements and taxes are some of the many rules that impact your clients. They are likely to have questions. We’ve got the answers. Our Health Care Reform Quickfinder Handbook makes it easy for you to quickly locate answers and keep your clients in compliance.

Topics covered in the Handbook include:

• Employer mandate to offer health insurance to employees
• Penalty for not providing adequate insurance and guidance on responding to IRS penalty notices
• Premium tax credit and cost-sharing subsidies for individuals
• Obtaining health insurance through a state marketplace
• Premium tax credit eligibility, reporting, and reconciling
• Health insurance market reforms
• Small employers eligible for SHOP participation
• Small employer health insurance credit
• Notice and reporting requirements
• Other taxes and fees

• Health Care Reform Quickfinder Handbook 2020
  • Health Care Reform Quickfinder® Handbook
  • Tab 1—Health Insurance Mandate for Individuals
    • Overview
    • Individuals Who Were Exempt From the Shared Responsibility Penalty
    • What Is Minimum Essential Coverage?
      • Plan in the Individual Market
    • Calculating the Shared Responsibility Penalty (Payment)
    • Calculating the Individual Shared Responsibility Penalty Worksheet (2018)
  • Tab 2—Obtaining Insurance Through a State Marketplace
    • What Are Insurance Marketplaces?
    • Eligibility to Purchase Insurance Through a State Marketplace
    • Applying for Insurance Through a Marketplace
  • Tab 3—Premium Tax Credits and Cost-Sharing Subsidies for Individuals
    • Premium Tax Credit (PTC)
    • Completing Form 8962
    • Reduced Cost-Sharing for Low-Income Taxpayers
  • Tab 4—Health Insurance Mandate for Employers
    • Overview
    • Applicable Large Employers (ALEs)
    • Employer Defined
    • Application of Aggregation Rules
    • Employee Defined
    • Determining Hours of Service
    • Dependents Who Must Be Offered Coverage
    • Full-Time Status Determination
    • Ongoing Employees
    • New Variable Hour and Seasonal Employees
    • Transition From New Employee to Ongoing Employee
    • Administrative Period—New Employees
    • Change In Employment Status
    • Returning and Rehired Employees
    • Comprehensive Example—Determining ALE Status
      • Variation 2: Seasonal Worker Exception When There Are Multiple Seasons
  • Tab 5—Employer Shared Responsibility Penalties
    • Section 4980H(a) Penalty for Not Offering Coverage
    • Section 4980H(b) Penalty for Not Offering Affordable MV Coverage
    • Determining if Coverage Provides MV
    • Determining if Coverage Is Affordable
    • Affordability Safe Harbors
  • Tab 6—Small Employers
    • Small Business Health Options Program (SHOP)
    • SHOP Coverage Requirements
    • Enrolling Employees
    • Plans Offered in the SHOP
    • Small Employer Health Insurance Credit
    • Steps to Determine Eligibility for the Credit
    • Step 1: Meeting the Uniformity Requirement
    • Step 2: Determining Employees Taken Into Account
    • Step 3: Calculating Number of Hours of Service
    • Step 6: Determining Premiums Paid By the Employer
    • Calculating the Credit
    • Claiming the Credit
    • Comprehensive Example—Small Employer Health Insurance Credit
      • Variation
    • Small Employer Health Insurance Credit Worksheet
  • Tab 7—Other Taxes
    • Overview
    • 3.8% Net Investment Income Tax
    • Individuals Subject to the 3.8% NIIT
    • Calculating the 3.8% NIIT for Individuals
    • Net Investment Income (NII)
    • Properly Allocable Deductions
    • Income Not Included in NII
    • Estates and Trusts
    • 0.9% Medicare Tax on Earned Income
    • Employer Withholding Requirements
    • Excise Tax On Cadillac Plans
    • Excise Tax On Medical Devices
    • Excise Tax On Indoor Tanning Services
  • Tab 8—Notice and Reporting Requirements
    • Health Insurance Coverage Reporting on Form 1095-C
    • Health Insurance Coverage Reporting on Form 1095-B
    • Reporting Employer Provided Health Coverage on Form W-2
  • Tab 9—Market Reforms
    • Grandfathered Plans
    • Medical Reimbursement Plans and Employer Payment Plans
    • Health Reimbursement Arrangement (HRA)
    • Penalty for Failing to Meet Market Reform Requirements
  • Glossary
  • Back Cover

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