nevada health exchange - aca employers need to know presentation
DESCRIPTION
June 2013TRANSCRIPT
Nevada Health Link Exchange Summit: What Employers Need to Know About Health
Care Reform Katherine L. Georger
Disclaimer
This is an overview. – There is no substitute for reading the statute, rules and
agency guidance. – Check the rules when it is time to comply (see last slide
for link). – Contact your attorney, accountant, tax and/or financial
planner to address questions about your unique business and circumstances.
Many of the rules are provisional. Additional rules and guidance are issued frequently and current provisional rules and interpretations of the ACA may change.
This does not establish an attorney-client relationship. This does not constitute legal advice.
ACA: Key Provisions
Individual Mandate Expansion of Medicaid Employer Responsibility Provisions
– Penalties—covered employer may face penalties for failure to provide any or inadequate coverage to eligible employees.
– Reporting Requirements—Form W-2s; Exchanges; Affordable Insurance Exchange—creates state-
based, joint federal-state, or federally run exchanges – Essential Health Benefit Benchmark – Small Business Health Option Program (SHOP)
Constitutional Challenge
Individual Mandate – Requires vast majority of Americans to obtain “minimum
essential” health insurance coverage – Penalties—individual fails to comply with individual
mandate, will have to pay “shared responsibility payment” (penalty) payable with the individual’s taxes; Upheld under Congress’s constitutional power to tax
Medicaid Expansion – ACA provided additional Medicaid funds, but required
States to cover all individuals up to 138% FPL or risk losing all Medicaid funding Struck down as unconstitutional use of federal power to attach
penalty of loss of all Medicaid funding for opting out of increase
Unanticipated Consequences for Large Employers? States that decline the Medicaid expansion
component of ACA could expand potential liability of large employers – Exchange-eligible employees are full-time employees
(FTE) with household incomes between 138% and 400% FPL
Medicaid expansion would have covered nearly all persons with household income up to 138% FPL
If states reject expansion, FTE with household income of 100% to 138% FPL eligible for the exchange and eligible to get a subsidy or tax credit
Employer-Related Issues
– Employer Responsibility Provisions Penalties: large employers’ failure to provide ANY coverage or
INADEQUATE coverage to full-time employees (and their dependents)
Reporting Requirements: large employer must file return certifying it offers full-timers(and their dependents) opportunity to enroll in minimum essential coverage and report number of full-timers.
– Tax Related Issues Form W2s: cost of coverage (250+ employees) Small Business Tax Credits: less than 25 full-timers, avg.
income < $50,000.
– Exchanges Employer Reporting Requirements: Coverage & COBRA
elections
Employer Responsibility Provisions Applicable “large employer” may be subject to an
“assessable payment” (penalty) if: – It fails to offer its “full-time employees” (and their
“dependents”) the opportunity to enroll in a “minimum essential coverage” employer-sponsored plan; OR
– The full-time employee’s contribution for “self-only coverage” exceeds 9.5% of the employee’s “household income;” OR
– The employer-sponsored plan fails to give the full-time employee “minimum value”
Penalty ONLY triggered if a full-time employee applies for and receives a premium subsidy or tax credit*
Employer Responsibility Provisions: Covered Employers Beginning Jan. 1, 2014— “large employers” may
face penalties for not offering health coverage or for failing to offer adequate coverage – Large employers are employers with at least 50 full-time
equivalent employees Hours of part-timers (those working less than 30 hours per
week) are included in calculation of “large employer”; HOWEVER, part-timers are not eligible to receive tax credit
Hours of seasonal workers may count
– Only large employers who have at least one full-time employee (FTE) receiving premium subsidy or tax credit through an exchange and employ at least 30 full-time workers may pay penalty
Potential Employer Penalties: No Coverage Large employer’s failure to provide any coverage
– If covered employer does not offer coverage full-timers and at least one of its full-timers receives a “premium tax credit” or “cost sharing subsidy,” then employer is assessed penalty of $2,000 per full-time employee beyond company’s first 30 full-time employee.
– Assessed on monthly basis – Example: Company A has 100 full-timers but no full-
timers receive credits. Penalty? No—because employer penalty only triggered upon full-time
employee’s receipt of tax credit
Employer Penalties: No Coverage (cont.) Example: Company B has 30 full-timers and 100
part-timers. Penalties? – No—employer is considered “large employer” with 80
full-time equivalent workers; however, penalty is only assessed against number of full-time employees beyond the first 30 full-timers.
Example: Company C has 50 full-timer and one full-timer files for tax credit. Penalties? – Yes, employer will have to pay (50-30)X$2,000=
$40,000 annual assessment.
Potential Employer Penalties: Inadequate Coverage Large employer’s failure to provide “affordable” or
adequate coverage may face penalties if: – Cost of self-only enrollment is more than 9.5% of the
full-timer’s family income OR – Employer’s plan covers less than minimum value or
less than 60% of the health care expenses for a typical population.
Penalty only triggered if full-timer applies for tax credit and obtains coverage on an Exchange. – Employer assessed annual penalty of $3,000 for each
full-timer receiving a tax credit **BUT cannot exceed penalty for offering NO coverage.
Employer Penalties: Inadequate Coverage (cont.) Example: Firm A has 50 full-timers, 10 of which
must pay more than 9.5% of family income and apply for and receive premium credits – Employer will be assessed annual penalty of ($3,000 X
10) = $30,000 Example: firm has 50 full-timers, but coverage is
unaffordable for 20 who receive premium credits. – Employer would be assessed annual penalty of ($3,000
X 20) = $60,000 – HOWEVER, because that penalty exceeds the penalty
of offering no coverage at all, the penalty cannot exceed $2,000 X (50-30) = $40,000
ACA Employer Assessable Payment Flowchart
Employer
50 or more full-time equivalents
(FTEs)
Employer offers
coverage
Tax credit obtained by at least one full-timer because coverage is
“unaffordable” or does not meet “minimum
value
Annual penalty of $3,000 per full-
timer who receives the credit
Tax credit not obtained by any full-
timer
Employee Elects Plan
No employer penalty
Employee rejects Plan
Employee buys own plan
No employer penalty
Employee opts to forgo insurance
and pay individual assessment
No employer penalty
Employer does not offer
coverage
Tax credit obtained by at least one full-timer
Annual penalty of $2,000 X full-
timers (after the first 30*)
Tax credit not obtained by any full-timer
No employer penalty
Less than 50 full-time equivalents
(FTEs) No employer
penalty
IRS Guidance: Definitions
Employer – Controlled group – Affiliated service group
Employee:“common law” definition – Excludes: leased employee, sole proprietor, partner, 2%
Sub S Shareholder Full-time employee
– 130 hours per calendar month as monthly equivalent Hours of Service
– Paid for work, vacation, holiday, illness, incapacity, layoff, jury duty, military duty or leave of absence
IRS Guidance: Definitions
Large Employer: Means employer employs an average of 50 full-time equivalent employees
Full-time equivalent (FTE): all employees (including part-time, variable, seasonal) who work less than 30 hours per week are included in calculating the employer’s FTEs for a given month
Seasonal Worker Exception: if sum of employer’s full-time employees & FTEs is 50 for 120 days (4 months) or less during the preceding calendar year, not a large employer – The four calendar months and 120 days are not
required to be consecutive
Large Employer
New Businesses: Employers not in existence in preceding calendar year are counted as applicable large employers for current calendar year if they “reasonably expected to employ” an avg of 50+ full-time/FTEs during current year and actually do
Aggregate Rules – All company units (control group & affiliated service groups as defined
under section 414(b), (c), (m) & (o)) count for: Determining large employer status (50 full-time equivalents) and thus,
whether penalties apply Determining 30 first full-time employee reduction in no-coverage
penalty formula (each member gets pro rata share) – Subsidiaries do NOT count for
Determining whether an employer is subject to an assessable payment and amount of that penalty
IRS has said liability is assessed on a individual member basis
Large Employer Determination
Corporation P (no full-timers)
Corporation S (40 full-timers)
Corporation T (60 full-timers)
Which corporations are “large employers”? Which are large employer “members”?
Large Employer Assessment
Corporation A (40 full-timers)
Corporation B (35 full-timers)
•Corp A does not sponsor a plan during 2015 •Corp A receives a “certification” that at least one of its full-timers obtained a premium tax credit for 2015 •How much is Corp A’s assessment? •How much is Corp B’s assessment?
Calculating FTEs
Full-time: At least 30 hours per week or 130 hours per month – Clarifies that ALL periods of paid leave considered
Full-time equivalent: take aggregate hours of service for all non-full-timers (less than 30 hours of service per wk) in given month /120 = FTE month
Calculating hours: – Hourly: ACTUAL hours worked (time cards) – Non-hourly: 3 options; BUT cannot use to understate
Actual Hours Worked Days Worked Equivalency: 8 hours per day Weeks Worked Equivalency: 40 hours per week
Calculating FTEs (cont.)
Foreign Workers: hours worked outside U.S. (outsourced) not calculated for large employer determination
Educators: full-time employees (paid time off) Adjunct faculty, Pilots, Transportation,
Commission: IRS seeking comments – “Reasonable method” to calculate for now – Expect future rules
Dependents
ACA requires large employers to offer “all full-time employees and their dependents”
Dependent: IRS has interpreted to this to mean ONLY an employee’s children who are under 26 years and not spouse or domestic partner – Transitional Relief Safe-harbor: Employer begins to “take steps”
during the 2014 plan year toward offering dependent coverage to full-timers (where it did not formerly offer such coverage), no penalty. ONLY applies for the 2014 plan year.
For purposes of determining “affordability” only need to look at cost of coverage of self-only coverage that cannot exceed 9.5% of wages.
– Dependent coverage and coverage of related individuals is deemed to be affordable based on self-only coverage even if family coverage exceeds 9.5% of the employee’s household income.
– If a related individual (e.g., spouse or dependents) is eligible for minimum essential coverage under the employer-sponsored plan, then they are ineligible for subsidized coverage from a public exchange if the employee premium cost for self-only coverage (not family) does not exceed 9.5% of household income.
Determining Full-Timers
Look-Back Period – Measurement Period
Initial Period—new variable or seasonal hour workers – Optional 3-12 month look back
Standard Period—ongoing workers – Optional 3-12 month lookback
– Administrative Period – Stability Period
Ongoing Employees: standard measurement period (3-12 months), administrative period, stabilization period
Example: Standard-measurement period: Oct. 15, 2013 through Oct. 14, 2014. Administrative period: Oct. 15, 2014 through Dec. 31, 2014. Stabilization period: Jan. 1, 2015-Dec. 31, 2015
Determining Full-Timers
New Employee: any employee who has been employed less than one completed standard measurement period, including new “Break in Service” rules. – Employee may be treated as new employee for purposes of determining
full-time employee status if time of no credited hours of service exceeds 26 weeks.
– Rule of parity: periods with no credited hours of service (of less than 26 weeks) is at least four weeks long and longer than employee’s period of employment immediately preceding that period with no credited hours of service.
New Variable Employees: facts and circumstances of start date, “reasonably likely” to be full-time must be given coverage – Employer cannot take into account the likelihood that it will terminate
employee before the end of the initial measurement period – High turnover position—have to measure because you hired them with
expectation they would be full-time
Short Term & Seasonal Workers
New Short-term Employees: no penalties if employment period less than 3 months
Temp Agencies: Anti-abuse rule – No use of temp agencies to evade penalty provisions.
Seasonal Workers—performs work on a seasonal basis as defined by the Secretary of Labor, including (but not limited to) workers covered by 29 CFR 500.20(s)(1) (agricultural) and retail workers employed exclusively during Holiday seasons. – Employers may apply a “reasonable, good faith
interpretation” of the term “seasonal worker” – Expect future rules & guidance on seasonal workers
Temporary Employees
IRS: will take into account the factual nature of the common law analysis in determining who is the common law employer of the workers providing the services.
IRS: “It is anticipated that many new employees of temporary staffing agencies will be variable hour employees” based on the facts and circumstances – Example: individual hired by temp agency as its “common law
employee” can be expected to be offered more than one or more assignments with different clients each lasting no more than 2-3 months, clients have different requests with respect to hours and gaps between assignments, then employees would be a variable hour employee.
May be instances where employee is full-timer (i.e. technical/professional workers)
IRS has requested further comments
Employer Responsibility Provision Safe-Harbors Large Employer Determination (2014 only)
– Employer look-back to any 6 consecutive month period in 2013 to determine if employed avg. of 50 FTEs
No Coverage – 95% Compliance: large employer deemed compliant if
offers coverage to all but 5% or if greater, 5 full-timers Affordability: Self-Only Coverage
– Form W2: employee’s annual wages (Box 1) – Rate of Pay: hourly rate X 130 hours X 9.5% – Federal Poverty Line: self-only coverage < 9.5% of FPL
Minimum Value – Minimum Value Calculator (HHS rolled out Feb. 2013)
Form W-2 SafeHarbor
Employee A is full-timer of Corp. Z from Jan. 1, 2015 through Dec. 31, 2015. Z offers minimum essential coverage during that period that meets the minimum value requirements.
A’s contribution is $100 per month. A’s Form W-2 wages for 2015 are $24,000 Affordable?
– Yes. Monthly premium ($100) x 12 months to get the employee’s contribution cost ($1,200)
– Next take the employee’s contribution cost and divide by his W-2 annual wage amount ($1,200/$24,000) to get the percentage of the employee contribution (5%)
Form W-2 SafeHarbor
Employee B is full-timer employed by Corp. Y from Jan 1, 2015 through Sept. 30, 2015.
Y offers B and her dependents minimum essential coverage during that period that meets minimum value requirements.
B’s contribution is $100 per month. B’s Form W-2 wages are $18,000 Affordable?
– Yes. $100 X 9 months (# months employed & offered coverage)= $900/$18,000=5% of employee’s wages.
Form W-2 SafeHarbor
Employee C is full-timer employed by Corp. X from May 15, 2015 through Dec. 31, 2015.
X offers C coverage on Aug. 1, 2015 (90 day waiting period).
Employee contribution for self-only coverage is $100 per calendar month.
C’s Form W-2 wages are $15,000 Affordable?
– Yes. Take wages ($15,000) and multiple by 5/8 (the proportionate share of covered months over employed months during the year)= $9,375; multiply that figure by the employee’s contribution cost ($500)=5.33%of wages
Rate of Pay SafeHarbor
Co. employs D full-time from Jan. 1, 2015 through Dec. 31, 2015. Co. offers D and his dependents minimum essential coverage during the period that meets the minimum value requirements.
Employee contribution is $85 per month D is paid a rate of $7.25 per hour for the entire year. Take 130 hours (monthly) service X $7.25= $942.50 Compare $85 figure to assumed income $942.50 Affordable?
– Yes. $85/$942.50=9.01% of employee’s income per month
Rate of Pay SafeHarbor
E employed by V from May 15, 2015 through Dec. 31, 2015.
V offers E coverage from Aug. 1-Dec. 31, 2015 Employee contribution for self-only coverage is
$100 per month. May 15-Oct. 31, 2015, E paid $10 per hour Nov. 1-Dec. 31, 2015, E paid $12 per hour Affordable?
– Yes. V may assume that E earned $1,300 per month (130 hours of service X lowest hourly rate of pay for calendar year); $100/$1,300=7.69% of income per month
FPL SafeHarbor
F is employed by W from Jan. 1, 2015 through Dec. 31, 2015. W offers coverage providing minimum essential coverage during
the period that meets minimum value. W uses a “look-back measurement” method, under which F is
treated as a full-timer the entire year. W is credited with 35 hours per week, but only works 20 hours
in March and 15 hours in August FPL for individual is $11,170. W determines monthly
contribution of 9.5% X $11,170 = $1,061. 15/12=$88.42 monthly contribution
Affordable? – Yes. Because regardless of F’s actual wages for any calendar month
(like March and August when F has lower wages b/c of lower hours of service), coverage is treated as affordable under the FPL Safeharbor
HHS Final Rule: Minimum Value
February 25, 2013: HHS issued final rules on Minimum Value and described several options for determining MV. – Use the Minimum Value Calculator – Safe Harbors developed by HHS or IRS – Non-standard plans: Actuarial certification from a
member of the American Academy of Actuaries – Small group plan: provides bronze level plan.
MV Calculator
Allows employers to determine if their employer sponsored plan covers no less than 60% of total allowed costs
Based on 2009 data where enrollees continuously enrolled for 12 months
Denominator: avg allowed cost of all services for the standard population in the year
Numerator: share of avg allowed cost covered by the plan, using the cost-sharing parameters specified
MV Calculator
Select user inputs for plan parameters – Integrated (applies to both medical & Rx) or Separate
deductible, maximum out-of-pocket, and/or coinsurance spending limits
– Grandfathered Plan Option—user may enter cost-sharing for preventive services (cannot select this option for other plans)
– HSA/HRA Employer Contribution Option – Blended Network/Point of Service (POS) Plan
MV Calculator available at: cciio.cms.gov/resources/files/mv-calculator-final-2-20-2013.xlsm http://cciio.cms.gov/resources/regulations/index.ht
MV: IRS Proposed Regulations
May 3, 2013: IRS Proposed Regulations—purpose to clarify the health benefits considered in determining the “share of benefit costs paid by a plan.” – HSAs: employer contributions for current plan year
considered in determining plan’s share of costs for MV. – HRAs integrated into group health plan: employer’s
current year contributions considered in plan’s share of cost only for cost-sharing
– Wellness programs: reduction in cost-sharing through wellness programs may count toward MV only if every individual satisfies the terms of a non-discriminatory program aimed at tobacco prevention/reduction.
MV Safeharbors
IRS proposed rule has three safe harbors for determining MV – Plan with a $3,500 integrated medical & drug
deductible, 80% cost sharing and $5,000 max out of pocket limit.
– Plan with $4,500 integrated deductible; 70% cost sharing, $6,400 max out of pocket limit, $500 employer contribution to HAS.
– Plan with $3,500, $0 drug deductible, 60% medical cost sharing, $10/$20/$50 copay tiered drug plan and 75% coinsurance for specialty drugs.
– IRS has request suggestions for other common plans that would satisfy MV.
IRS MV Regulations: Other Issues Clarifies that former employees eligible for retiree
coverage are excluded from eligibility for premium tax credits only if they enroll in such coverage
Active employees eligible for COBRA coverage b/c of reduced hours will have eligibility for premium tax credit determined applying the same MV rules that apply to other active employees.
Employer penalty & FLSA violation if: – Employer that fails to offer MV but requires employees
to accept a sub-MV plan (DQ’ing the employee from receiving a premium tax credit b/c he/she is enrolled in employer coverage).
IRS Proposed Regulations: Affordability Affordability: employer HSA contributions &
contributions to HRAs integrated into group health plan (cost-sharing only) can be considered to increase the affordability of employee coverage. – Wellness incentives that reduce premium will NOT be
considered to increase affordability except for premiums charged to tobacco users who complete a non-discriminatory wellness program related to tobacco use.
– 2014: if employee receives premium tax credit because plan unaffordable, employer not subject to employer mandate penalty if: Coverage would have been affordable had employee satisfied
requirements of the non-discriminatory wellness program in effect at the time of the publication of the rule.
Process & Appeals
1. Employee seeks coverage through the Exchange and seeks subsidies for coverage.
2. If not eligible for Medicaid, Exchange will make a determination on eligibility for subsidies based on information provided by employee (employee supposed to provide all relevant information regarding plans available from employer(s))
3. Notice of Eligibility provided to employee and employer
– Small employers may receive these – this does not mean there is liability for penalties.
Process & Appeals
4. If employee denied tax credit/cost sharing subsidy, has 90 days to appeal to the Exchange
30 days to appeal to HHS, judicial review 5. If employee is held eligible for tax credit/cost
sharing subsidy, employer has 90 days from the date of the determination letter to request an appeal to the Exchange
– Appeal can be requested by telephone, mail, in person where available, or by Internet.
– Employee notified of appeal and both opportunity to submit additional information to the Exchange (i.e. Employer may want to show that individual is not an “employee” or that it meets a safeharbor
Process & Appeals
5. Appeal must be of determination that employer – Does not offer coverage; – Offers coverage that is not affordable; or – Offers coverage that does not meet the minimum value
standards Review by one or more impartial officials who have not been directly involved in the employee eligibility determination.
6. Exchange/appeal agency must provide written appeal decision within 90 days of the date the appeal request is received.
– Unlike individual appeal, employer has no right to appeal to HHS in the event Exchange rules unfavorably upon the appeal
Process & Appeals
Employer may contest tax penalties through separate IRS tax appeal procedures.
Unclear how Exchanges, HHS & IRS will coordinate information that arises from these various procedures
HHS currently working on standardized template for employers to use to gather, submit and disseminate information about their coverage options to allow an Exchange to verify whether an employee has access to employer-based insurance coverage and/or the value of that coverage
Employer Responsibility Provision Checklist Step 1: Large Employer
– Most will be clear, but for those close to 50 FTEs, need to consider Aggregate Rules & Methods of Calculation
Step 2: Determine full-timers – Look-Back Period (standard measurement period)
Step 3: Determine affordability – W2 Form, Rate of Pay, FPL
Step 4: Determine minimum value – Minimum Value Calculator
Step 5: Certification, Process & Appeal – HHS working on standardized template for employers to
use to gather, submit and disseminate info about plans
Employer Reporting Requirements: 2013 January 2013: Beginning with the 2012 taxable
year, employers with 250+ are required to report the value of the employer-sponsored group health plan benefits on employees’ annual Form W-2 – Mandatory reporting for ALL large employers 2015
Employer Reporting Requirements: 2013 March 2013: Employers must provide written
notice to all new hires and current employees of: – Existence of an exchange – Employee’s potential eligibility for tax credit and subsidy – Employee’s potential loss of employer contribution if
employee purchases plan through exchange Small employers should provide notice too DOL has extended Exchange notice deadline to
“late Summer or early Fall 2013”
DOL: Temporary Guidance & Model Notice Applicable employers?
– Section 18B of the FLSA: (1) one or more employees; (2) interstate commerce; (3) generally at least $500,000 in annual volume of business; (4) hospitals, nursing homes, schools
Who gets notice? – All employees regardless of plan enrollment status or
part-time/full-time status Content?
– Must inform employees (1) of the Exchange; (2) eligibility to qualify for tax credit; (3) loss of employer contribution & that all or some of the contribution may be excludable from income for income tax purposes.
DOL: Temporary Guidance & Model Notice Timing?
– New Hires: Must provide notice to new employees at the time of hiring beginning on October 1, 2013; 2014: DOL considers notice timely if provided within 14 days of
employee’s start date
– Current Employees: Must provide notice not later than October 1, 2013;
Manner? – Notice must be automatic and free of charge to
employees & must be provided in writing either: Via first-class mail OR electronically pursuant to 29 CFR
2520.104b-1.
DOL: Model Notices
One model for employers who do not offer health pan
One model for employers who offer a health plan to some or all of its employees
Employers may use, these models or a modified version, provided the notice meets the content requirements.
COBRA Model Notice: revised to make qualified beneficiaries aware of other coverage options available on the Exchange.
http://www.dol.gov/ebsa/healthreform/
Whistleblower Provisions
Whistle blower Provisions
DOL: No employer shall discharge or discriminate against “any employee with respect to his or her compensation, terms, conditions, or other privileges of employment” because employee has “received” credit or subsidy. – Employee’s hours or pay may not be reduced for having
received a subsidy – Leaves open whether courts will view whistleblower
provisions as applicable to the reduction of an employee’s hours so that employee would not have coverage and also not be full-time an ineligible for subsidy (triggering event to employer penalties)
Complainant must show that protected activity was a “contributing factor” leading to the adverse employment action
Whistleblower Provisions
IRS interprets whistleblower provisions to close loophole: – Mandatory enrollment in unaffordable plans will be
viewed the same as not supplying any benefits and the employer will be penalized as though it did not offer any coverage at all (i.e. $2,000 X (# full-timers-30)).
IRS’s interpretation means that employee does not actually need to receive the premium subsidy/credit in order for the ACA whistleblower protection to apply.
Small Business Health Option Program Small Business Health Option Program: Eligible
employees may receive subsidies for coverage obtained through SHOP exchange (if make between 133%-400% FPL) – April 1, 2013: Obama administration announced delay in
33 federally-run SHOP exchanges Benefit of offering coverage: premiums are tax
deductible for the employer (lose out on tax deduction if stop offering coverage)
Small Business Tax Credits
Small businesses (up to 25 FTEs with average annual salary of less than $50,000) can get up to 50% tax credit for 2014 and 2015 if they purchase coverage from a SHOP
Want more?
Contact: Katherine L. Georger – [email protected]
For more information about health care topics, including the ACA, and for a schedule of our upcoming health law events please visit Holland & Hart’s Health Law Blog – www.hhhealthlawblog.com
Resources
For general ACA information and recent regulations, including the IRS’s Proposed Employer Responsibility Provision rules visit – http://www.cms.gov/cciio/index.html
The Center for Consumer Information & Insurance Oversight – http://www.cms.gov/cciio/resources/regulations-and-
guidance/index.html Dep’t of Labor—Notice Requirements
– http://www.dol.gov/ebsa/healthreform/