Health Care

In order to navigate the complicated and ever-changing laws surrounding health care and your business, you need attorneys who understand your challenges. The Pittsburgh health care lawyers at Houston Harbaugh, P.C., have the knowledge and experience to help you manage everyday issues, as well as plan for the future.

New Year, New Delays for ACA Reporting Requirements

Among the more onerous requirements of the Affordable Care Act (the  ACA), employers are charged with completing numerous reports and filings regarding the health insurance provided to their employees.  The ACA requires that employers with 50 or more full-time equivalent employees (known in the ACA as “Applicable Large Employers”) use Form 1095 to report whether they provided their employees with access to affordable, minimum essential coverage at minimum value to employees.  These reports must be made for all employees who at any time in 2015 held full-time status for at least one month. Furthermore, any employer sponsoring a self-insured health plan must use Form 1095-C to report on all employees who participate in the health plan, including part-time employees and former employees electing COBRA coverage.

In response to trade and industry association requests, on December 28, 2015, the IRS and the Treasury Department extended the deadlines for several of these requirements through publication of Notice 2016-4.

For reports to individuals:

2015 Form 1095-B, Health Coverage, must now be given to individual employees by March 31, 2016 (originally a February 1, 2016 deadline).

  • 2015 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, must now be given to individual employees by March 31, 2016 (originally a February 1, 2016 deadline).
  • Notice 2016-4 also extended certain deadlines for employers to file the following four forms with the IRS:
  • 2015 Form 1094-B, Transmittal of Health Coverage Information Returns;
  • 2015 Form 1095-B, Health Coverage;
  • 2015 Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns; and
  • 2015 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.
  • The deadlines for filing these forms with the IRS depends on whether the forms will be filed in paper form or electronically.  If filing in paper form, the deadline has been extended from February 29, 2016 to May 31, 2016.  For electronic filers, the deadline has been extended from March 31, 2016 to June 30, 2016.

ACA penalties will be imposed on employers failing to comply with these extended deadlines.

Notice 2016-4 also addresses employees who may not receive, as a result of these extensions, their copies of Forms 1095-B or 1095-C by the time they file their 2015 individual income tax returns. These employees will not need to file this information with their tax returns, but will need to keep the forms with their income tax records once the forms are received.

The delays detailed in Notice 2016-4 will supersede any individually-filed extensions relating to 2015 tax returns and information statements.  Notice 2016-4 indicates that these individual requests will not be formally granted.

About Us

In order to navigate the complicated and ever-changing laws surrounding health care and your business, you need attorneys who understand your challenges. The Pittsburgh health care lawyers at Houston Harbaugh, P.C., have the knowledge and experience to help you manage everyday issues, as well as plan for the future.

Jessica Ellel Pittsburgh health care lawyer

Jessica A. Ellel - Practice Chair

Chair of Houston Harbaugh’s Health Law Practice, Jessica works almost exclusively with health care entities and health practitioners. She has extensive experience with:

  • Drafting and negotiating physician employment agreements from both the physician and employer perspectives
  • Negotiating contracts between physicians and hospitals
  • Preparing purchase agreements to govern the sale of medical practices
  • Advising on corporate governance issues, from practice formation to dissolution
  • Developing comprehensive compliance plans for physician practices, hospitals, third-party billing administrators, and other health care and related entities
  • Organizing strategies for compliance with fraud and abuse laws
  • Addressing HIPAA compliance

Jessica is especially well-versed in HIPAA compliance and authors numerous client updates and bulletins on the subject. She conducts on-site and remote HIPAA training and also maintains Houston Harbaugh’s HIPAA compliance manual, ” Federal HIPAA Privacy Standards Simplified: A Comprehensive Tool-Kit”.