On Thursday, NAHU submitted comments to the Treasury Department in response to their request for information (RFI) on reducing the regulatory burden of the ACA concerning President Trump’s executive order issued on January 20. We advocated for the Trump Administration to provide better compliance education, avoid lengthy and confusing resources, and establish reasonable deadlines, lengthy transition periods, and ample time for comment. We specifically addressed issues for improvement with employer reporting, opt-out requirements, the health insurance tax (HIT), forthcoming Section 105h non-discrimination rules, section 125 regulations, Form 5500 health and welfare reporting, expatriate health plans, short-term policies, and other issues. Our comment letter follows comments sent in prior weeks for similar RFIs to the Department of Labor and the Centers for Medicare and Medicaid Services.

Employer Reporting

• Allow for a voluntary certification system for employers to report if they are offering coverage.
• Permanently extend the distribution deadline for 1095 B and C forms to March 1, and the deadline to submit forms to March 31.

Employer Mandate

• Exempt employers subject to the employer mandate from having to meet small group participation requirements.
• Adopt a national maximum for premium adjustments based on low participation requirements.
• Clarify that issuers may only impose renewal participation requirements for those subject to the employer mandate if a state law requires a minimum participation requirement.
• Specify that all issuers, including stop-loss plans, treat all individuals offered coverage based on full-time status during the measurement period, as full-time for coverage participation requirements during the stability period.
• Clarify accommodations for individual enrollments of newly eligible employees.

Opt-Out Requirements

• Rescind the proposed rule issued on July 8, 2016, that was not finalized.

Cadillac/excise Tax

• Promote materials to employers on how the administration plans to implement the tax.
• Review feedback from Notices 2015-16 and 2015-52 and provide information to employers about implementation of the tax regarding their plans.
• Publicize information on how adjustments will be made to the statutory threshold to current levels, how the coverage valuation will be calculated, and how adjustments will be applied.

Health Insurance Tax (HIT)

• Clarify that the HIT’s collection will no longer be considered as taxable business revenue of issuers, to prevent this from being a “tax on a tax.”

Patient-Centered Outcomes Research Institute (PCORI) Fee

• Discontinue the practice of requiring health reimbursement arrangements to calculate and pay PCORI fees separately.

Non-Discrimination (105h)

• Continue previous policy to not issue regulations and to not enforce compliance beyond the requirements currently in force on self-funded plans.

Section 125 Regulations

• Review, revise, and reissue the proposed regulations issued on August 6, 2007, to provide compliance certainty to employee benefit plans.

W-2 Reporting

• Continue previous policy of not issuing regulations to require expanded compliance with W-2 Reporting for smaller employers for at least the next four years.

HSA Embedded Deductible

• Rescind the guidance prohibiting application of the statutory requirement that an individual’s deductible and maximum out-of-pocket costs must be two times the amount of self-only coverage; encourage Congress to address the gap between high deductible health plan requirements and the ACA’s mandates for out-of-pocket limits.

Health and Welfare Form 5500

• Finalize the proposed rule issue on December 5, 2016, with significant changes: eliminate the proposed “Schedule J” reporting and restore the reporting exemption for small welfare plans; allow a reporting exemption for health plans that qualify for the small plan exception and those that are excepted benefits under the Health Insurance Portability and Accountability Act.

Expatriate Health Plans

• Review the comments to the expatriate act and make amendments to ensure American insurers will be on a level playing field with foreign competitors and that American expatriates doing missionary work will not be penalized.

Excepted Benefits and Short-Term Policies

• Do not finalize the excepted benefit provisions of the proposed rule issued on June 10, 2016, and rescind the draft requirements.

Rescind the 2016 short-term policy rule and encourage the National Association of Insurance Commissioners to continue its efforts of improving model legislation and regulations establishing minimum standards for limited duration policies.