Friday, December 4, 2015

Penalty Risk When Dropping Coverage for Unpaid Premiums During Leaves Under PPAA

 From Graydon Head & Ritchey LLP.:
... Fortunately, the path to avoiding ACA penalties in this situation should look very familiar for employers subject to COBRA.  
The IRS treats an employer as having made an offer of coverage to a full-time employee if coverage terminates because the employee fails to timely pay the premiums. Effectively, you can terminate the employee’s coverage without fear that the employee will go to the exchanges, receive a subsidy, and trigger the penalties. However, just like COBRA, the IRS treats a premium payment as timely if paid within a 30-day grace period, and it is considered paid on the date the employee mails the check. So, for our scenario above, you may need to hold tight through the beginning of the third month before you verify that premiums will not be timely paid and terminate coverage.   Once you terminate the coverage for failing to pay a premium, you do not have to offer the employee coverage again until the next open enrollment period even if the employee returns to work sooner, and then only if the employee returns to a full-time position or is determined to be a full-time lookback employee despite the time spent on leave. ...