With decades of experience working at the intersection of employee benefits and health care law, Hodgson Russ is well positioned to address employer concerns in connection with the broad provisions of the Patient Protection and Affordable Care Act (Affordable Care Act or ACA).

Keeping up with the continuous flow of ACA guidance and case law is a major challenge for employers and group health plans, both insured and self-insured. Meeting this challenge requires the help of legal advisors who are willing and able to master the complex provisions of the ACA, react quickly and intelligently to new developments, and help clients cost-effectively implement any changes that may be needed. In particular, we have demonstrated experience successfully defending clients from assessments under the employer mandate of the ACA, including preparing mandatory tax filings and adopting plan design strategies to avoid exposure to penalty assessments.

Our Experience

We have successfully defended dozens of employers to avoid millions of dollars in proposed assessments.

We assist employers in determining:

  • “Applicable Large Employer” status based on controlled group
  • Full-time employee status (standard and “lookback measurement period”)
  • Medical coverage affordability (W-2, rate of pay, and federal poverty line safe harbors)

We assist employers with ESRP annual filing:

  • Line-by-line guidance on completing IRS Forms 1094-C and 1095-C
  • Requesting a filing deadline extension

We defend employers receiving ESRP Proposed Assessment or Late Filing Letters from the IRS:

  • Preparing a response strategy
  • Drafting a written statement and coordination of substantiating documents
  • Representing employer in pre-assessment conference with IRS

We design strategies to help employers avoid or mitigate future potential proposed assessments.

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Affordable Care Act / News & Insights