Yesterday the IRS released final regulations regarding the PCOR fee that applies to insured and self-insured health coverage. The PCOR fee is intended to fund research and other grants. The final regulations adopted the proposed regulations, but the final regulations do provide additional details on certain types of questions, including the following –• COBRA coverage is included in determining the PCOR fee. • A self-insured plan can exclude coverage provided through insured options in calculating the fee. • Only US residents are included in the PCOR fee, who are persons with a place of abode in the United States. • Special calculation rules for covered lives apply to a plan year beginning before July 11, 2012 and ending on or after October 1, 2012. • Employers (and not TPAs) are required to report and pay the PCOR fee. • Retiree-only plans are subject to the PCOR fee. The final regulations also adopted the following exclusions for certain types of coverage, based on the proposed regulations – • Employee assistance programs, wellness programs and disease management programs are excluded, if those programs do not provide significant medical benefits. • Stand-alone dental and vision benefits are excluded. • Health FSAs are excluded, if the health FSA is a HIPAA excepted benefit. Special rules also exist for counting covered lives when a plan offers more than one self-insured medical option, separate prescription drug coverage, and for HRAs.
While we are pleased to have you contact us by telephone, surface mail, electronic mail, or by facsimile transmission, contacting Kilpatrick Townsend & Stockton LLP or any of its attorneys does not create an attorney-client relationship. The formation of an attorney-client relationship requires consideration of multiple factors, including possible conflicts of interest. An attorney-client relationship is formed only when both you and the Firm have agreed to proceed with a defined engagement.
DO NOT CONVEY TO US ANY INFORMATION YOU REGARD AS CONFIDENTIAL UNTIL A FORMAL CLIENT-ATTORNEY RELATIONSHIP HAS BEEN ESTABLISHED.
If you do convey information, you recognize that we may review and disclose the information, and you agree that even if you regard the information as highly confidential and even if it is transmitted in a good faith effort to retain us, such a review does not preclude us from representing another client directly adverse to you, even in a matter where that information could be used against you.