Affordable Care Act Mandate Enforcement Continues

From ChamberChoice

Under the Affordable Care Act (ACA) taxpayers are required to maintain what is considered “minimum essential coverage” (MEC) health care for themselves, their spouses and dependents, as applicable. Failure to maintain MEC during any month in the year (with limited exceptions) exposes a taxpayer to a “shared responsibility” penalty. Because the tax penalty has the effect of requiring individuals to have health coverage, this aspect of the ACA is commonly referred to as the “individual mandate.”

Additionally, the ACA requires that an Applicable Large Employer (ALE) offer its full-time employees and dependents minimum essential coverage. That coverage must also provide minimum value and be affordable for the full-time employee. If the employer does not meet this responsibility, and a full-time employee receives subsidized coverage from the Marketplace, then the employer may be assessed a penalty. The amount of the penalty will depend on whether the offer of MEC was met (it must be offered to 95 percent of full-time employees and dependents), and whether the coverage offered was affordable minimum value. This penalty is referred to as the “employer mandate.”

The Internal Revenue Service is the agency that is responsible for the enforcement of both mandates.

Individual Mandate

For individuals who were covered with minimum essential coverage in 2015, coverage providers began providing individuals with a Form 1095-B or 1095-C in 2016. This information was also provided to the IRS as assistance with the administration and enforcement of the individual mandate. These forms are required to be provided every year in January as long as the ACA is in effect.

Taxpayers use the information from a Form 1095-B or 1095-C to indicate on their 1040 tax filing whether they and everyone on their returns had health coverage, were exempt from the health coverage requirement, or are making a penalty payment. In response to President Trump’s executive order telling agencies to exercise authority and discretion to reduce potential burdens under the ACA, the IRS accepted 2017 tax returns, regardless of whether the health coverage information was or was not provided. Thus, the tax filing process may have been delayed, but it was not rejected.

In mid-October, the IRS stated that for the 2018 tax filings, electronic taxpayer returns that do not indicate meeting the ACA health coverage requirements or are not paying the penalty will be rejected. If a taxpayer files a paper return, the IRS provides it could suspend processing of the return and delay any taxpayer refund if the filing omits information addressing the individual shared responsibility.

Employer Mandate
As to the employer mandate, the IRS has confirmed that employers are still subject to the mandate and compliance is expected. There are indications that the IRS will begin mandate enforcement and will begin issuing penalty notices. Take note, “indications” does not mean a confirmed statement from either the IRS or
the Administration.

As a reminder, an ALE’s ACA reporting obligation requires that it must provide its full-time employees a Form 1095-C by Jan. 31 of every year. The employer then files a Form 1094-C with the IRS attaching copies of the 1095-C distributed to employees.

In 2016, the IRS sent letters notifying employers that they may be noncompliant with their ACA reporting obligations. This communication gave employers the opportunity to either file their ACA returns late, or provide further information to the IRS. However, receipt of a letter, or actually not receiving a letter, was not a determination that the employer would, or would not be penalized.

The IRS’ guidance on the collection of information under the individual and employer mandates is a reminder that the Affordable Care Act is still a viable law and requires compliance. The ultimate enforcement
of the ACA mandate provisions by the agency remains to be seen and probably relies on further Administration guidance. In the meantime, employers should continue their ACA compliance strategy in order to avoid possible penalties. If that strategy consisted of not complying with the mandate, then a possible strategy review may need to be considered.

Businesses & Individuals Encouraged to Explore Health Insurance Options During Open Enrollment

Panelists at the recent community health insurance forum included (L-R); Craig Pritts, ChamberChoice; Craig Shively, Geisinger Health Plan; Sandy Darlington, Columbia Montour Area Agency on Aging; and Mark Middlebrook, PA Health Access Network.

As evaluating and selecting health insurance in today’s ever-changing environment is confusing, resources exist to help individuals and businesses choose the best option. At a recent community forum co-sponsored by the Chamber, panelists advised people on the marketplace to reevaluate their coverage. This year’s timeline for making changes is considerably shorter than in previous years, as open enrollment ends Dec. 15.

Recent changes to the Affordable Care Act are significantly impacting health insurance marketplace rates, particularly with silver-level plans, according to the panelists. In some cases, gold-level plans with better benefits can be competitive with silver plans. Group plans have also seen smaller annual increases, compelling small business owners to revisit the overall affordability of having an employer-sponsored plan.

The forum, held Nov. 15 at The Greenly Center, was co-sponsored by the United Way of Columbia and Montour County. Panelists included representatives of Geisinger Health Plan, the Columbia Montour Area Agency on Aging, the PA Health Access Network, and ChamberChoice, the Chamber’s member benefits program. The PA Health Access Network offers the services of free navigators to help individuals register and enroll with the marketplace. ChamberChoice agents can also help individuals select plans and work with members to set up group plans for employers, including health savings accounts and flexible spending accounts. Certified counselors at the Agency on Aging can work with anyone of any age who is eligible for Medicare. Geisinger Health Plan has local representatives to help individuals and businesses understand their options on and off the marketplace.

State Legislation Aims to Reduce Opioid Abuse

Recently, President Trump declared the opioid epidemic a national public health emergency, which is touching all socioeconomic classes. From a legislative perspective, one strategy for addressing the crisis would be to implement a prescription drug formulary in Pennsylvania’s workers’ compensations system, which would streamline medication prescriptions to help patients avoid the overuse that can result in addiction. In doing so, it is also expected to lower rising costs within the workers’ compensation system – as has been proven in other states like Ohio, where the number of opioid prescriptions dropped by 38 percent and the number of opioid-dependent WC patients was reduced by half just three years after their formulary was adopted.

Over 70 chambers from across Pennsylvania, including the Columbia Montour Chamber, are supporting House Bill 18 and Senate Bill 936, which would create a drug formulary. A letter was sent to members of the General Assembly in mid-November. S.B. 936 recently cleared the Senate with bipartisan support and the House is expected to consider the legislation in the few session days remaining this year.

Organizations and individuals are also encouraged to contact their state representative and urge them to support S.B. 936. Tell them that drug formularies are common across other state workers’ compensation systems, private healthcare and public programs like Medicare and the Children’s Health Insurance Program; and have been shown to help address overuse of and addition to prescription drugs among injured workers in the states that adopt these policies.

Welcome McDonald’s in Berwick, Bloomsburg, Elysburg and Mifflinville

More than 400 businesses and organizations belong to the Chamber to receive benefits and support efforts to strengthen their businesses and our region. Increased membership allows us to offer additional programs and benefits, have a stronger voice in advocacy and be involved in more activities and initiatives in our communities. The Chamber welcomes its newest members, four McDonald’s franchise locations in and around Columbia County, to help us fulfill our mission.

The McDonald’s in Bloomsburg, Berwick, Mifflinville and Elysburg are all owned by franchisee R&K Foods of PA, and we welcome all four locations as our newest members in the Chamber. These locations in and around Columbia County are just four of the more than 36,000 McDonald’s restaurants around the world, more than 80% of which worldwide and nearly 90% of which in the United States, are owned and operated by approximately 5,000 independent small and mid-sized businessmen and women as franchises. The McDonald’s in Bloomsburg recently debuted a new touch-screen kiosk that allows customers to place their own orders, which can then be brought directly to their table. The McDonald’s in Bloomsburg is located at 945 New Berwick Highway (Rt. 11), and can be reached at 570-784-3906. McDonald’s in Berwick is located at 10 Briar Creek Plaza, right in front of Giant and across the street from Sheetz just off Route 11, and can be reached at 570-752-2729. McDonald’s in Mifflinville is located at 435 West 3rd St., just off exit 242 on I-80 and can be reached at 570-752-4333. McDonald’s in Elysburg is located at 1 W Valley Ave (Rt. 487), right next to Sheetz and can be reached at 570-672-2890. 

McDonald’s in Elysburg

McDonald’s in Mifflinville

McDonald’s in Berwick

McDonald’s in Bloomsburg

Member News – November 22, 2017

Member News

  • Longstanding local retail floral owner Todd D. Wagner enthusiastically announced the acquisition of the assets of Ralph Dillon’s Flowers on Nov. 13. Dillon’s customer base both locally and out of the area will be serviced by Bloomsburg Floral and Berwick Floral from the headquarters at 201 W. 2nd St., Berwick.After the passing of Ralph Dillon, Jr. earlier this year, the retail location of Ralph Dillon’s Flowers at 254 East St., Bloomsburg, was closed as they searched for a potential buyer or partner to continue the operation. Effective Nov. 13, an agreement was reached with Dillon’s family giving Wagner the authority to service all existing customers of the operation.Ralph Dillon’s Flowers was an institution in Bloomsburg for decades and served their customer base with quality products and outstanding customer service. Wagner entered the retail floral business in 1996 with the purchase of Bloomsburg Floral Center and then acquired Berwick Floral Center and The Flower Station in Benton. In 2013, Wagner expanded his Berwick operation with the purchase of the Nardi Funeral Home building at 201 W. 2nd St., Berwick, where he opened The Shoppes at Woodin Place, which houses his floral and gift establishment, Autumn’s Haven, Suntex Dry Cleaners and a host of other consignment vendors. Berwick Floral hosted a Chamber Business After Hours last week. 


  • Secret Agent 23 Skodoo will bring its unique kid-friendly hip-hop to the Weis Center for the Performing Arts on Tuesday, Dec. 5 at 7 p.m.

    Secret Agent 23 Skidoo

    The performance is free and tickets are not required. More Fraggles than Wiggles, more Soul Train than Thomas the Train, Secret Agent 23 Skidoo is equal parts Dr. Seuss and Dr. Dre. This Grammy-winning artist combines the excitement of hip-hop with the magical world of childhood. With sophisticated instrumental funk and positive, witty wordplay, he has earned a loyal national following. His latest album, Infinity Plus One, took home the Grammy Award for Best Children’s Album of the Year. 



  • Dr. David Hamilton of Hamilton Dental Care and president of the The Jubilate Choir and Orchestra, is pleased to announce The Jubilate Choir and Orchestra’s Annual Christmas Concert, A Holy Night of Angels, will be on Saturday, Dec. 9 at 7 p.m. and Sunday, Dec. 10 at 3 p.m. The choir and orchestra, under the direction of Dr. Alan J. Hack, is made up of community singers and instrumentalists along with Mrs. Kathy George accompanying on the piano. It invites all to join them at St. Matthew’s Lutheran Church, 123 Market St., Bloomsburg for this exciting concert, a high point of the Christmas season celebration in our area!