2022 Compliance and Reporting Requirements

Some of the COVID-related reporting requirements are ending. However, others are resuming or being introduced for the first time.

Pharmacy and Health Care Spending Reporting

The Consolidated Appropriations Act (CAA) requires all employer groups who offer health plans, along with insurers and pharmacy benefit managers, to submit information on pharmacy and health care spending to the Departments of Health and Human Services (HHS), Labor (DOL) and Treasury. HHS plans to use the information to compile an annual report beginning in 2023 on the impact these costs have on premiums and consumer out-of-pocket costs.

The first reporting deadline is December 27, 2022, and then changes to June 1st each year after that.

PCORI Fee Adjustment

For plan years that end on or after October 1, 2021, and before October 1, 2022, the new PCORI fee is $2.79 per covered life. This payment is due on or before July 31, 2022.

ACA Safe Harbor Reporting

The IRS has decreased the affordability percentage index for eligible employees’ affordable health care options from 9.81% to 9.61% for 2022. Another slight increase, to 9.7%, is expected for 2023 but not yet confirmed.

“For employers who use the Federal Poverty Level (FPL) Safe Harbor method, coverage is deemed affordable if the employee’s required monthly contribution for the lowest-cost, self-only, ACA-compliant coverage does not exceed the FPL for a single individual. Eligible employees must not be required to pay more than $103.15 per month for plans beginning July 11, 2021, to December 31, 2022.”

Good Faith Relief for ACA Reporting Errors

Good faith relief for ACA Reporting errors has ended. Employers need to review forms 1094-B or C and 1095-C carefully before submitting them to the IRS each year. The annual deadline for reporting requirements has been moved permanently to March 2.

In addition, employer penalties have increased to $280 per employee for failure to provide form 1095-B or C plus $280 per employee for failure to file with the IRS, for potential employer penalties of up to $560 per employee.