IRS Proposes Ways to Determine ‘Minimum Value’ of Health Coverage

The Internal Revenue Service issued a trio of notices Thursday related to the health care reform law, including how one might determine whether a health insurance plan provides “minimum value.”

Notice 2012-31 describes and requests comments on several possible approaches to determining whether health coverage under an eligible employer-sponsored plan provides minimum value.

Beginning in 2014, eligible individuals who purchase coverage under a qualified health plan through an Affordable Insurance Exchange may receive a premium tax credit under Section 36B only if they are not eligible for other minimum essential coverage, including coverage under an employer-sponsored plan that is affordable and provides minimum value.

A plan fails to provide minimum value if the plan covers less than 60 percent of the total allowed costs of benefits provided under the plan.  If an employee receives a premium tax credit an applicable large employer may be liable for an assessable payment under Section 4980H, the IRS noted.

Notice 2012-32 invites comments on the reporting requirements under Section 6055 of the Tax Code for health insurance issuers, government agencies, employers that sponsor self-insured plans, and other persons that provide minimum essential coverage to an individual. 

Minimum essential coverage includes individual health insurance coverage, eligible employer-sponsored plans, and government-sponsored coverage such as Medicare, Medicaid, TRICARE, and veterans’ health care.  Entities that provide minimum essential coverage after Jan. 1, 2014, must file annual returns reporting information for each individual covered.

Notice 2012-33 invites comments on reporting under Section 6056 by applicable large employers. Section 6056 requires reporting of certain information on employer-provided health care coverage provided on or after Jan. 1, 2014. Notice 2012-33 advises the public that the Treasury and the IRS intend to propose regulations implementing Section 6056 and invites comments on issues arising under that section of the Tax Code, including on possible approaches for coordinating and minimizing duplication between the information required to be reported and furnished by employers under Section 6056 and information required to be reported and/or furnished by employers or other persons under other applicable Code provisions.