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FAQS ABOUT AFFORDABLE CARE ACT
IMPLEMENTATION PART 37
U.S. Department of Labor
Employee Benefits Security Administration
January 12, 2017
Set out below are additional Frequently Asked Questions (FAQs) regarding implementation of the
Affordable Care Act. These FAQs have been prepared jointly by the Departments of Labor (DOL),
Health and Human Services (HHS), and the Treasury (collectively, the Departments). Like previously
issued FAQs (available at and www.dol.gov/ebsa/healthreform/index.html
), these FAQs answer questions from
www.cms.gov/cciio/resources/fact-sheets-and-faqs/index.html
stakeholders to help people understand the law and benefit from it, as intended.
HEALTH REIMBURSEMENT ARRANGEMENTS
On September 13, 2013, DOL published Technical Release 2013-03
addressing the application of the
Affordable Care Act market reforms to health reimbursement arrangements (HRAs) and employer
payment plans (EPPs).
The Treasury Department and the Internal Revenue Service (IRS)
contemporaneously published parallel guidance in Notice 2013-54,
and HHS issued guidance stating
that it concurred in the application of the laws under its jurisdiction as set forth in the guidance
issued by DOL, Treasury, and IRS.
Subsequent guidance reiterated and clarified the application of
the market reforms to HRAs and EPPs.
EPPs and HRAs typically consist of an arrangement under which an employer reimburses medical
expenses (whether in the form of direct payments or reimbursements for premiums or other medical
costs) up to a certain dollar amount. As explained in Technical Release 2013-03 and Notice 2013-54,
Technical Release 2013-03 is available at . http://www.dol.gov/ebsa/newsroom/tr13-03.html
Section 1001 of the Affordable Care Act added new Public Health Service Act (PHS Act) sections 2711-2719. Section
1563 of the Affordable Care Act (as amended by Affordable Care Act section 10107(b)) added Internal Revenue Code
(Code) section 9815(a) and Employee Retirement Income Security Act (ERISA) section 715(a) to incorporate the
provisions of part A of title XXVII of the PHS Act into the Code and ERISA, and to make them applicable to group health
plans and health insurance issuers providing health insurance coverage in connection with group health plans. The PHS
Act sections incorporated by these references are sections 2701 through 2728. Accordingly, these referenced PHS Act
sections (i.e., the market reforms) are subject to shared interpretive jurisdiction by the Departments.
2013-40 IRB 287. Notice 2013-54 is available at . http://www.irs.gov/pub/irs-drop/n-13-54.pdf
See Insurance Standards Bulletin, Application of Affordable Care Act Provisions to Certain Healthcare Arrangements,
September 16, 2013, available at https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/cms-hra-
. notice-9-16-2013.pdf
There have been several issuances on the topics addressed in the 2013 guidance: (1) FAQs About Affordable Care Act
Implementation (Part XI), issued on January 24, 2013 by DOL ( ) and HHS http://www.dol.gov/ebsa/faqs/faq-aca11.html
( ); (2) IRS Notice 2013-54 http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs11.html
and DOL Technical Release 2013-03, issued on September 13, 2013; (3) IRS FAQ on Employer Healthcare Arrangements
( ); (4) FAQs About Affordable Care Act http://www.irs.gov/Affordable-Care-Act/Employer-Health-Care-Arrangements
Implementation (Part XXII), issued on November 6, 2014 by DOL ( ) and HHS http://www.dol.gov/ebsa/faqs/faq-aca22.html
( ); (5) Notice 2015-17, http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FAQs-Part-XXII-FINAL.pdf
2015-14 IRB 845, issued by Treasury and IRS on February 18, 2015; and (6) Notice 2015-87, 2015-52 IRB 889, Q&A-1 to
Q&A-6, issued by Treasury and IRS on December 16, 2015. See also 26 CFR 54.9815-2711(d), 29 CFR 2590.715-2711(d),
and 45 CFR 147.126(d) (80 FR 72192, Nov. 18, 2015).