Practice Strengths

Now that the precedent-setting national health care reform legislation has been signed into law, clients across various industries are eager to understand the potential impact on their business. Baker Hostetler has positioned itself as a leading source of information on the intricacies of the new law.

Our attorneys, analysts and legislative professionals followed the proposed legislation throughout its life cycle, providing us with a deep understanding of the final law. To address those aspects of health care reform most likely to have an impact on businesses, and on healthcare industry providers and insurers, Baker Hostetler has assembled a comprehensive cross-practice Health Care Reform Group that includes representatives from our experienced Healthcare Industry, Employee Benefits, Tax, Employment and Labor and Legislative Teams. Through this collaboration, we bring clients the most up-to-date information on implementation and significant milestones for businesses, employers, hospitals, physicians and insurers. The group also works with clients to develop customized, creative solutions for reform-related issues employers and providers may face.

With seasoned practitioners on the Health Care Reform Team, Baker Hostetler is poised to assist clients navigate the complexities that lie ahead.

Our lawyers closely follow developments in health care reform and will keep you updated on such reform topics as:

For Businesses and Employers:

• Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act—updated12/8/2011
• Claims, Appeals and Review Processes—updated 8/31/2010 
• Coverage of Preventive Health Services—updated 7/16/2010
• Dependent Child Coverage—updated 9/15/2010
• Early Retiree Reinsurance Program—updated 6/30/2010
• Flexible Spending Accounts and Health Reimbursement Accounts—updated 9/9/2010
• Grandfathered Health Plans—updated 8/18/2011
• Informational Reporting Requirements—updated 7/16/2010
• Nondiscrimination Requirements—updated 1/7/2011
• Preexisting Condition Limits, Lifetime and Annual Limits for Essential Health Benefits, Rescissions and Patient Choice—updated 7/19/2010
• Small Business Health Care Tax Credit—updated 9/15/2010

Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act

Earlier this year, President Obama signed into law two sweeping health care reform bills (frequently referred to together as “PPACA” or the “health care reform law”). The first of the two acts, the Patient Protection and Affordable Care Act was signed into law on March 23, 2010. The second of the two acts or the “reconciliation bill,” the Health Care and Education Reconciliation Act of 2010, was signed into law on March 30, 2010.

Alerts:

• 12/8/2011—New FAQs Delay Summary of Benefits and Coverage Compliance Date and Provide Guidance on the Mental Health Parity Act
• 12/8/2011—The Controversy Over State-Based Health Insurance Exchanges: Politics As Usual or Dangerous Brinksmanship?
• 10/27/2011—Methods and Criteria to Define “Essential Health Benefits” Unveiled
• 9/1/2011—Health Reform: Agencies Publish Guidance on Summary of Benefits and Coverage and Uniform Glossary Disclosure Requirement
• 8/4/2011—DOL Forum Addresses Automatic Enrollment Concerns Under PPACA
• 7/21/2011—HHS Publishes Long-Awaited Guidance on Insurance Exchanges
• 7/21/2011—Employers Be Forewarned: Medicare Part D Annual Notices Must Be Provided Earlier
• 5/13/2010—Health Reform Implementation—Key Developments; Early Progress
• 5/13/2010—Health Reform: Beyond the Basics—What Every Business Needs to Know
• 4/8/2010—Health Care Reform: Employer Advisory
• 4/5/2010—Health Care and Education Reconciliation Act of 2010 (H.R. 4872): Summary of Main Tax-Related Provisions
• 4/1/2010—A Baker’s Dozen of Significant Changes in Health Reform
• 1/21/2010—Outlook on Health Reform: The Clock is Ticking
• 1/5/2010—House and Senate Health Care Proposals—Comparison of Key Tax Provisions

Resources:

• Unofficial consolidated version of PPACA and HCERA

Claims, Appeals and Review Processes

August 31, 2010—Regulatory Agencies Publish Interim Procedures for Federal External Review Processes for Non-Grandfathered Self-Insured Health Plans and Model Notices for Internal Appeal and External Review Determinations

Non-grandfathered self-insured group health plans now have guidance regarding the new requirements for federal external reviews of adverse benefit determinations. On August 26, 2010, the Departments of the Treasury, Labor, and Health and Human Services published a notice announcing the issuance of the Employee Benefits Security Administration’s Technical Release 2010-01 (the “Technical Release”). The Technical Release announces interim procedures that self-insured group health plans must implement for plan years beginning on or after September 23, 2010. The interim procedures will remain in effect until superseded by to-be-issued finalized guidance. Read More...

Resources:

• Availability of Interim Procedures for Federal External Review and Model Notices Relating to Internal Claims and Appeals and External Review Under the Patient Protection and Affordable Care Act; Notice
• Employee Benefits Security Administration’s Technical Release 2010-01
• Model Notice of Adverse Benefit Determination
• Model Notice of Final Internal Adverse Benefit Determination
• Model Notice of Final External Review Decision

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July 29, 2010—Guidance on Internal and External Appeals Processes Published

On July 23, 2010, the Departments of the Treasury, Labor and Health and Human Services (collectively, the “Departments”) jointly published interim final rules for group health plans and health insurance issuers relating to internal claims and appeals and external review processes under Section 2719 of the Public Health Service Act (as added by the Patient Protection and Affordable Care Act (“PPACA”)). These interim final rules generally apply for plan years beginning on or after September 23, 2010 (January 1, 2011, for calendar-year plans and policies). Notably, the new requirements effectively apply to all private-sector and public-sector group health plans and individual policies other than grandfathered group health plans and policies. Read More...

Resources:

• Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External Review Processes Under the Patient Protection and Affordable Care Act

COVERAGE OF PREVENTIVE HEALTH SERVICES

July 16, 2010—New Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Health Services Without Cost Sharing

On July 14, 2010, the U.S. Treasury Department, Internal Revenue Service, the Department of Labor’s Employee Benefits Security Administration and the U.S. Department of Health and Human Services issued interim final rules to implement the provisions of the new PPACA requiring non-grandfathered group health plans and health insurance issuers in the group and individual markets to provide coverage for preventive health services listed in certain recommendations and guidelines without imposing any cost-sharing requirements on covered individuals. The prohibition on cost-sharing includes copayments, coinsurance or deductibles. Read More...

Resources:

• Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services under the Patient Protection and Affordable Care Act (published in the Federal Register on July 19, 2010)

Dependent Child Coverage Up to Age 26

July 19, 2010—Model Notice for Extension of Dependent Coverage to Age 26 and Opportunity to Enroll

Beginning not later than the first day of the first plan year on or after September 23, 2010, plans providing dependent coverage must provide an enrollment opportunity, and a written notice regarding the same, for dependents whose plan coverage terminated, or who were not eligible for, or were denied, coverage, before the attainment of age 26. The notice may be included with other plan enrollment materials, as long as the statement is prominent. The Department of Labor has issued model language which may be used to satisfy this notice requirement. Read more...

Resources:

• DOL Model Language—Notice of Opportunity to Enroll in Connection with Extension of Coverage to Age 26

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May 28, 2010—Dependent Coverage to Age 26 (Effective for Plan Years beginning after September 23, 2010)

One of the first provisions of the new health care reform act (the “Act”) to be effective is the requirement to extend dependent coverage to children up to age 26. Regulations regarding this requirement were issued on May 13, 2010, and although the regulations do not answer all the possible questions regarding this provision of the Act, they do provide some much-needed guidance. Effective on the first day of the first plan year following September 23, 2010 (i.e. January 1, 2011, for calendar year plans), group health plans (including insured and self-funded plans) and health insurance issuers offering group or individual health insurance policies which offer dependent coverage, will be required to extend that dependent coverage to children up to age 26. Read More...

Resources:

• Interim Final Rule for Group Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient Protection and Affordable Care Act (Updated as of September 15, 2010)

Early Retiree Reinsurance Program

Early Retiree Reinsurance Program Interim Rule (Published May 5, 2010)

The Department of Health and Human Services (“HHS”) issued guidance implementing the Early Retiree Reinsurance Program (the “Program”) three weeks earlier than the deadline set by Congress. The health care reform legislation provided for the Early Retiree Reinsurance Program to become effective not later than 90 days after the health care reform legislation’s enactment, which would have been June 21, 2010. However, HHS issued an Interim Final Rule providing a June 1, 2010, effective date for reimbursements under the Program. Therefore, group health plan sponsors (i.e., employers, VEBAs, multiemployer plans, unions, employee organizations, or state or local governments) providing early retiree medical coverage should take action immediately to determine whether participating in the Early Retiree Reinsurance Program is right for them. While HHS has not yet released a final application form for the Early Retiree Reinsurance Program, plan sponsors interested in participating in the Program should take steps now to be ready. A plan sponsor must submit an application to HHS, the application must be approved, and the plan sponsor and plan must be certified by HHS in order for the plan sponsor to be eligible to participate in the Program. The Program will close on the earlier of January 1, 2014, or when the Program exhausts its funding of $5 billion. Additionally, HHS may stop accepting applications for participation in the Program once it determines that funding will be exhausted based upon the applications already received. Read More...

Resources:

• Interim Final Rule Regarding the Early Retiree Reinsurance Program
• HHS Early Retiree Reinsurance Program Frequently Asked Questions
• Early Retiree Reinsurance Program Application
• ERRP Application Instructions

See also:

• Questions and Answers Regarding the Early Retiree Reinsurance Program

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June 30, 2010—HHS Is Now Accepting Early Retiree Reinsurance Program Applications

HHS began accepting ERRP applications on June 29, 2010. Plan sponsors interested in applying for the ERRP must submit, via U.S. Postal Service, the signed paper original of their completed official ERRP application, along with any attachments, to HHS ERRP Application Center, 4700 Corridor Place, Suite D, Beltsville, MD 20705. Currently, HHS only is accepting hard copy applications (no electronic versions). Plan sponsors should note that prior versions of the ERRP application will not be accepted. Additionally, applicants should refer to the HHS’ "Dos and Don’ts" list for additional tips. As a reminder, because HHS plans to review and approve applications on a first-come, first-served basis, and may reject applications once it appears that the ERRP may run out of funds based upon applications received and approved, plan sponsors interested in participating in the ERRP will want to promptly submit accurate and complete applications.

If your company is applying for the ERRP and has questions, please contact , , , or any member of the Baker Hostetler Health Care Reform Team.

Resources:

• Final Early Retiree Reinsurance Program Application (posted on HHS website on June 29, 2010)
• Final Early Retiree Reinsurance Program Plan Sponsor Application Instructions (posted on HHS website on June 29, 2010)

See also:

• HHS Early Retiree Reinsurance Program Application Submission Dos and Don’ts
• The Affordable Care Act’s Early Retiree Reinsurance Program Answers to Frequently Asked Questions (Updated as of June 29, 2010) (published by HHS)

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June 14, 2010—Early Retiree Reinsurance Program Application Now Available

The Department of Health and Human Services (“HHS”) has made available the final form of the Early Retiree Reinsurance Program (“ERRP”) Application on its website. While HHS has not yet stated when or how the applications may be submitted, HHS has indicated that applications will be accepted beginning no later than June 30, 2010. The Application itself, and the instructions to the application, indicate that the Account Manager and/or the Authorized Representative of the plan sponsor are to complete the application. The “Authorized Representative” is an individual who generally holds legal authority to sign on behalf of, and bind, the plan sponsor to the terms of a contract or agreement. An Authorized Representative may be the plan sponsor’s CFO, CEO, President, general partner, Human Resource Director, or other individual in a position of similar status and authority, or, for a multiemployer plan, a member of the jointly appointed board of trustees which includes both labor and management trustees. The Authorized Representative must sign the Plan Sponsor Agreement portion of the application and certify that the information contained in the application is true and accurate to the best of the plan sponsor’s knowledge and belief. In contrast, the “Account Manager” is the individual who coordinates the application process for the plan sponsor, and may be an employee of the plan sponsor or an outside consultant (or other non-employee) assisting the plan sponsor with the application process. The Account Manager will serve as the plan sponsor’s primary contact with HHS with respect to the application. Only one individual may serve as an Authorized Representative and only one individual may serve as an Account Manager, at a time.

As a reminder, a plan sponsor must submit a separate application for each plan for which the plan sponsor desires to participate in the ERRP. The application must be fully completed and approved by HHS, and the plan sponsor and plan each must be certified by HHS to participate in the ERRP before the plan sponsor may submit eligible claims for reimbursement in the ERRP. Note that HHS may deny applications, even if they are complete, if it appears that the ERRP may run out of funds. Therefore, plan sponsors who are interested in participating in the ERRP should begin preparing their applications now, and should monitor this website and the HHS website for information regarding where and when to file the completed applications, to maximize their chances of filing a timely and complete application once HHS opens up the application process for submissions.

View the Application and the Instructions to the Application

 

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June 7, 2010—Draft Early Retiree Reinsurance Program Application Available on the Internet

A draft application for the Early Retiree Reinsurance Program (the “Program”) and draft instructions for the application have been posted by the Office of Management and Budget on the Internet. While the application has not yet been finalized by Department of Health and Human Services (“HHS”), the draft provides plan sponsors with insight regarding the actual information to be submitted on the application. The draft application closely follows the application requirements outlined in the Program’s Interim Final Rule guidance issued by HHS; however, the draft application provides additional points of clarification and identifies a few additional application requirements. We will post additional information to our Health Care Reform website once the finalized application is available.

View the Draft Application

 

Flexible Spending Accounts and Health Reimbursement Accounts

September 9, 2010—IRS Issues Guidance Regarding Use of Tax-Favored Vehicles to Pay for Over-the-Counter Medicines and Drugs

On September 3, 2010, the Internal Revenue Service (the "IRS") issued guidance under the Patient Protection and Affordable Care Act (the "Affordable Care Act") regarding the use of tax-favored vehicles to pay for over-the-counter medicines and drugs. The new guidance is set forth in IRS News Release IR-2010-95, IRS Notice 2010-59 and Revenue Ruling 2010-23. Read More...

 

Grandfathered Health Plans

August 18, 2011—It’s That Time of Year Again: An Open Enrollment Notice Checklist for Employer-Sponsored Group Health Plans

Believe it or not, the open enrollment period for calendar-year employee benefit plans is just around the corner. But fear not! This year’s open enrollment period likely will be much easier to navigate than last year’s because several of the healthcare reform-related notice requirements of last year need not be repeated this year. Below is a checklist of notices employers should begin developing in preparation for the 2012 plan year open enrollment period:

 

• Medicare Part D Notice (as we mentioned in a prior edition of the Health Law Update this notice must now be disseminated prior to October 15th);
• CHIPRA Notice Regarding Special Enrollment Rights;
• Women’s Health and Cancer Rights Act Notice; and
• Wellness Programs “Alternative Standards” Notice. Read More...

 

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July 19, 2010—Model Language for Grandfathered Health Plan Disclosure (Contained in the Interim Final and Proposed Regulations)

Beginning no later than plan years beginning on or after September 23, 2010, health plans or health insurance issuers which desire to retain “grandfathered” status, must, among other requirements, provide notice to participants and beneficiaries that the plan or coverage is believed to be a “grandfathered health plan.” The notice must be included in any plan materials provided to participants and beneficiaries which describe the benefits provided under the plan or coverage. The Interim Final and Proposed Regulations set forth model language for such notice. Read More...

Resources:

• DOL’s Excerpt Containing Model Language for the Grandfathered Health Plan Disclosure
   

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June 15, 2010—New Rules on Grandfathered Health Plans

Interim final and proposed regulations relating to the status of “grandfathered health plans” under the Patient Protection and Affordable Care Act (“PPACA”) will be published by the Departments of Treasury, Labor and Health and Human Services on June 17, 2010, in the Federal Register. Grandfathered health plans (i.e., those existing as of March 23, 2010, the date of the PPACA's enactment) are exempt from some, but not all, of the mandates imposed on group health plans (both insured and self-funded) under the PPACA. Generally, the regulations describe the extent to which employers may amend their group health plans and still maintain their grandfathered health plan status. While these regulations provide plans with some flexibility to make design and benefit changes without sacrificing their grandfathered status, this flexibility is limited and many plans may find themselves relinquishing their grandfathered status if they pursue plan changes that decrease benefits or increase participants’ out-of-pocket costs. The regulations also describe transitional rules and special rules for collectively bargained plans. A complete analysis of the regulations regarding the grandfather rules will be provided in additional alerts and will be posted on the Baker Hostetler Health Care Reform website in the near future.

Resources:

• Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act (Updated as of June 17, 2010) 
• Grandfathered Health Plans Fact Sheet
• Grandfathered Health Plans FAQs

Informational Reporting Requirements

July 16, 2010—IRS Invites Public Comments on Expanded Informational Reporting Requirements (Effective for Payments Made After December 31, 2011)

On Friday July 2, 2010, the Internal Revenue Service published Notice 2010-51 inviting public comments on the guidance to be provided regarding the expanded information reporting requirements established under Section 9006 of PPACA. Under Internal Revenue Code Section 6041 (as amended by PPACA), informational reporting through the issuance of Form 1099-MISC, Miscellaneous Income, will be expanded to encompass payments of “gross proceeds” and “amounts in consideration for property.” In addition, Form 1099-MISC informational reporting will also extend payments to corporations, other than certain tax-exempt corporations. Previously, payments to corporations were exempt from Form 1099-MISC reporting requirements. Read More...

Resources:

• IRS Notice 2010-51 

Nondiscrimination Requirements

January 1, 2010—IRS Announces Delay in Nondiscrimination Rules for Insured Medical Plans 


On December 22, 2010, the Internal Revenue Service released IRS Notice 2011-1 (to be published in the Internal Revenue Bulletin on January 10, 2011) delaying the implementation of new nondiscrimination rules for fully insured medical plans. As discussed in an earlier Baker Hostetler Executive Alert (IRS Provides Initial Guidance on Application of Nondiscrimination Rules to Fully Insured Plans), Section 2716 of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act extended the nondiscrimination rules under Internal Revenue Code Section 105(h) to fully insured medical plans. Previously, these rules have applied only to self-insured medical plans. As a result of the Health Care Reform legislation, “similar” nondiscrimination rules now will apply to fully insured employer-sponsored medical plans, unless those plans have been grandfathered under the Health Care Reform legislation. The change is effective for plan years beginning on and after September 23, 2010 (i.e., calendar years beginning on or after January 1, 2011, for most plans). Failure to comply with the new nondiscrimination requirements will result in an employer excise tax equal to $100 per day for each individual to whom the failure relates. Read More...

Resources:

• Notice 2011-1 Affordable Care Act Nondiscrimination Provisions Applicable to Insured Group Health Plans

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October 6, 2010—IRS Provides Initial Guidance on Application of Nondiscrimination Rules to Fully Insured Plans

On September 20, 2010, the Internal Revenue Service released IRS Notice 2010-63 (to be published in the Internal Revenue Bulletin on October 12, 2010). The Notice relates to the extension of the Internal Revenue Code Section 105(h) nondiscrimination rules to fully insured, medical plans. Prior to the enactment of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act these rules only applied to self-insured arrangements. Effective for plan years beginning on and after September 23, 2010, similar nondiscrimination rules also will apply to fully insured employer-sponsored medical plans. Read More...

Resources:

•  Request for Comments on Requirements Prohibiting Discrimination in Favor of Highly Compensated Individuals in Insured Group Health Plans: IRS Notice 2010-63

Preexisting Condition Limits, Lifetime and Annual Limits for Essential Health Benefits, Rescissions and Patient Choice

July 19, 2010—Patient Protection Model Notice and Prohibition on Lifetime Limits Model Notice

Patient Protection Model Notice
Beginning no later than the first day of the first plan year beginning on or after September 23, 2010, health plans and health insurance issuers which require participants and subscribers to designate a primary care physician or pediatrician must provide their participants and subscribers with notice of their rights to choose any participating primary care physician or pediatrician. Additionally, plans and issuers that provide coverage for obstetrical and gynecological care must provide their participants and subscribers with notice of their rights to obtain access to such care without prior authorization. These notices must be provided whenever a summary plan description or a similar description of benefits is provided. The Department of Labor has issued model language which may be used to satisfy these notice requirements. Read More...

Resources:

• DOL Model Language: Patient Protection Model Disclosure

Prohibition on Lifetime Limits Model Notice
Beginning not later than the first day of the first plan year on or after September 23, 2010, health plans and health insurance issuers must provide a notice that the lifetime limit on the dollar value of benefits no longer applies to any individual whose coverage or benefits ended due to reaching the lifetime limit and who becomes eligible for benefits or is required to become eligible for benefits. Additionally, if an individual is not enrolled in the plan or health insurance coverage, or if an enrolled individual is eligible for but not enrolled in any benefit package under the plan or coverage, then the plan or issuer also must provide the individual an opportunity to enroll and notice of that opportunity to enroll. These notices may be included with other plan enrollment materials, as long as the statement is prominent. The Department of Labor has issued model language which may be used to satisfy this notice requirement. Read More...

Resources:

• DOL Model Language: Model Language Notice Lifetime Limit No Longer Applies and Enrollment Opportunity

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June 23, 2010—New Rules Restrict Preexisting Condition Limits, Uncap Lifetime and Annual Limits for Essential Health Benefits, Limit Rescissions and Expand Patient Choice

On June 22, 2010, the U.S. Treasury Department, the Internal Revenue Service (IRS), the Department of Labor’s Employee Benefit Security Administration (EBSA) and the U.S. Department of Health and Human Services (DHHS) issued interim final rules and the proposed regulations to implement the following new Patient Protection and Affordable Care Act (PPACA) provisions:

 

• Prohibit health insurers and group health plan sponsors from imposing preexisting condition limitations on individuals who have not yet attained age 19, and prohibit such insurers and sponsors from denying coverage to such individuals based on the existence of a preexisting condition (and outlaw all such limitations and coverage denials, regardless of age, starting in 2014).
• Prohibit health insurers and group health plan sponsors from imposing lifetime dollar limits on essential health benefits, and require health insurers and group health plan sponsors to sharply increase annual dollar limits on essential health benefits (and eventually eliminate such annual limits starting in 2014).
• Prohibit coverage rescissions (except in the case of fraud or intentional misrepresentation).
• Provide plan-covered and insured individuals with greater control over choosing a primary care physician (and, as applicable, a pediatrician, obstetrician and/or gynecologist), and with greater access to emergency services and related care.

These prohibitions and protections are some of the many changes made by PPACA and by the Health Care Reconciliation Act (which was signed into law as a companion to PPACA).

The rules, which are to be formally published June 28, take effect August 27, 2010. Except as indicated above, they apply to group health plans and health insurers for plan years and policy years beginning on or after Sept. 23, 2010. An analysis of the new rules, and their expected effect on employers and health insurers, will be provided in additional alerts and will be posted on Baker Hostetler’s Health Care Reform website in the near future.

Resources:

• Patient Protection and Affordable Care Act; Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections; Final Rule and Proposed Rule (Updated as of June 28, 2010)

See also:

• Obama Administration Summary of the New Changes

Small Business Health Care Tax Credit

September 15, 2010—Small Business Health Care Tax Credit—Draft Form 8941 Released By IRS

On Tuesday, September 7, 2010, the Internal Revenue Service released a draft of the Form 8941 to be used by eligible small employers (including eligible tax-exempt entities) for calculating their small business health care tax credit under Section 45R of the Internal Revenue Code for the 2010 tax filing season. Small employers using the Form are then instructed to report the calculated credit as part of their general business credit on their regular income tax return for the year. Tax-exempt entities should report their calculated credit on a Form 990-T. (Form 990-T has yet to be revised for this purpose.) Read More...

Resources:

• IRS Draft Form 8941
• IRS Press Release: IRS Releases Form to Help Small Businesses Claim New Health Care Tax Credit
• IRS Step-By-Step Guide
• IRS’ Small Business Health Care Tax Credit: Frequently Asked Questions

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May 20, 2010—Small Business Health Care Tax Credit

On Monday, May 17, 2010, the Internal Revenue Service released Notice 2010-44, providing additional guidance on the new health care tax credit for small businesses. Among other items, the Notice provides more detailed guidance regarding:

1. how businesses can determine whether they qualify for the tax credit,
2. what types of health insurance coverage (in addition to major medical) qualify for the credit,
3. how the credit interacts with state tax credits and subsidies, and
4. transition relief for businesses that wish to claim the credit in 2010.

The Notice also provides more than 15 factual examples to assist taxpayers in determining both their potential eligibility and available tax credit.

Note: The IRS previously released a chart containing average premiums in each state for use in calculating the small employer health insurance credit. That chart was published in Revenue Ruling 2010-13, released at the beginning of May.

Resources:

• IRS Notice 2010-44
• IRS Revenue Ruling 2010-13
• Additional IRS (Informal) Guidance