Indianapolis, IN – Nov. 8, 2012 – Maintenance of the health care reform status quo in Washington, D.C. (the re-election of President Barack Obama, with a split congress) means that implementation of the Patient Protection and Affordable Care Act (PPACA) likely will move forward largely as the law was passed in 2010. The law leaves many details to the regulatory agencies (the Department of Labor, the Internal Revenue Service and the Department of Health and Human Services), and with many questions remaining unanswered, employers can expect an onslaught of regulations between now and the end of 2013.
Of greatest interest to many employers is the employer-shared responsibility (“play or pay”) requirement. As of Jan. 1, 2014, employers with 50 or more full-time (30 or more hours per week) employees must offer “minimum essential” (basic) medical coverage or pay a penalty of $2,000 per full-time employee, excluding the first 30 employees. Employers who offer coverage deemed not “affordable,” or who fail to provide “minimum value” must pay a penalty of $3,000 for each employee who receives a premium credit. (Coverage is not “affordable” if the employee’s cost of single coverage is more than 9.5 percent of income. Coverage does not provide minimum value if it is expected to pay less than 60 percent of anticipated claims.)
Health insurance exchanges, scheduled to begin operation in January 2014, also play an important role in employer obligations. While PPACA is a federal law, health insurance exchanges were designed to be operated by the states, many of whom have stalled work pending the outcome of this election. A few have affirmatively decided against a state exchange, in which case the federal government will run one on the state’s behalf. Employees who have access to coverage through their employers may still choose to obtain coverage through the health insurance exchange, making it necessary for employers to understand the status of their state’s exchange.
In addition to deciding whether to “play” (continue providing health coverage) or “pay” (the penalties), employers (including those with fewer than 50 employees) have a number of compliance obligations between now and 2014. Find out what these obligations are at http://www.ubabenefits.com/Wisdom/ComplianceSolutions/tabid/246/Default.aspx and let an experienced advisor help you understand your options and obligations under PPACA.
About United Benefit Advisors
One of the nation’s top five employee benefits advisory organizations, United Benefit Advisors is a Member-owned alliance of more than 140 premier independent benefit advisory Firms with more than 200 offices throughout the U.S., Canada and the U.K. As trusted and knowledgeable advisors, UBA Members collaborate with more than 2,200 professionals to deliver expertise, thought leadership and best-in-class solutions that positively impact employers and make a real difference in the lives of their employees and families. Employers, advisors and industry-related organizations interested in obtaining powerful results from the shared wisdom of our Members should visit UBA online at www.UBAbenefits.com.
Carina Sammartino
Fisher Vista
650.477.4839
csammartino@fishervista.com