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Regs, Ruling Open Eyes to PPACA Impact

Source: UBA

As federal agencies continue to release more guidance on the Patient Protection and Affordable Care Act (PPACA), everyone from employees to companies to benefit advisors are taking notice.

The latest rules proposal concerns the waiting period on benefit eligibility. According to United Benefit Advisors, this new rule would require companies to provide access to health benefits no later than 90 days after the start of employment. If the 91st day falls on a holiday or weekend, the plan must start coverage prior to that date.

The government is allowing a few instances in which the deadline can be altered, the UBA report notes. For instance, when a part-time employee who is ineligible becomes an eligible full-time employee, the clock starts ticking on the day on which the employee becomes eligible. But in most instances, the strict 90-day waiting period will apply to any new hires.

“The agencies stuck to their guns on not allowing waiting periods to exceed 90 calendar days – no exceptions for weekends” or holidays, Amy Bergner of PricewaterhouseCoopers L.L.P. told Business Insurance.

This rule is only one in a sea of regulations that has been pouring out of Washington since the Supreme Court upheld the constitutionality of the law in 2012. With PPACA’s future settled, the impact of the law is starting to trickle down to employees.

A new poll by Prudential finds that almost half (46 percent) of employees expect PPACA to drive up overall health insurance costs, according to a report in PLANSPONSOR. In addition, 31 percent of workers said they think it is likely that fewer companies will offer health insurance benefits in the future because of the law.

The same poll found that employers are nervous about their benefit support needs, with 56 percent citing that as their top worry. Fifty-five percent of employers also said they were concerned about how the law might change the number of benefits they offer to their employees.

To alleviate these worries, employers are turning to skilled benefit advisors to help them grapple with these new challenges created by PPACA. In turn, advisors are working more closely with insurance providers to find new solutions.

“Brokers tell us that helping clients navigate health care reform and lowering clients’ benefits costs are their most critical priorities,” said Vishal Jain, a vice president with Prudential in the PLANSPONSOR report. “They are looking to us, the carriers, to provide the marketing, education and communications that will help employers to continue to deliver strong benefit offerings.”