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Self-Funded Plans and PPACA

Originally posted by United Benefit Advisors (UBA)

PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to self-funded plans.

Provisions Effective 2013 or Later


Provisions Effective 2010 – 2012

Note: For 2014 and 2015, the Patient Protection and Affordable Care Act (PPACA) considers a small group one that has up to 50 employees. (In most states, part-time employees count pro rata toward full-time equivalent employees using the same method as the play or pay requirement.) Beginning in 2016, for purposes of the insurance market requirements – but not the employer shared responsibility/play or pay requirement – a small group will be defined as up to 100 employees.

Sept. 19, 2013