Originally posted April 30, 2014 by Dorothy Summers on http://ebn.benefitnews.com
Most of the political discussion surrounding the Affordable Care Act involves whether the law will be further delayed and/or repealed. While the government continues its in-fighting, the Obama Administration has pushed forward. In fact, in the first quarter of 2014, the government issued two significant pieces of final guidance related to implementing the major requirements of the law.
Employer mandate final regulations
The first piece of guidance was the employer mandate final regulations. These “play or pay” rules provide some clarity as well as a deadline for compliance. For large employers—businesses with 100 or more full-time and full-time equivalent employees—the deadline is January 1, 2015, or the month in which your health plans renews in 2015. While 2015 seems far off, the reality is that it is only eight short months from now.
Employers with between 50 and 99 full-time and FTE employees have a bit more breathing room—they have until 2016 to comply. Businesses with fewer than 50 full-time and FTE employees do not need to meet the play or pay requirements.
The second set of final regulations from the government addressed information reporting. These regulations include two separate types of reporting: to employees and to the government. The first reports must be completed using information collected in 2015 and then distributed to employees and the government in 2016. The government will issue a Form 1095 for this reporting.
While 2016 seems well into the future, the collection of required data must begin in January 2015. The reporting will be done on a calendar year basis regardless of whether your health plan operates on the calendar year.
So, are you ready to act on the government’s final guidance? Are you certain? To determine the answer, review your current plan against this checklist:
First, count your employees to determine if you are a large employer and subject to the employer mandate in 2015. If you qualify as a large employer in 2015, take the following steps:
▪ Determine whether health coverage is offered to at least 70% of your full-time employees and their dependents.
▪ Review whether the plan being offered to at least 70% of your full-time employees and their dependents provides minimum value by using one of the three available methods: the minimum value calculator; safe harbor checklists; or actuarial certification.
▪ Confirm the information provided from the fully insured carrier on the Summary of Benefits and Coverage.
▪ Assess the affordability of your lowest-cost single health coverage under one of the IRS’ affordability safe harbors using the W-2, rate of pay, or the federal poverty line.
▪ Provide required information regarding plan coverage and participation in accordance with information return requirements, and file the report in 2016 using 2015 data.
When the government announced last summer that it was delaying the employer mandate, many employers let out a sigh of relief. They relaxed. However, now it’s time to pick up the pace again. Before you know it, 2015 and 2016 will be here and the ACA will be an everyday reality for employers.