(This post was written by Karen Aframe and Steve Gerlach of Bernstein Shur, September 5, 2013)
With the rollout of the Health Insurance Exchange (the “exchange”)—also known as the Health Insurance Marketplace—scheduled for this fall, and the employer’s exchange notice due by October 1, employers need to know how to talk to employees about the exchange. Here are some tips:
Comply with Notice Requirements
- Exchange Notice. Effective October 1, 2013, employers are required to provide a notice to employees about the exchange including that they may have access to subsidies if their employer does not offer affordable health care. Model notices are available on the Employee Benefits Security Administration website.
How to Communicate
- Focus on what matters now. The Affordable Care Act is an enormously complicated law; communicating too much to employees can be unnecessarily confusing. Don’t overwhelm employees with “what if” scenarios, or how things may turn out in 2018.
- Plan for ongoing communication. Use all resources available to you and keep employees updated on current developments.
- Keep it simple.
- Make it accessible. Use intranet, social media, videos and real-life examples to help explain.
What to Communicate
- Tell employees that the ACA is now the law. According to recent surveys by Kaiser Family Foundation, 40 percent of Americans do not know the ACA is the law.
- Communicate that the ACA changes many rules about health insurance in 2014. For example:
- Insurance companies must accept everyone who applies for coverage, regardless of health status.
- The individual mandate requires that every individual must be covered or pay a fine.
- Employers are required to provide employees with information regarding employees’ ability to purchase health insurance on the exchange.
- Focus on the exchange.
- Explain that exchanges are marketplaces where individuals and small employers can buy health insurance.
- Explain that government subsidies are available for some individuals who purchase health insurance on the exchange, but that if the individual is offered coverage through his or her employer that meets certain minimum standards, the individual may not be eligible.
- Communicate that the exchange may be helpful to some employees, e.g., part-time employees, seasonal employees, early retirees and temporary workers.
What To Avoid
- Avoid discussing with employees the administrative burden or financial impact that the ACA is having on the company.
- Avoid offering advice to employees regarding the type of insurance he or she should select.
- Avoid inducing your employee to purchase health insurance through the exchange rather than through the employer or vice versa.
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Guest post written by Steve Gerlach of the firm Bernstein Shur; July 9, 2013
On July 2, the Department of the Treasury announced a one-year delay in the implementation of certain parts of the Affordable Care Act’s reporting requirements, as well as a delay in the assessment of “pay-or-play” penalties. Although this delay will be helpful to many employers, all employers need to know which provisions are delayed and which are not.
- Reporting requirements: Mandatory reporting of health coverage information by large employers is postponed until January 1, 2015.
- Penalties: Assessment of employer penalties under the “pay-or-play” rules (for failure to offer adequate health coverage to employees) is postponed until January 1, 2015.
- Individual mandate
- Health insurance exchanges
- Exchange notices: Employers are still required to issue exchange notices to employees starting on October 1, 2013. Click here to see available model notices.
- Summaries of benefits and coverage: A short, language-appropriate description of the employer’s health coverage to be distributed to employees, effective for plan years starting on or after September 23, 2012. Click here for templates.
- Patient Centered Outcomes Research Institute fee: This fee, first due on July 1, 2013, is assessed against insurers and self-insured plans.
- W-2 reporting: No changes have been made to this requirement. Employers issuing more than 250 W-2s are required to report health insurance costs on those W-2s. Employers issuing 250 or fewer W-2s are not required to comply with this requirement.
- Expiration of annual limit waivers: Annual limit waivers will not continue after December 31, 2013.
- Limit on medical FSAs: The $2,500 limit, effective as of January 1, 2013, remains in effect.
- Insurance market reforms: The prohibition of annual and lifetime limits, the prohibition of waiting periods in excess of 90 days and other market reforms are still planned to take effect on January 1, 2014.
Use Additional Time to Develop Compliance Strategies
Delays in the implementation of major tax provisions are not uncommon. Based on our experience with rollouts of other laws, we believe that the underlying infrastructure and requirements of the ACA will remain in place during the delay, with further guidance coming from the IRS and other regulatory agencies. We strongly encourage employers to use this additional time to develop and tweak their compliance strategies. The Treasury plans to begin issuing additional guidance within the next week.
For more information about the Affordable Care Act, contact Steve Gerlach.
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(Post was written by James McCarthy, Mainebiz)
Rick Dacri, owner of a Kennebunkport-based consulting firm that advises businesses on work force issues, says his client list ranges from Fortune 500 companies to nonprofits employing fewer than 10 people. Whatever their size, he says, health care benefits and their costs have long been a front-burner issue for Maine employers.
Yet, when asked about the 5–4 Supreme Court decision upholding the Affordable Care Act, Dacri carefully sidesteps the political controversy that preceded the June 28 ruling and continues in its aftermath. He prefers to focus more on the practical steps employers need to take now that the law has been ruled constitutional.
“I don’t think it’s as big a deal as is being portrayed,” Dacri says, noting that most of his Maine clients, even the smaller companies, already provide health insurance to their employees. For them, he says, it’s an essential way to attract and keep quality employees. Continue reading