A look into recent updates and insights into the recent 2014 changes and requirements going forward for employers regarding the Affordable Care Act and the ACA. Hear from our expert panelists are they discuss fines, penalties and requirements for companies regarding health benefits and communication for the ACA.
This webinar is eligible for HRCI recertification credit. Visit http://b4j.com/hrciwebinars & register to get PHR, SPHR & GPHR cert credits free.
5. 1200 pages of legislation
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Employer Mandate and Employer
responsibilities
Individual Mandate
This a complex law with over 1200 pages of legislation
and many more pages of regulation. We are giving an
overview and nothing should be construed as legal
advice.
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6. Important Pieces of ACA
Went into effect January 1, 2014 & includes
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Individual Mandate
Insurance Exchanges
Medicaid Expansion
Employer mandate
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8. ACA timeline of events
Access graphic at http://b4j.co/2014-ACA
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9. Who is a "Large Employer?”
• Employers with 50 or more FTEs
• Fulltime employees (30 or more hours
per wk)
• The monthly sum of hours of employees
working less than 30 hours per week
divided by 120.
• Added together if the total is 50 or
more the employer is covered
• Includes working hours & compensated
hours
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10. Legislation key points
• Offer “Affordable” Insurance to full-time
employees or pay a penalty
• Provide written notice to employees at
time of hiring of what is provided (this
notice must be provided to current
employees by March 1, 2013)
• Provide W-2s with insurance values
• As of 2014, make annual reports to the
Secretary of the Treasury
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11. What “affordable” means
“Affordable” insurance is deemed
affordable if :
• The cost of coverage for employeeonly coverage is no more than 9.5% of
the employee’s household W-2
income
• Safe Harbor Provisions
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12. Key points
• Employers are NOT required to pay 100%
of the cost of coverage
• Employees can be required to contribute
to the cost of coverage in increasing
amounts based on increased income
• Employees can be required to pay the
full cost of dependent coverage
• Large employers are only required to
OFFER coverage and there is no penalty if
the employee declines.
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13. Employer Penalties
• They don’t
provide any
insurance
coverage
• They provide
“unaffordable”
or “inadequate”
coverage
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14. Defining inadequate
• The cost is 9.5% of the employee’s
household income
• Minimum Essential Coverage
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15. Employer penalties
The penalty is the lesser of:
• $2000 x the total number of full-time
employees
• Or $3000 X #full-time employees who
receive a tax credit or subsidy and
purchase through an exchange
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17. Calculating Penalties Continued
• Tackhammer: $3000 times number of
employees for whom you provided inadequate
insurance AND who then successfully purchased
coverage with tax credit.. But that total may never
be an amount greater than the amount you
would have paid if you had provided no
insurance at all (must be less than the amount
you would have paid those same folks had you
not give them any insurance at all).
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18. How to Calculate No of Full Time
Employees
• Count the number of employees work more than
30 or more hours a week
• Calculate hours of non-full time equivalent
employees including seasonable employees &
divide by 120
• Add the number calculated in the 2 bullets
above for each of the 12 months in the
preceding calendar year.
• Add monthly totals and divide by 12.
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20. Exchanges and employers
• Exchanges determine if individuals are
eligible
• Exchanges notify employers of full-time
employees who qualify for subsidy or
credit
• If employees have adequate coverage
they will NOT qualify for the subsidy
• If assessed a penalty employers can
appeal
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21. Automatic enrollment
• Employers with 200 or more FTEs must
automatically enroll all new full-time
employees in one of their employersponsored plans
• Employees not wanting insurance must
opt out
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22. Information return
In 2014 employers must file reports with the
Secretary of the Treasury detailing:
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Whether or not they offer insurance
Details of the plans if they do
Costs of the plans
# of employees with full identification
Additionally a full report must be supplied
to each employee named in the report
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24. 2014 Changes & Updates
• 2015 Enrollment Date Changes
• Continuous communication
• Open enrollment for Healthcare.gov ends
3/31/14
• Religious groups contraceptive mandate
changes
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25. ACA Timeline of Events
Access graphic at http://b4j.co/2014-ACA
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27. Learn more about . . .
• Mary Wright www.b4j.co/mary-wright
• Jessica Miller-Merrell www.b4j.co/JMMbio-12
Other resources: 2015 Enrollment Changes - http://b4j.co/15-aca-chg; ACA timeline of
events - http://b4j.co/2014-ACA; ACA Communication Graphic - http://b4j.co/acatalk; NPR ACA article - http://b4j.co/npr-aca; List of states w/ & w/o exchanges http://b4j.co/aca-exchange
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28. Get HRCI Recert Credits
• Visit http://b4j.com/hrciwebinars
& register to get PHR, SPHR & GPHR cert
credits free.
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Notes de l'éditeur
DEREK
Signed into law March 23, 2010 and is the most significant regulatory overhaul of US health system since the passage of Medicade in 1965. IMO most complex law impacting employers since the Americans with Disabilities Act went into effect into 1990. Read this prior to discussion: http://b4j.co/npr-aca
►The ACA aims to expand health coverage through a series of provisions that generally go into effect on January 1, 2014: ►Individual mandate: Mandates all Americans, with some exceptions, to maintain a minimum level of health coverage or face a tax. ►Insurance Exchanges: Creates health insurance Exchanges and provides premium tax credits to assist eligible individuals with the purchase of coverage. ►Medicaid expansion: Allows states to expand Medicaid up to 133% of federal poverty level. ►Employer mandate: Mandates employers with 50 or more full-time equivalents to offer coverage to full-time employees and their dependents or pay taxes if an employee obtains Exchange coverage and a premium tax credit.
This includes vacation time and time off. Cover this in particular. This is thecalucation that everything is based on.
Jess will discuss
STEP 1: Employer provides employee information about exchangesSTEP 2: Employer provides exchange information to determine eligibilitySTEP 3: Exchange verifies information & eligibility regarding tax creditSTEP 4: Exchange notifies employer to receive tax credit & Employer has right to appeal employee eligibility within 90 daysSTEP 5: Employer files info with IRS & Employee files personal returnSTEP 6: Assessment of tax penalties & employer has right to appeal tax liability to IRShttp://b4j.co/aca-talk
2015 enrollment window for second year is delayed for 11/15/14 and 1/15/15 allowing for more time to set rates Employee communication is so essential and its important to note that individuals have until 3/31/14 to enroll on the Heathcare.gov site. This should be communicated to employees.