ACA Employer Play or Pay Requirements: What Does it Mean for Employers?
Beginning in 2014, the Affordable Care Act (ACA) will require “large” employers to offer their full-time employees healthcare coverage that meets certain standards or pay a penalty. Whether an employer opts to “play-or-pay” is a critical business decision that impacts both their benefits and workforce strategies. With the effective date of the ACA play-or-pay penalty just months away, employers must understand how the mandate works and what it means for their business. The following are key questions employers must ask to make sure they are prepared for the dramatic changes ahead.
Health Care Reform Adds to the Web of Anti-Retaliation Laws Applicable to Employers
While many employers have focused on the requirements for health coverage, they must be mindful of the new whistleblower and anti-retaliation protections established by the Patient Protection and Affordable Care Act (the "PPACA"). Section 1558 of the PPACA amends the Fair Labor Standards Act to protect employees from retaliation for (i) reporting alleged violations of the PPACA or (ii) receiving premium tax credits or subsidies for participating in health insurance exchanges. This provision applies to both private and public employers and protects current and former employees as well as applicants for employment. Earlier this year, the Department of Labor, through the Occupational Safety and Health Administration ("OSHA"), issued an interim final rule that governs whistleblower complaints under the PPACA.
Affordable Care Act – Guidance on Notice Requirement
The Patient Protection and Affordable Care Act (“ACA”) created a new section of the Fair Labor Standards Act (“FLSA”) that requires employers to provide employees with notice of coverage options in the Health Insurance Marketplace, i.e., what plans are available and what they cost. (The “Marketplace” is what was previously referred to as the “Exchange.”) Originally, the deadline for the notice was March 1. The Employee Benefits Security Administration of the Department of Labor (“DOL”) released temporary guidance on May 8, 2013, regarding the notice requirement as well as model notices that many employers have long been awaiting.
Monthly Benefits Update - May 2013
Health Care Reform: Agencies Issue Final Regulations on Wellness Programs Under ACA
The Internal Revenue Service (IRS), Department of Labor (DOL), and the Department of Health and Human Services (HHS) finalized regulations on wellness program incentives, revising earlier guidance issued in November of 2012. As in the proposed regulations, the final regulations increase the maximum reward that may be offered by a health-contingent wellness program from 20 percent to 30 percent and the maximum reward for reducing tobacco use from 30 to 50 percent.
IRS Paves the Way for "Boilerplate" 403(b) Plan Documents
The IRS has opened up a program, in Revenue Procedure 2013-22 (see 403b_prototype.pdf) that will eventually allow Section 501(c)(3) tax-exempt organizations, public schools, and other state and local governmental entities, churches and certain church-controlled organizations to adopt a pre-approved plan document (in plain English, a "boilerplate" plan of sorts) and have reliance that the plan complies in form with applicable with the tax requirements for 403(b) plans.
Employee Notices About PPACA Insurance Exchanges - Guidance Issued
One of the 2013 action items for employers under the Patient Protection and Affordable Care Act (PPACA) is the production and distribution of a notice to employees about the health insurance exchanges that will become effective in 2014. Under the statute, these notices were originally required to be distributed by March 1, 2013. However, in January 2013, the U.S. Department of Labor (DOL) delayed this distribution requirement until it had an opportunity to issue further guidance. On May 8, 2013, the DOL issued that guidance in the form of Technical Release 2013-02 and a model notice published on the DOL's website. The DOL describes the insurance exchanges as "Marketplaces," a term we will use in this alert.
Most Employers Will Continue to Provide Health Coverage Next Year, Survey Finds
The number of employers that plan to continue providing their employees with health insurance has increased, according to a new survey conducted by the International Foundation of Employee Benefit Plans (IFEBP). The survey – 2013 Employer-Sponsored Health Care: ACA’s Impact – addresses how employers are responding to changes made by the Affordable Care Act (ACA). Most (94%) of the 966 benefits and human resource professionals, general and financial managers, and other company officials who responded to the March 2013 survey claimed that they “definitely” or “very likely” will continue providing health insurance coverage when many of ACA’s provisions take effect in 2014, up from 86% who responded similarly in 2012. A large majority (69%) responded that they would definitely continue providing coverage, up from the 46% who made the same claim in 2012. According to the survey, 91% of responding employers already offer medical benefits to employees who work more than 30 hours per week.
Legal Alert: Notice of Health Exchange Coverage Options Guidance Released
Executive Summary: The Affordable Care Act added section 18B to the Fair Labor Standards Act (FLSA), which requires certain employers to send out notices to employees regarding the availability of the state-based Health Insurance Exchanges ("Exchange Notice"). Under the FLSA, these Exchange Notices were supposed to be provided to employees no later than March 1, 2013. However, on January 24, 2013, the Department of Labor (DOL) issued guidance delaying the Exchange Notice requirement until the summer or fall of 2013.
Workplace Policy Institute: The Labor, Employment and Benefits Law Implications of the Affordable Care Act - Are You Prepared?
For millions of employers around the country, the Patient Protection and Affordable Care Act (ACA) represents much more than a collection of new requirements for health plans. The sweeping healthcare reform law potentially changes the landscape of the American workplace and workforce. While the law imposes significant new obligations on employers and group health plans, legal and political uncertainty about the ACA's future may have delayed planning for its full implementation. Now, with the law's key provisions slated to become effective in 2014, employers are viewing the ACA with a renewed sense of urgency.
IRS Issues Proposed Rule Clarifying Health Plan Minimum Value Determinations
The Internal Revenue Service has released a proposed rule that provides some guidance on what constitutes minimum value (MV) of an employer-sponsored health plan under the Affordable Care Act (ACA) for purposes of eligibility for a premium tax credit.