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August 27, 2015
What ACA issues should employers be focusing on now?

By Jessica Webb-Ayer, JD

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Since the Affordable Care Act (ACA) became law in 2010, employers have been busy trying to make sure they understand the law's intricacies and how to remain in compliance with all its myriad provisions. This summer, the law survived yet another judicial challenge when the U.S. Supreme Court decided in King v. Burwell that ACA tax credits are available to individuals in states that have federal exchanges. Essentially, the ruling meant that nothing changed for employers regarding their healthcare insurance reform requirements.

Many interested parties were waiting to see what would happen in the case and may have even slowed down their ACA compliance planning. So what’s new with the law, and what are the things that employers need to be thinking about now?

The ACA "play or pay" provision

Under the ACA's employer shared responsibility section (also commonly referred to as the "play or pay" provision), employers face penalties if they do not offer health insurance coverage or if the coverage they offer is insufficient. Applicable large employers with 100 or more employees started having to contend with possible penalties under the play or pay provision in 2015. Additionally, applicable large employers with 50 to 99 employees will begin to face potential penalties under the provision in 2016.

Employer and insurer reporting requirements

To help the IRS collect data and enforce the play or pay provision, the ACA amended the Internal Revenue Code to provide for related reporting requirements. Section 6056 concerns information reporting by applicable large employers on health insurance coverage offered under employer-sponsored plans, while Section 6055 deals with information reporting requirements for providers of minimum essential health coverage (including self-insured employers that provide "minimum essential coverage" to individuals). Such reporting is first required in early 2016 with respect to calendar year 2015.

Preparing for the "Cadillac tax"

Another ACA provision that employers also need to be planning for is the excise tax on so-called "Cadillac" plans that becomes effective in 2018. Generally, under this provision, a 40 percent excise tax is imposed on employer-sponsored health plans with total values that exceed $10,200 for individual coverage and $27,500 for family coverage.

New regulations and guidance

Various agencies have also recently issued new guidance on the ACA. In June 2015, the Department of Health and Human Services, the Department of Labor, and the IRS (collectively, "Departments") issued new final regulations related to the ACA's summary of benefits and coverage (SBC) requirement. The agencies had previously issued proposed rules regarding the SBC provision in December 2014. The new final regulations take into account public comments the agencies received about the proposed regulations, amend the previous final SBC regulations published in February 2012, and are effective on August 17, 2015.

Additionally in July 2015, the Departments issued final regulations on coverage of certain preventive services under the ACA. More specifically, the new regulations focus on the ACA's controversial "contraceptive mandate." The new regulations set out another alternative way for religious nonprofit organizations eligible for an accommodation to give notice of their religious objections to providing contraceptive services coverage. The new regulations extend the same accommodations available to religious nonprofit organizations to certain closely held for-profit entities.

Employer planning

Employers should be particularly concerned about the ACA provisions discussed above and must be planning for these issues. Additionally, employers need to make sure they are monitoring developments on the law, including new regulations and guidance from various agencies and any applicable court decisions.

Jessica Webb-Ayer, JD, has written and edited countless publications on labor and employment law including the Benefits Compliance Advisor an online newsletter and the benefits manual — Benefits Compliance: Strategies for Plans, Programs and Policies. Ms. Webb-Ayer has also worked on various Americans with Disabilities Act (ADA) and workers’ compensation/safety products. She graduated summa cum laude with a BA in Psychology from Lipscomb University in Nashville, Tennessee, and graduated cum laude with a law degree from the University of Tennessee College of Law in Knoxville, Tennessee. Ms. Webb-Ayer is licensed to practice law in Tennessee.

Video: Watch Jessica's recent video about preparing for healthcare reform changes .

Jessica's Recent Video

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