Final Employer Responsibility Regulations Released
Originally posted by Melissa Duffy on https://www.the-alliance.org
The federal government has released final rules governing the Affordable Care Act's Employer Responsibility (aka Pay or Play) provisions that will take effect in 2015 for many Alliance members. Once in effect, the ACA will impose penalties on employers that do not offer "affordable" and "minimum value" coverage to certain full-time workers, currently defined as an average of 30 hours or more per week.
The IRS has posted Frequently Asked Questions to help employers understand the new guidelines and the safe harbors that were created to help employers avoid penalties. Penalties are triggered only when one or more of a company’s full-time workers accesses tax credits to purchase coverage on the public exchange.
The final regulations include some changes to the proposed regulation that were released more than a year ago. Key changes include:
- An exemption from penalties for employers in 2015 that have 50-99 workers as long as they certify that they have not reduced their workforce to fall under the 100 employee threshold. Employers of this size would be subject to penalties in 2016 if their regulations are not changed once again.
- More wiggle room for employers that do not offer all employees coverage. Under the new rules, an employer with 100 or more workers will not be subject to the "4980H(a)" penalty ($2,000 X all FT employees minus 30) as long as they offer coverage to at least 70 percent of employees in 2015. This threshold increases to 95 percent in 2016. However, employers will still be subject to "4980H(b)" penalties equaling $3,000 per year for any full-time employee that is able to access exchange tax credits or cost sharing reductions.
- A new definition for "seasonal employees" to apply to those positions for which customary annual employment is six months or less. For these individuals, the offer of coverage can wait until the end of a measurement period. This is not to be confused with the term “seasonal worker” used for the purposes of determining whether an employer is large enough to be subject to penalties.
Congress Considers Changing the Definition of Full-Time
In a related note, a Congressional committee has approved one of several bills introduced this session to modify the Employer Responsibility provisions in the Affordable Care Act. The bill, which would define full-time as 40 hours for the purposes of the ACA, passed the House Ways and Means Committee on a party-line vote with Republicans on the committee supporting the measure and Democrats opposing it. Similar bills have gained bipartisan support but are stalled in the Senate.
Click here to view testimony from the public hearing held on this issue.
Final Employer ACA Regs from IRS Provide Transition Relief to Mid-Sized Employers
Originally posted on https://www.ifebp.org
The Internal Revenue Service (IRS) issued final regulations implementing the employer responsibility provisions under the Affordable Care Act (ACA) that take effect in 2015.
The final rules implement the employer shared responsibility provisions of the ACA, under section 4980H of the Internal Revenue Code. The rules make a number of changes in response to input on the proposed regulations issued in December 2012.
Highlights of the rules include addressing a number of questions about how plans can comply with the employer shared responsibility provisions; ensuring that volunteers such as firefighters and emergency responders do not count as full-time employees; and phasing in provisions for businesses with 50 to 99 full-time employees and those that offer coverage to most but not yet all of their full-time workers.
The final rules provide, for 2015, that:
- The employer responsibility provision will generally apply to larger firms with 100 or more full-time employees starting in 2015 and employers with 50 to 99 full-time employees starting in 2016.
- To avoid a payment for failing to offer health coverage, employers need to offer coverage to 70 percent of their full-time employees in 2015 and 95 percent in 2016 and beyond, helping employers that, for example, may offer coverage to employees with 35 or more hours, but not yet to that fraction of their employees who work 30 to 34 hours. (Proposed regulations would have required employers to offer coverage to 95 percent of their full-time employees in 2015.)
Various Employee Categories
The final regulations provide clarifications regarding whether employees of certain types or in certain occupations are considered full-time, including:
- Volunteers: Hours contributed by bona fide volunteers for a government or tax-exempt entity, such as volunteer firefighters and emergency responders, will not cause them to be considered full-time employees.
- Educational employees: Teachers and other educational employees will not be treated as part-time for the year simply because their school is closed or operating on a limited schedule during the summer.
- Seasonal employees: Those in positions for which the customary annual employment is six months or less generally will not be considered full-time employees.
- Student work-study programs: Service performed by students under federal or state-sponsored work-study programs will not be counted in determining whether they are full-time employees.
- Adjunct faculty: Based on the comments received, the final regulations provide as a general rule that, until further guidance is issued, employers of adjunct faculty are to use a method of crediting hours of service for those employees that is reasonable in the circumstances and consistent with the employer responsibility provisions. However, to accommodate the need for predictability and ease of administration and consistent with the request for a “bright line” approach suggested in a number of the comments, the final regulations expressly allow crediting an adjunct faculty member with 2 ¼ hours of service per week for each hour of teaching or classroom time as a reasonable method for this purpose.
U.S. Treasury Press Release
U.S. Treasury Fact Sheet
IRS Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act
“Play or Pay” Rules Delayed Until 2016 for Smaller Employers
Originally posted by https://blog.thinkhr.com
The Department of the Treasury and the Internal Revenue Service announced today that the Affordable Care Act’s health coverage mandate for employers with more than 50 employees but fewer than 100 employees working at least 30 hours per week will be delayed another year until 2016.
Employers with over 100 employees working at least 30 hours per week will become subject to the health coverage mandate under the Affordable Care Act (ACA) as previously announced beginning in January 2015. If these employers decide not to offer insurance to their employees, they will make an employer shared responsibility payment beginning in 2015 to help offset the costs to taxpayers for employees getting tax credits through the Health Insurance Marketplace.
“While about 96 percent of employers are not subject to the employer responsibility provision, for those employers that are, we will continue to make the compliance process simpler and easier to navigate,” said Assistant Secretary for Tax Policy Mark J. Mazur in the Treasury press release. “Today’s final regulations phase in the standards to ensure that larger employers either offer quality, affordable coverage or make an employer responsibility payment starting in 2015 to help offset the cost to taxpayers of coverage or subsidies to their employees.”
Today’s announcement included final regulations for implementing the employer shared responsibility provisions under the ACA, often referred to as the “Play or Pay” rules that will take effect in 2015.
To avoid this payment for the failure to offer affordable coverage meeting the minimum requirements as set forth in the regulations, these large employers will need to offer coverage to 70 percent of their full-time employees in 2015 and 95 percent starting in 2016. Full-time employment is defined as regularly working at 30 or more hours per week.
The immediate practical impact for employers includes:
- For employers with fewer than 50 employees: No impact, as this group was not subject to the employer shared responsibility provisions previously.
- For employers with 50 to 99 employees: For employers in this group that do not provide full-time employees with quality affordable health insurance, they will not have to pay any employer responsibility penalties in 2015. For 2015, this group will still be subject to provide an employee and coverage report as outlined in the ACA rules but will have until 2016 before the employer responsibility payments begin.
- For employers with 100 or more employees: Employers in this group are still subject to the mandate starting in 2015. What follows below are the highlights of the final regulations released today impacting the mandate for these employees to comply in 2015.
Key Elements of the Final Rules Impacting Employers with 100+ Employees in 2015
According to the Treasury Department Fact Sheet, the final regulations include the following changes:
- Coverage Thresholds: To avoid a payment for failing to offer health coverage, employers need to offer coverage to 70 percent of their full-time employees in 2015 and 95 percent starting in 2016. The original ACA rules required the 95 percent coverage beginning immediately.
- Full-time Employee Definitions:
- Volunteers: Bona fide volunteers for a government or tax-exempt entity, such as volunteer firefighters and emergency responders, will not be considered full-time employees.
- Educational employees: Teachers and other educational employees will not be treated as part-time for the year simply because their school is closed or operating on a limited schedule during the summer.
- Seasonal employees: Those in positions for which the customary annual employment is six months or less generally will not be considered full-time employees.
- Student work-study programs: Service performed by students under federal or state-sponsored work-study programs will not be counted in determining whether they are full-time employees.
- Adjunct faculty: Until further guidance is issued, employers of adjunct faculty are to use a method of crediting hours of service for those employees that is reasonable in the circumstances and consistent with the employer responsibility provisions. However, to accommodate the need for predictability and ease of administration and consistency, the final regulations expressly allow crediting an adjunct faculty member with 2 ¼ hours of service per week for each hour of teaching or classroom time as a reasonable method for this purpose.
- Full-time Employee Measurements: The final rules remain unchanged from the proposed rules that allow employers to use an optional look-back measurement method to determine whether employees with varying hours and seasonal employees are full-time. On a one-time basis, in 2014 preparing for 2015, plans may use a measurement period of six months even with respect to a stability period – the time during which an employee with variable hours must be offered coverage – of up to 12 months.
- Affordability Safe Harbors: As with the proposed regulations, the final rules provide safe harbors for employers to determine whether the coverage they offer is affordable to employees, including the W-2 wages, employees’ hourly rates, or the federal poverty level.
- Other Provisions of the Final Regulations:
- Employers first subject to shared responsibility provision: Employers can determine whether they had at least 100 full-time or full-time equivalent employees in the previous year by reference to a period of at least six consecutive months, instead of a full year.
- Non-calendar year plans: Employers with plan years that do not start on January 1 will be able to begin compliance with employer responsibility at the start of their plan years in 2015 rather than on January 1, 2015, and the conditions for this relief are expanded to include more plan sponsors.
- Dependent coverage: The policy that employers offer coverage to their full-time employees’ dependents will not apply in 2015 to employers that are taking steps to arrange for such coverage to begin in 2016.
Treasury and the IRS stated that additional final regulations will be forthcoming to streamline the ACA reporting requirements. Final rules will be published in the Federal Register on February 12th. We will continue to provide updates as more information is known.
For more information:
Treasury Press Release: https://www.treasury.gov/press-center/press-releases/Pages/jl2290.aspx
Treasury Fact Sheet: https://www.treasury.gov/press-center/press-releases/Documents/Fact%20Sheet%20021014.pdf
IRS Regulations (227 pages): https://s3.amazonaws.com/public-inspection.federalregister.gov/2014-03082.pdf
Kaiser Health Tracking Poll for January 2014
Originally posted January 30, 2014 on https://kff.org
January 1st may have been a monumental date for those working on and closely following the Affordable Care Act (ACA), but the latest Kaiser Health Tracking Poll finds little change in the public’s knowledge and views of the law. With enrollment in new coverage options underway, a majority of the public believes that only “some” of the ACA’s provisions have been put into place, while just about one in five think “most” or “all” of the law has been implemented. Awareness of the law’s individual mandate and health insurance exchanges has increased slightly since last year, but about four in ten of the public overall and half the uninsured remain unaware of other major provisions. For the third month in a row, overall views of the law remain at their post-rollout more negative levels (50 percent unfavorable, 34 percent favorable), though over half the public – including three in ten of those who view the law unfavorably – say opponents should work on improving the law rather than keeping up efforts to repeal it.
Among the uninsured – a key group for outreach under the law – unfavorable views now outnumber favorable views by roughly a 2-to-1 margin (47 percent versus 24 percent). This is a change from last month when 43 percent of the uninsured had an unfavorable view and 36 percent were favorable. More of those without coverage say the law has made the uninsured as a group worse off (39 percent) than better off (26 percent). Despite these views, large shares of the uninsured see health insurance as “very important” and say they need it, while four in ten say they’ve tried to get coverage in the past 6 months, and half expect to get it this year.
January 1st Didn’t Register With The Public
The latest Kaiser Health Tracking Poll finds that even after most of the ACA’s major provisions took effect on January 1, a large majority of the public (62 percent) continues to believe that only “some” provisions of the ACA have been put into place thus far. Only about one in five (19 percent) say “most” or “all” provisions have been implemented, up somewhat from 9 percent last March.
When it comes to the individual elements of the law, awareness has increased slightly for two of the big ones: the individual mandate (81 percent now say it is part of the law, up from 74 percent last March) and the health insurance exchanges (68 percent, up from 58 percent). Still, large shares of the public – and even higher shares of the uninsured – remain unaware of some other major provisions of the law. For example, roughly four in ten adults overall, and about half of the uninsured, are not aware that the law provides financial help to low- and moderate-income Americans to help them purchase coverage, gives states the options of expanding their Medicaid programs, and prohibits insurance companies from denying coverage based on pre-existing conditions.
| FIGURE 2: Many Uninsured Remain Unaware Of Some Major ACA Provisions | ||||
| Total public | Uninsured, age<65 | |||
| To the best of your knowledge, would you say the health reform law does or does not…? | Yes, law does this | No/Don’t know | Yes, law does this | No/Don’t know |
| Require nearly all Americans to have health insurance or else pay a fine | 81 | 19 | 79 | 22 |
| Create health insurance exchanges or marketplaces where people who don’t get coverage through their employers can shop for insurance and compare prices and benefits | 68 | 31 | 62 | 38 |
| Provide financial help to low and moderate income Americans who don’t get insurance through their jobs to help them purchase coverage | 63 | 38 | 54 | 46 |
| Give states the option of expanding their existing Medicaid program to cover more low-income, uninsured adults | 58 | 42 | 49 | 51 |
| Prohibit insurance companies from denying coverage because of a person’s medical history | 54 | 46 | 48 | 53 |
On a more personal level, 44 percent of the public overall – including 66 percent of the uninsured –continue to say they don’t have enough information to understand how the law will impact their families.
Overall Views Remain Negative, But Public Wants Opponents To Work On Fixes Rather Than Repeal
Views of the law overall remain more negative than positive this month, with 50 percent saying they have an unfavorable view and 34 percent favorable, almost identical to the split in opinion since November. Still, more than half the public overall, including three in ten of those who view the law unfavorably, say opponents should accept that it’s the law of the land and work to improve it, while fewer than four in ten want opponents to keep up the repeal fight.
Most Continue To Say They Haven’t Felt An Impact From The ACA, But More Feel They’ve Been Affected Negatively Than Positively
At the same time, most Americans continue to report no personal experience with the law to date. Roughly six in ten say they haven’t been directly impacted by the law in a positive or negative way, though the share who perceive that they’ve been negatively impacted continues to be larger than the share who feel they’ve benefited (27 percent versus 15 percent). Those who feel they’ve been negatively impacted by the law are most likely to point to high costs of health care and insurance as the reason. With official data showing that only a very small share of the public overall have enrolled in the ACA’s coverage arrangements so far, these shares likely reflect people’s perceptions of being helped or harmed by the law, rather than actual experiences with new insurance options under the ACA.
Among The Uninsured, Unfavorable Views Outnumber Favorable By 2-to-1, And More Believe They’re Worse Off Under The Law Than Better
Among the uninsured – a key group targeted by the ACA – views of the law shifted negative this month. A quarter (24 percent) of those who currently lack coverage now say they have a favorable view of the law, while nearly twice as many (47 percent) have an unfavorable view and about three in ten (28 percent) decline to offer an opinion. In December, views among the uninsured were more evenly split (36 percent favorable, 43 percent unfavorable).
More than half of the uninsured (54 percent) say the law hasn’t made much difference for their families, and the share who feel they’re worse off as a result of the law is more than twice the share who feel they’re better off (30 percent versus 13 percent). When asked about the uninsured as a group, those without coverage are more likely to say the law has left this group worse off than better (39 percent versus 26 percent). We will continue to track these perceptions as more of the uninsured gain coverage.
Most Uninsured Say They Need Coverage; Four In Ten Have Tried To Get It In The Last 6 Months; Half Expect To Get It This Year
The survey also finds that most of the uninsured see health insurance coverage as very important (70 percent) and something they need (73 percent). Among those who currently lack coverage, four in ten say they have tried to get it in the past 6 months, including about one in five each who tried to get coverage from Medicaid (19 percent), directly from a private insurance company (19 percent), and through a state or federal health insurance exchange (18 percent).1
When told or reminded of the law’s requirement that most Americans obtain insurance or pay a fine, half the uninsured say they expect to get coverage, including about one in five (18 percent) who expect to purchase it themselves (either from a private insurance company or through an exchange), 8 percent who expect to get it from Medicaid, and 6 percent who expect to get coverage from an employer. A sizable share (17 percent of the uninsured overall) say they expect to get coverage but are unsure where.
Four in ten of those without coverage say they expect to remain uninsured, with most of these saying they don’t think they’ll be able to find an affordable plan. As noted above, many of the uninsured remain unaware of the additional options available to them under the ACA, including the insurance exchanges, subsidies, and expanded Medicaid in some states.
A Quarter Of The Public Overall Report A Change In Their Insurance Situation In The Past 6 months, Including One In Ten Who Attribute It To The ACA
As we pointed out in this Data Note [hyperlink], national public opinion polls aren’t the best vehicle for measuring the experiences of the small group of people who’ve actually gained coverage through the ACA so far. One thing we can do on the Kaiser Health Tracking Poll is to measure people’s perceptions about changes in their insurance situation and what role they think the law has played in those changes. This month’s poll finds a quarter (24 percent) of the public reports that they’ve had a change in their health insurance situation in the past 6 months, and four in ten of these (10 percent of the public overall) believe this change was a result of the health care law.
Among the 10 percent who perceive that their insurance status has changed as a result of the ACA, twice as many believe it was a change for the worse rather than for the better. However, about half this group currently has coverage through an employer, and most report that the change in their coverage was a change from one plan to another, suggesting that many of them may be attributing regular changes in insurance coverage to the law.
| FIGURE 11: Perceptions And Demographics Of Those Who Believe They Had A Change In Insurance Status As A Result Of The ACA | |
| Among the 10% who had a change in insurance status and believe it was a result of the ACA | |
| Would you say the change in your health insurance situation was a change for the better or a change for the worse? | |
| Better | 29% |
| Worse | 61 |
| No difference/Don’t know/Refused | 10 |
| Which best describes the change in your health insurance situation? | |
| Changed plans | 45 |
| Lost or dropped coverage | 14 |
| Got health insurance after being uninsured | 15 |
| Costs went up (vol.) | 12 |
| Some other change | 10 |
| Current health insurance status/type | |
| Insured (NET) | 92 |
| Employer | 50 |
| Self-purchase | 19 |
| Medicare | 6 |
| Medicaid | 13 |
| Other coverage | 3 |
| Uninsured | 6 |
| Don’t know/Refused | 2 |
More Report Seeing News Stories About Negative Rather Than Positive Impacts On People
This month’s poll also examined views of the media environment surrounding the ACA, and finds the majority say coverage of the law is focused more on politics and controversies (56 percent) rather than on how the law might impact people (6 percent), shares that have held steady since last fall. When it comes to personal stories in the news, about half the public (47 percent) reports hearing at least one story in the last month about an individual or family who was impacted by the law, with about twice as many saying they saw more stories about people being harmed (27 percent) as saying they saw more stories about people being helped (13 percent).
1. Multiple responses were allowed, since people may have tried to get coverage from more than one source in the past 6 months
Committee approves full-time worker bill
Originally posted February 04, 2014 by Allison Bell on https://www.benefitspro.com
Members of the House Ways and Means Committee today voted 23-14 to pass H.R. 2575, the Save American Workers Act bill.
For purposes of applying the Patient Protection and Affordable Care Act employer “shared responsibility” coverage mandate, the bill would define a full-time worker as an employee who works 40 hours or more per week.
PPACA now defines a full-time employee as an employee who works 30 or more hours per week.
PPACA requires employers that have the equivalent of 50 or more full-time employees to provide a minimum level of health coverage if one or more workers apply for coverage from a PPACA health insurance exchange.
Part-time workers count when employers are calculating the number of full-time equivalents they have, but employers subject to the PPACA “play or pay” mandate penalties tied to the number of actual full-time workers they have. When employers are calculating the actual penalty payment amounts, they can exclude part-time workers.
Rep. Todd Young, R-Ind., the sponsor, said the 30-hour limit is encouraging many employers to limit hours to avoid penalties.
“An employee seeing their hours cut from 39 hours to 29 hours will lose an entire week’s paycheck over the course of a month,” Young said.
Democrats on the committee said the bill would gut the coverage mandate by letting employers classify workers who work as many as 39 hours per week as part-time workers.
Rep. Xavier Becerra, D-Calif., noted that Ways and Means leaders gave the bipartisan Joint Committee on Taxation only a week to analyze the bill.
Budget analysts have not yet estimated how the bill might affect federal spending, taxes or the federal budget deficit, Becerra said.
“We’re essentially voting in the blind,” Becerra said.
Survey: Employees still under-informed on ACA, wellness
Originally posted November 8, 2013 by Tristan Lejeune on ebn.benefitnews.com
Only 15.1% of workers at large employers say they are “knowledgeable” or “very knowledgeable” about health care reform and the Affordable Care Act’s public exchanges, and nearly one in five can’t say for sure if their company has a wellness program or not, according a recent survey. The poll’s results, released this month, speak to a population that has confidence in the communication efforts of their benefits administrators, and that points out some serious shortfalls in that communication.
The survey, which spoke with 400 employees at companies with north of 2,000 each, found that only 29.5% could correctly identify times when they can make changes to their health plans, like open enrollment, according to the Jellyvison Labs. Jellyvision, which created ALEX, a virtual employee benefits counselor, says all but one of the employers involved in the survey offer health insurance, but employees still demonstrate large education gaps on their own benefits.
More than 90% of surveyed workers say it’s at least “somewhat important” to understand ACA and its implications, but less than a fifth actually consider themselves knowledgeable. The good news is employee confidence in their employers’ ability to communicate the necessary information is high: nearly 80% think their companies can properly bring them up to speed, and more than one in three rate their confidence levels on this point at eight or higher on a 10-point scale.
Some 77.6% of those polled agree that it is at least “somewhat important” for their organizations to offer a wellness program, but almost one-fifth don’t know with any certainty whether or not their company does so.
“One of the most important things we learned from this data,” says Josh Fosburg, vice president of business development for the Jellyvision Lab, “is employees aren’t getting everything they need to know about their employers’ wellness programs and other benefits. For instance, nearly half of employees in our survey think they have to pay something in order to take advantage of the wellness programming that will help them manage their weight, stay on top of their prescribed medications, or cease smoking. That’s bananas.”
Jellyvision says employers need to “up their communications game” in order to help employees take advantage of everything included in their benefits offerings.
For one year, White House revives health plans canceled under ACA
Originally posted November 14, 2013 by Tristan Lejeune and Brian M. Kalish on https://ebn.benefitnews.com
President Barack Obama announced that Americans whose health care plans have been canceled because they fall short of Affordable Care Act standards have been granted a one-year reprieve. With the decision, state governors and insurance commissioners would have the authority to keep would-be canceled plans active until the end of 2014.
“The Affordable Care Act is going to work for the American people,” Obama said from the White House briefing room in remarks that opened with sympathy and support for the typhoon-ravaged Philippines. Obama acknowledged that his team “fumbled the roll-out of the health care law,” but he hopes that extending existing plans will help win “back the confidence of the American people.”
The decision, which helps live up to a promise Obama made when pushing for passage of health reform, is couched as an administrative fix that says following ACA will not require insurance companies to upgrade their plan for individuals who have been in these existing plans so far. In what the White House is calling “an extension of grandfathering principle” Americans should now all be able to re-enroll in their current coverage so long as it is still offered by their provider.
“Two important things we require from insurance companies,” says the administration, “one is they notify consumers what protections these renewed plans do not include. And two, they notify consumers that they will have new options available on the marketplace that offer better coverage, and tax credits are available for many people.”
Insurers and participants in the individual and small group markets will not be considered noncompliant in these plans next year. This is a policy “targeted and very targeted” to those individuals who are in those policies today, it is not allowing to be sold to people not in plans. IN other words, the policy change only applies to extant plans; all new plans must comply with Obamacare in full.
Next year is an election cycle for 33 senators and the entire House of Representatives. This move will widely be seen as trying to appease voters furious about having their plans canceled after pledges were repeatedly made that exactly that would not happen.
State authorities can still decide to consider plans non-compliant next year and insist insurers get up to speed.
Obama said that Healthcare.gov enrollment is “absolutely not” where he wants it to be, “but there’s no question that there’s great demand for high-quality health care,” and he urged health care consumers not to try to throw out the baby with the bathwater and return to the landscape circa 2009.
“It’s important that we pretend that that’s not a place worth going back to,” Obama said. “And that’s why I will not accept proposals that are just a brazen attempt to overturn the law and go back to a broken system.”
He added: "This fix won't solve every problem for every person but it will help a lot of people. Doing more will require work with Congress."
Why employers need to pay attention to ACA's insurance exchanges
Originally posted November 06, 2013 by Al Karr on www.federaltimes.com
When the Affordable Care Act first passed, most self-insured employers thought they wouldn't need to pay much attention to the new health insurance exchanges (or marketplaces) created by the law. After all, they were intended to help uninsured people get access to insurance, and their employees were obviously insured. And President Obama did promise that if people liked their employer coverage, they would get to keep it. So there wasn't really anything for self-insured employers to worry about, right?
Well, it turns out that things aren't that simple. Employers do need to pay attention to the exchanges that have launched in their states — either by the state or the federal government — because even if their employees don't use them, the functioning of the exchanges depends pretty heavily on some critical interactions among exchanges, employers, and their employees.
Most employers are aware by now that the requirement for large employers to offer coverage has been delayed for one year. But there are still many provisions in the ACA that place burdens and obligations on employers related to the exchanges. Most importantly, all employers (regardless of whether they currently offer insurance) must still provide notification to their employees describing the exchanges, and explaining the implications of applying for a tax credit on the exchange. There are also regulatory processes for exchanges to verify with employers information that individuals provide on exchange enrollment applications.
So employers are starting to realize that they really do need a communications strategy for how to tackle exchange education with their employees. Simply mailing the required notification form to all employees and calling it a day won't cut it.
Confused employees
Employees are going to have questions — lots of them. Some have been following the health care reform discussion, and those that hadn't been following it probably are now, thanks to the major issues the federal exchange has been having since its launch on October 1. Employees are seeing TV ads, print ads in magazines and newspapers, in addition to the media coverage on the exchange launch. And policy experts have noticed that some of these advertisements are totally devoid of any mention that the exchange is Obamacare or the ACA, and most don't mention anything at all about the individual mandate and that the exchanges are how to fulfill the mandate.
Employees could come into contact with navigators, certified application counselors, or in-person assisters (individuals hired by exchanges to assist with enrollment), all of which will be emphasizing the exchanges and the individual mandate, but probably don't know much about employer-sponsored plans in general, let alone each individual's circumstances regarding employer-sponsored coverage.
Recent polls have shown that as many as half of Americans believe the ACA was either repealed, or held unconstitutional, so these messages will no doubt be confusing for employees to hear. Despite all of the media coverage of the disastrous exchange launch, there are still people out there who might know about exchanges, but don't know what the ACA means to them.
Employers should be taking action now to devise a communications strategy aimed at their employees that is relevant to their workforces and fits appropriately within their company cultures. We all know that employees don't read the volumes of (boring) information employers provide during open enrollment season. Educating employees about exchanges is going to require a different and more ongoing approach. Some of the tactics employers should consider include:
- Human resources staff should be meeting with executive leadership to devise and invest in an employee communications strategy
- Contracting with a call center to do outbound calling to every employee
- Requiring all employees to meet face-to-face with an HR staff member
- Producing short videos about the exchanges for use in company communications
- Requiring attendance at "all staff" meetings
- Creating one-pagers to post on company intranet sites or to distribute through company newsletters
Navigators
One thing that has been discussed by some employers, but that may not be the best thing to rely on as a sole tactic, are the navigators. While a lot of organizations have become navigators, there is general agreement among policy makers that the program itself is woefully underfunded. And since some exchanges are run by states themselves, and the federal government runs others, it’s anticipated that the number of navigators hired and the training they will receive will vary from state to state. Also, there is no statutory requirement that navigators be trained on the nuances of employer-sponsored coverage, so there is no guarantee that they will be able to answer employees' questions about the coverage they are offered at work.
Almost Half Of Workers Don’t Know What Impact Affordable Care Act Will Have On Them
Originally posted November 06, 2013 on https://www.insurancebroadcasting.com
Online resources cited as most reliable source of information about law
COLUMBIA, S.C.--(BUSINESS WIRE)--A survey conducted online by Harris Interactive on behalf of Colonial Life & Accident Insurance Company shows nearly half of American workers don’t feel knowledgeable about how the Affordable Care Act will impact them personally.
“Despite all the attention the Affordable Care Act has received in the past few years, nearly half of American workers still say they don’t know much about it”
In a poll of more than 1,000 U.S. employees (full-time and/or part-time)1, 47 percent of workers say they are not very knowledgeable or not at all knowledgeable about the impact the Affordable Care Act will have on them. Thirty-three percent say they’re not very knowledgeable about the law and its proposed personal impact, and 14 percent say they’re not at all knowledgeable.
“Despite all the attention the Affordable Care Act has received in the past few years, nearly half of American workers still say they don’t know much about it,” says Steve Bygott, assistant vice president of core market services at Colonial Life.
In other survey findings, 48 percent of workers say federal government websites are the most reliable source of information about the ACA and its personal impact on them. They rated internet or other online news sources as the next most reliable, cited by 44 percent of employees. Other sources viewed as reliable options include:
Their employers or HR departments
36 percent
Insurance company websites or literature
30 percent
TV news programs
25 percent
Printed magazines or newspapers
20 percent
Family or friends
18 percent
Other
8 percent
“Workers clearly need help understanding this law and its personal impact on them and their families,” says Bygott. “Because employers are viewed as one of the top three sources of reliable information on this topic, they have a tremendous opportunity to help their workers get the information they need when they communicate their benefits programs.”
Survey results were included as part of a white paper recently published by Colonial Life called “Beyond Health Care Reform.” The research paper outlines what employers should know about health care reform, employee benefits and the subsequent need for increased benefits education.
Survey Methodology
This survey was conducted online within the United States by Harris Interactive on behalf of Colonial Life from September 3-5, 2013 among 2,046 adults ages 18 and older, among whom 1,023 are employed full-time or part-time. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey methodology, including weighting variables, please contact Jeanna Moffett at Colonial Life at JMoffett@ColonialLife.com.
1 Online survey conducted within the United States for Colonial Life & Accident Insurance Company by Harris Interactive, Sept. 3-5, 2013, among 2,046 U.S. adults age 18 and older, among whom 1,023 are employed full-time or part-time.
Cost of benefits, ACA compliance main concerns of midsized businesses
Originally posted by Andrea Davis on https://ebn.benefitnews.com
The cost of health coverage, the Affordable Care Act and the volume of government regulations are the top three concerns of midsized business owners and executives, according to a new survey from the ADP Research Institute.
Seventy percent of midsized businesses – those with between 50 and 999 employees – surveyed said their biggest challenge in 2013 is the cost of health coverage and benefits. ACA legislation came in as the No. 2 concern, cited by 59%, a 16% increase over last year. And rounding out the top three list of concerns was the level and volume of government regulations, cited by 54%.
“What was a surprise to us was that midsized business owners’ level of confidence in their ability to comply with the laws and regulations doesn’t reflect reality,” says Jessica Saperstein, division vice president of strategy and business development at ADP.
For example, the survey finds that, overall, 83% of midsized businesses are confident they’re compliant with payroll tax laws and regulations, nearly one-third reported unintended expenses – fines, penalties or lawsuits – as a result of not being compliant.
“The majority say they’re confident but many of them are experiencing these fines and penalties,” says Saperstein. “On average, it’s about six times a year and the average cost of one of these penalties or fines is $90,000.”
Nearly two-thirds of benefits decision-makers at midsized companies are not confident they understand the ACA and what they need to do to be compliant. Ninety percent aren’t confident their employees understand the effects of the ACA on their benefits choices.