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The Affordable Care Act: Latest Developments

The Affordable Care Act: Latest Developments
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by Jason Cogdill on 04 May, 2015 with Add new comment

I hope that 2015 is going well for you and your organization. On the ACA front, new activity has been relatively "calm" since a busy February. The only significant development in the last two months was the EEOC's April 16 release of proposed regs relating to wellness programs and compliance with the Americans with Disabilities Act. If you work with wellness programs and have not reviewed a summary of the new regs, you can access a helpful summary here. The short story is that the proposed regs do not change the overall wellness compliance analysis, but they clarify certain factors that wellness programs will want to consider going forward.

I expect that the relative calm will continue between now and the Supreme Court's expected June decision in King v. Burwell. We'll likely see new guidance and FAQs from the agencies between now and then, but I am not anticipating any significant changes.

The top ACA compliance topics for 2015 continue to be:

  • Play-or-Pay compliance for employers subject to the mandate in 2015 (those with 100 or more FT + FTE calculated during 2014);
  • New ACA reporting requirements applicable in 2015 for employers with 50 or more FT + FTE (calculated during 2014); and
  • Play-or-Pay planning for 2016 for employers with 50 or more FT + FTE (calculated during 2015).

Other current hot topics:

  • Spousal coverage exclusions;
  • Individual health premium reimbursement for active employees;
  • Options for reimbursement of retiree health premiums (including individual premiums for pre-65 retirees and Medicare Supplement premiums for post-65 retirees); and
  • Change of small group insurance definition from 50 to 100 for 2016 (which affects state/carrier rules and premium rating methodology, but does not impact employer mandate).

There is no question that ACA reporting is the most significant new topic of 2015. As we proceed through this first year that reporting applies, most employers do not know about the requirements and are not yet preparing to report. This short article is on point in terms of where employers stand today both nationally and in our markets. As you assess how to best to address this for your organization, we plan to offer several options to assist with education and training. Contact us if we can be of assistance.

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Jason Cogdill

Jason Cogdill

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