The employer mandate of the Patient Protection and Affordable Care Act was the core topic of our presentation yesterday at the Kane DuPage HR Association luncheon. Attorneys Michael F. Hughes and Rebecca Dobbs Bush, partners with Smith Amundsen, led the robust and informative discussion on “Health Care Reform – Developing a Strategy Your Company Can Afford.”
Top 3 tips concerning the ACA employer mandate and its legal implications:
- Original legislation offered a transitional look-back for any 6 consecutive month period in 2013 to determine whether an employer meets the applicability threshold for 2014. At this time, there is no indication that the 6-month transitional look-back for the applicability threshold will be available for 2014, now that the employer mandate has been pushed back to 2015. So assume that the applicability threshold must review your number of FEs and FTEs for the entire year of 2014.
- Three insurer fees begin in 2014: 1) Health Insurance Industry Fee; 2) Transitional Reinsurance Program (TRP); and 3) Patient Centered Outcomes Research Institute (PCORI). For insured plans, all three fees will be paid by the insurance company and passed on to the employer. Self-insured plans are not subject to the Health Insurance Industry Fee, but are subject to the other two plan fees.
- For 2015, new full-time employees must be deemed eligible for your employer health insurance coverage within 90 days after starting employment. That is 90 calendar days, not the 1st of the month after 90 calendar days.
In addition to the legal implications and applications discussed, Michael offered excellent insights into a fuller perspective on whether your business chooses to “pay or play.” Specifically, he encouraged employers to take into consideration how your choices will impact employee morale in the short-term, and employee retention and recruitment for a competitive advantage in the long-run.
A big thank-you to Colonial Café East for the hearty meal, finishing with their signature flourish of individual “tulip turtle” sundaes.
Republished with permission (including modest content and format edits). Originally published by Elyse on our employer blog in 2013.