The Affordable Care Act (ACA), which was signed into law in March 2010, put in place comprehensive health coverage reform, with effective dates spread out over a period of four years and beyond. Some of ACA’s reform initiatives are already in effect for employers and their group health plans, such as the Form W-2 reporting requirement for large employers and the requirement for non-grandfathered health plans to cover certain preventive care services without cost-sharing. Many of ACA’s key reform initiatives will become effective in 2014 . Key ACA reforms that will affect employers in 2014 include health plan design changes, increased wellness program incentives, a new reinsurance fee, the employer “pay or play” mandate, and additional reporting requirements. To prepare for this next phase of ACA reform, employers should review upcoming requirements and make sure they have a compliance strategy in place. This Legislative Brief provides a health care reform compliance checklist for 2014...
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Beginning January 1, 2014, individuals and employees of small businesses will have access to insurance coverage through the Affordable Care Act’s (ACA) health insurance exchanges (Exchanges). Open enrollment under the Exchanges will begin October 1, 2013. ACA requires employers to provide all new hires and current employees with a written notice about ACA’s Exchanges. This requirement is found in Section 18B of the Fair Labor Standards Act (FLSA). On May 8, 2013, the Department of Labor (DOL) released Technical Release 2013-02 to provide temporary guidance on the Exchange notice requirement. This temporary guidance will remain in effect until DOL issues regulations or other guidance. According to DOL, future regulations or other guidance will provide employers with adequate time to comply with any additional or modified requirements. In connection with the temporary guidance, DOL announced the availability of model Exchange notices for employers to use to sa...
The Affordable Care Act (ACA) requires health plans and health insurance issuers to provide a summary of benefits and coverage (SBC) to applicants and enrollees. The SBC is intended to be a short, simple explanation about the health plan’s benefits and coverage than can help consumers more easily compare plan options. On April 23, 2013, the U.S. Department of Labor (DOL), Department of Health and Human Services (HHS), and the U.S. Treasury (the Departments) issued Frequently Asked Questions (FAQs Part XIV) on the SBC requirement for the second year of its applicability. This guidance was provided in addition to the final regulations issued on February 14, 2012 and three prior sets of FAQs related to the SBC rules (FAQs Parts VIII, IX and X). The new FAQs address issues related to providing SBCs in the second year of applicability, including: changes made to the templates for the SBC and the uniform glossary; Transition relief with respect to the minimum essential co...
On May 3, 2013, the Internal Revenue Service (IRS) released a proposed rule on the minimum value and affordability rules under the Affordable Care Act (ACA). In this proposed rule, IRS provides guidance on determining whether health coverage under an employer-sponsored plan is affordable and provides minimum value for purposes of determining the employer “pay or play” penalties. In particular, the proposed regulation: explains how to calculate minimum value (MV); outlines special rules for determining how health reimbursement arrangements (HRAs), health savings accounts (HSAs) and wellness program incentives are counted in determining MV and affordability; and provides new safe harbors for determining MV. This proposed rule would apply for tax years ending after December 31, 2013. Background Effective for 2014, ACA provides premium tax credits and cost-sharing reductions to eligible individuals who purchase qualified health plan coverage through a Health Insurance Exchange....
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a broad federal law regarding health coverage. It contains provisions related to administrative simplification, including: privacy and security of personally identifiable health information (privacy and security rules); enforcement of HIPAA requirements, including investigations, hearings, and penalties for violations (enforcement rule); and reporting requirements for breaches of unsecured protected health information (breach notification rule). HIPAA’s administrative simplification rules generally apply to health care providers, health plans, and health care clearinghouses (covered entities). In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted as part of the American Recovery and Reinvestment Act. The HITECH Act strengthened the enforcement of HIPAA’s administrative simplification provisions. On January 17, 2013, the U.S. Department of Health and Human Services ...
On February 6, 2013, the U.S. Department of Labor (DOL) marked the 20th anniversary of the signing of the Family and Medical Leave Act (FMLA) by releasing a set of final FMLA regulations . The final regulations, which become effective on March 8, 2013, implement two statutory expansions of FMLA leave protections. According to DOL: The first expansion provides families of eligible veterans with the same job-protected FMLA leave currently available to families of military service members, and it enables more military families to take leave for activities that arise when a service member is deployed. The second expansion modifies existing rules so that airline personnel and flight crews are better able to make use of FMLA protections. In connection with the final regulations, DOL indicated that it updated some of its model FMLA forms, including the model FMLA poster. The model FMLA forms are available on the DOL’s FMLA Web page . Prior to the regulations’ effective date, em...
The Affordable Care Act (ACA) requires employers to provide all new hires and current employees with a written notice about ACA’s Health Insurance Exchanges, effective March 1, 2013. On January 24, 2013, the U.S. Department of Labor (DOL) announced that employers will not be held to the March 1, 2013 deadline. They will not have to comply until final regulations are issued and a final effective date is specified. This HANYS Benefit Services Legislative Brief details the expected timeline for the Exchange notice requirements. Exchange Notice Requirements In general, the notice must: inform employees about the existence of the Exchange and describe the services provided by the Exchange; explain how employees may be eligible for a premium tax credit or a cost-sharing reduction if the employer's plan does not meet certain requirements; inform employees that if they purchase coverage through the Exchange, they may lose any employer contribution toward the cost of employer-...