HANYS Benefit Services

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

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).

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).

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.