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Health Benefits Consulting
Are you ready?
Are you able to manage all of the administrative requirements set forth by the affordable Care Act (ACA)? Group Services can help you determine if your systems are configured and compliant. Contact a Group Services certified Healthcare Reform Specialist today.
Employers with 50 or more full-time employees (including full-time equivalent employees) must offer affordable coverage. Employers must offer traditional plans to all full-time employees (and their dependents) that provide minimum value (at least 60% actuarial value), with the employee cost for single coverage capped at 9½ % of employee income (or Box 1 W-2 wages).
Employers with 200+ full-time employees must automatically enroll new employees in the employer’s group health plan. Insured employer group plans may not discriminate in favor of highly compensated employees.
Employers issuing 250 or more W-2’s for the calendar year 2011 must include value of group health coverage on the employees W-2 form for 2012. (i.e., Form W-2’s distributed January 2013). Employers must also confirm that this figure is printed on the W-2. One entry will show both Employee and Employer cost.
Beginning in 2013 this provision will allow employers to use all or part of calendar year 2013 as a “measuring period” to identify full-time employees for purposes of a “stability period” covering all or part of 2014, and there-by approximate their costs, in 2014, were they to “pay” excise taxes or “play” by offering those full-time employees group health coverage that is both “adequate” and “affordable” as defined under the assuming. We are assuming the group will use a 12 month look-back period for health reform purposes to determine full-time status for benefit eligibility.
For plan years beginning on or after 1/1/2014, permit-ted wellness incentives increase from 20% of the cost of coverage to 30% (50% if the wellness program is established for the purpose of tobacco use prevention reduction).
Employers must provide current employees with a notice describing availability of exchange coverage. The notice must be provided to new hires after 3/1/13. (Effective date delayed until late summer/fall to coordinate with open enrollment period for Exchange coverage.)
For plan years beginning on or after 1/1/2014, employer group insurance plans may not impose annual dollar limits on essential health benefits, waiting periods of longer than 90 days, or pre-existing condition exclusions.
Medicare tax on wages increases by 0.9. Applies to those earning $200,000 if single, $250,000 if married filing jointly, and $125,000 if married filing separately. However, employers must withhold on all amounts over $200,000, regardless of employee’s filing status.
For plan years on or after 1/1/13 a $2,500 limit applies to employee healthcare FSA contributions.
Employers must provide SBC’s for annual enrollment beginning on or after 9/23/12.
Employers must expand coverage for qualifying dependent children up to age 26.
Employers must have procedures in place to distribute MLR rebate dollars to eligible individuals, or spend the rebate on improving effectiveness of their health & welfare plans.
Contact Group Services today to learn how HR Technology can benefit your organization. Whether you need a review of your existing HR technology configuration to ensure compliance with health care reform, an analysis of your current HR technologies and workflows to ascertain efficiencies and gaps to maximize existing products, or assistance with selecting the right HR technology for payroll, time keeping, HRIS, benefits administration, performance management, recruitment/applicant tracking, and onboarding, Group Services can help.