The Affordable Care Act: A Synopsis of This Year and Next

HCR-Learning-Zone-FINAL-FORWEBIf you have been ignoring the Affordable Care Act in hopes it would just go away, it’s time to start paying attention to it. Relief has been granted from its provisions in 2014, and there will also be some relief in 2015; at the same time, requirements are ramping up.

Originally, all employers with 50 or more employees were considered Applicable Large Employers and required to provide insurance or pay a tax. That is still true, but make sure you know the numbers when it comes to the current employer mandate status. If you have between 50 and 99 employees, you have a one-year delay from this provision. If you have over 100 employees, you must provide benefits in 2015, or face paying the tax.

The Internal Revenue Service regulations, released February 10, 2014, granting the one-year delay to employers with 50-99 employees, come with rules attached. An employer cannot reduce the number of employees or the hours they work to artificially stay below the 100 employee threshold. Any coverage provided to employees as of February 9, 2014, cannot be eliminated or reduced, and employers must certify that they have met these criteria.

While employers with 100 or more employees must provide insurance to avoid taxes, they also receive substantial transition relief in reduced taxes if they do not provide it. If such an employer provides no insurance to full-time employees, the penalty is reduced, as well as if the employer provides insurance that does not meet minimum value or affordability tests.

Changes have also been made to categories that affect coverage. Step and foster children are no longer considered dependents. Seasonal employees are those who work six months or less and start around same time every year. Employees rehired after a break in service of at least 13 weeks are considered new employees for the purposes of required coverage, and that extends to 26 weeks for educational organizations. Additionally, work-study time for educational institutions is not counted towards full-time employment, although paid
internships are.

Finally, you should know that while you are not required to provide insurance in 2014, if you do, your plan must meet a number of standards. If you are curious about what you must do now and in the future, just call us at 800.884.1328 or visit our Health Care Reform Learning Zone. The learning zone is interactive, and allows you to you can learn about the health care reform provisions that apply to your organization. We can also come to your organization to provide an in-depth assessment on how you can plan to comply with this law.