Last month our newsletter asked ‘What is your Obama Care Strategy?’
This month we expand on that topic and have created a check list of what you need to know to ensure your group is in compliance with the new health care law.
PPACA: Obama Care Check List
Item 1: Understanding the Pay or Play Rule
Item 2: Determining if you are a ‘Large Employer’
Item 3: Offering dependent coverage
Item 4: Verifying if you offer the ‘Minimal Essential Coverage’
Item 5: Ensuring your plan provides ‘Minimal Value’
Item 6: Verifying the coverage is ‘Affordable’ for Employees
Item 7: Determining how penalties are calculated
Item 8: Discussing your Obama Care strategy
If we have not met with you already to discuss this check list, please feel free to contact us to set an appointment.
Employers Eye Bare-Bones Health Plans Under New Law
1Employers are increasingly recognizing they may be able to avoid certain penalties under the federal health law by offering very limited plans that can lack key benefits such as hospital coverage. These plans cover minimal requirements such as preventative services, but often little more. Some of the plans wouldn’t cover surgery, x-rays or prenatal care at all. Others will be paired with limited packages to cover additional services, for instance, $100 a day for a hospital visit.
Federal officials say this type of plan, in concept, would appear to qualify as acceptable minimum coverage under the law, and let most employers avoid an across-the-workforce $2,000 per worker penalty for firms that offer nothing. Employers could still face other penalties they anticipate would be far less costly. The idea that such plans would be allowable under the law has emerged only recently. Some benefits advisers still feel they could face regulatory uncertainty. Larger employers, generally with 50 or more employees, need cover only preventative services, without a lifetime or annual dollar value limit, in order to avoid the across the workforce penalty. Such policies would generally cost far less to provide than paying the penalty or providing more comprehensive benefits. “For certain organizations, it may be an ideal solution to minimize the cost of opting out”, said David Ellis, CEO of LifeStream Complete Senior Living, which employs about 350 workers.
These limited plans may not appeal to all workers, and while employers would avoid the broader $2,000 per worker penalty for all employees not offered coverage, they could still face a $3,000 individual fee for any employee who opts out and gets a subsidized policy on the exchanges. But the approach would appeal to companies with a lot of low-wage workers such as retailers and restaurant operators, who are willing to bet that those fees would add up slowly because even with subsidies, many workers won’t want to pay the cost of the richer exchange coverage.
1 This is an excerpt from an article by the Wall Street Journal. The full article can be found at www.wsj.com for subscribers or by finding the full print version, May 20, 2013, Vol CCLXI No. 117, pages A1, A14, by Christopher Weaver and Anna Wilde Mathews.
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