The Next Step in the Affordable Care Act has to be done NOW!

by Michael Haberman on September 18, 2013 · 0 comments


 

There is an October deadline under the ACA.

There is an October deadline under the ACA.

My primary consulting business is directed to small businesses. I am finding that many of them have NO CLUE that they have to comply with a piece of the Affordable Care Act NO LATER than October first. So here is what has to be done NOW.

Three notices

For Employers not offering healthcare plans

If you are an employer that does not offer health insurance and has fewer than 50 full-time equivalents you still are obligated to inform you employees of the availability of healthcare insurance through the Health Care Exchange. The MODEL NOTICE for employers not providing insurance can be found here. In Part B of this notice there is a section that must be completed by the employer. In Georgia there is NO state run marketplace. All employees must be referred to the Healthcare.gov website in order to shop for insurance.

For Employers who offer healthcare plans

 For employers who offer healthcare plans, whether or not they are under the 50 FTE mark, there is a MODEL NOTICE available here. In Part B there are two sections that need to be completed by the employer. This form informs the employee that they can possibly get insurance at a reduced cost through the insurance marketplace. As above the employee will have to visit the Federal government website Healthcare.gov to compare insurance.

For employers covered by COBRA

In addition to the information that has to be provided above all health plans that are covered by COBRA (more than 20 employees) must give their employees a new COBRA rights document which can be found here. As of October 1, 2013 all COBRA covered employers who terminate an employee must now give them the option of choosing COBRA to continue their coverage, or a second option of going into the exchange. The employee will have to understand the level of coverage and cost of both COBRA and the exchange. There’s deadline pressure for the employee, too. If they don’t make a choice within 60 days, they get neither, which would leave them uninsured. For employers, there’s no obligation to assist the employee in weighing options and making a smart decision. Whether or not they choose to assist is yet another decision which employers and their HR staffs will have to make with regard to PPACA. There are a number of areas that have to be completed by the employer.

For companies that use a third-party COBRA administrator that administrator may be the producer of this form. For companies that self-administer COBRA it is necessary to properly complete this form before it is given to the employee.

Summary

There are three levels of employers. Some compliance is required at all three levels.

First, there are employers who provide no insurance and have fewer than 50 FTEs. The must give their employees the notice that informs them of the availability of the Healthcare Exchange.

Secondly there are employers who offer insurance regardless of the size of the company. They must provide their employees with the notice of what coverage they have and where they can go to see if they can purchase insurance at a cheaper rate. For employers that are in this category and have more than 50 FTEs there are requirements on the affordability of the insurance. Check with your insurance broker to fully understand these metrics.

Thirdly there are employers that are subject to COBRA if they have more than 20 employees. If, as an employer, you are in this category then you must provide all terminated employees a new COBRA notice that not only offers them COBRA coverage but also information on getting insurance through the Healthcare exchange.  


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