By Ron Bachman, Chairman of Editorial Advisory Board, The Institute for HealthCare Consumerism
Who: An employer whose workforce exceeds 50 full-time employees for 120 days or fewer during a calendar year.
When: Beginning Jan. 1, 2014, employers with 50 or more full-time workers are required to provide health coverage or incur applicable penalties. At least through the end of 2014, employers may rely on the:
Employers will not be required to comply with any subsequent IRS guidance that is more restrictive until at least Jan. 1, 2015.
What: Determining the PPACA legally recognized number of full-time employees is critical to establishing compliance with aspects of PPACA requirements and exposure to certain coverage penalties.
A full-time employee with respect to any month is an employee who is employed on average at least 30 hours of service per week. To determine the number of full-time workers can be complicated.
Executive Summary: The IRS has put out guidelines for the calculation of full-time employees. It is not as easy as one might assume. In addition there are safe harbor and transition rules that apply.
There are two safe harbor options allowed when determining an employee’s full-time status:
An employer will not be subject to a penalty if the coverage offered to an employee is affordable based on the employee’s Form W-2 wages. This is often referred to as the affordability safe harbor.
In addition, use of any of the safe harbor methods described above are not required, but optional.
Actions: Employers will need to calculate the number of full-time workers related to PPACA requirements. It may be necessary to consider employment contracts and work schedules during 2013 in preparation for this 2014 requirement. Employers will need to be in compliance or incur penalties. Employers should check with their compliance and legal teams, insurance brokers, agents, consultants and insurers in preparation for the changes to be implemented in 2014.
For more details see IRS Notice 2012-58 at http://www.irs.gov/pub/irs-drop/n-12-58.pdf
The information presented and contained within this article was submitted by Ronald E. Bachman, President & CEO of Healthcare Vision. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult your legal advisors to determine the laws and regulations impacting your business.
All group health plan or health insurance issuer plans covered by the Patient Protection and Affordable Care Act (PPACA) preventive care mandate.
The United States Preventative Services Task Force’s Final Recommendation on Children’s Fluoride Varnish Treatments
Many of the private exchange strategies that employers are currently examining contemplate a private exchange offering “fully-insured” group health plans. Here, the employer contracts with an insurance company, effectively shifting all of the health risks of its employees to the insurer.
On April 1, 2014, the Protecting Access to Medicare Act of 2014 was signed into law. It included a provision that eliminated – retroactive to March 23, 2010, the effective date of PPACA – the maximum deductible allowed for small group plans.
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