Mike Humphrey
Sr. Benefit Advisor
The Wilson Agency, a UBA Partner Firm
The Affordable Care Act (ACA) has so many provisions to be aware of that it can be downright overwhelming. Here are the top three, often overlooked, strategies to help your company get ready for the changes to come.
- Determine who is eligible for the marketplace subsidy. Unless you pay for 100 percent of your employees’ premium, you have the possibility of a backlash from your staff. Here’s how it works: If their income is 400 percent or less of federal poverty levels, they are eligible for a federal subsidy to offset their premium and sometimes co-pay expenses (this could make the marketplace plan less expensive than your employers’ group health plan). If you are providing affordable coverage for your employees this means they end up missing out on their subsidy. This step may take additional footwork as you will need to find out what their household income is. You can accomplish this through a simple survey, though you’ll want to make sure it is HIPAA compliant to protect their information.
- Review all your options. Purchasing health insurance is a completely different process now. Self-funding options are now available for smaller groups. New products and financing options are surfacing that mimic group insurance but are individual products, taking the perceived risk of self-funding out of the picture.
- Evaluate your compliance. Certain mandates will automatically be dealt with or are already put in place, such as essential benefits, dependent coverage and lifetime limits. Others are set at the company policy level and many will need to be updated to stay in compliance. In particular, note what your waiting period is (must be less than 90 calendar days from the date of eligibility) and how many hours worked are needed to be eligible for coverage (30 hours will be the new federal full-time standard on Jan. 1, 2015). If you have seasonal or part-time employees, you’ll want to spend extra effort managing the hours they work so eligibility doesn’t catch you unaware. Payroll services are adapting their products to assist business owners with tracking the hours of part-time and seasonal employees.
Certainly there is a lot more to consider and know regarding the compliance, management, administration and strategy of health care reform. Unless you’re a large company with dedicated benefit professionals, you probably don’t have the staff or the time to dedicate to these new regulations. Lean on your benefit advisor for guidance on other strategies you can use as you prepare for 2014 and beyond.
