For many employers and recruiting/staffing firms, the delay of the employer mandate under the Affordable Care Act (ACA, or Obamacare) until 2015 may have felt like a temporary “get out of jail” card. But that doesn’t mean employers can just forget about Obamacare for the next year. There are a number of requirements that will still kick in next year, including:
- The employee mandate. Most individuals will be required to have healthcare insurance by 1/1/2014 or pay penalties. That means that employees will have more questions about their employers’ plans and about The Marketplace, the online system where individuals can shop for healthcare insurance. Companies need to be prepared for these questions.
- Plan changes. There are a number of group health plan requirements that will take effect on 1/1/2014. These include a ban on annual dollar limits on essential health benefits, new limits on out-of-pocket maximums, the elimination of pre-existing condition exclusions for adults, and providing coverage for clinical trial participants. If you offer employees or contractors health insurance, you will want to check with your carrier and/or broker to make sure your plan will comply with these new requirements.
- Limit on waiting periods. Starting 1/1/2014, the waiting period for coverage to be effective can’t exceed 90 days.
- Sending out SBCs. Although this is not a new requirement, it is worth noting that summaries of benefit coverage (SBCs) must again be provided to employees during open enrollment. These SBCs must include information regarding whether the plan meets the ACA’s “minimum value,” standard. So even though employers won’t be penalized for not meeting the minimum value standard now that the employer mandate has been delayed, they must still determine whether or not their plans meets it for these reporting purposes.
- Fees. In 2014, new transitional reinsurance fees and the health insurer tax will kick in. In addition, the Patient-Centered Outcomes Research Institute (PCORI) fee that went into effect in 2013 will be increased in 2014.
This is not an exhaustive list, but rather a summary of some of the most important requirements taking effect on 1/1/2014. The Society for Human Resource Management (SHRM) has a great article on the ACA requirements that you may want to refer to to learn more.
If you employ in-house employees and/or contractors, you will want to make sure you are in compliance with all of the provisions of the ACA. This includes a number of provisions that already went into effect, such as the requirement that health plans cover preventative health services. Even if you do not have employees, it’s a good idea to be aware of these issues so you are prepared to help your clients navigate the ACA.
This article is for informational purposes only and should not be construed as legal advice.
