Smart Business Magazine, November 2013

30 Smart Business St Louis November 2013 Moving forward How to fulfill your Affordable Care Act responsibilities The bulk of the Affordable Care Act ACA will be implemented on Jan 1 2014 Even though large employers dont necessarily need to go through the chess game of whether or not to offer insurance pay or play a number of new initiatives still come online The community rating rules which limit how insurance carriers can classify small employer groups the individual mandate and 8 billion insurer tax all will shape health care and premiums in the coming year Youve got to keep your eyes open and continue to see whats going on says Mark Haegele director of sales and account management at HealthLink Smart Business spoke with Haegele about how to develop a year end checklist of responsibilities related to health care reform What is the first thing an employer must do The ACA is not going away so you must determine how the law applies to your business Lets say you are contemplating offering in 2015 minimum essential coverage plans skinny plans that just cover preventive care Employers with 50 or more full time equivalent employees may want to consider making this move in 2014 even though the employer shared responsibility provision or employer mandate isnt in effect This prevents employees from getting subsidies and going through the new health care exchanges or marketplaces and then losing these funds in 2015 when you move over to a lower level plan Consider any future health care changes and how they will impact your employees for the next couple of years You dont want to aggravate staff and cause retention problems Whats important to know about your insurance Many people expect to see sharp spikes in health insurances costs and premiums after Jan 1 2014 which could be unsustainable The 8 billion insurer tax which likely will be passed onto employers in the form of premiums is being calculated as a 4 to 6 percent increase The community rating rules could drive premiums up by more than 60 percent if your insurance group is a young healthy population Out of pocket maximums have been limited to no higher than 6350 for self coverage and 12700 for family coverage for most insurance The upcoming January 2014 health insurance renewals are the last to come into compliance before many large employers face fines Consider where you are and the steps it will take to come into compliance before your 2015 renewal Business executives need to analyze the costs and benefits of remaining with their current insurance plan or moving to self funding which has more freedom from regulations Take the time to examine this regularly No one is sure how the insurance market will react to ACA measures Beyond strategic decisions what concrete actions need to be completed You need to make sure you sent out the notice to your employees about the new health care marketplaces or exchanges required as of Oct 1 2013 Its a good idea to include this with your orientation materials to ensure all new employees are notified In addition a Summary of Benefits and Coverage an easy to understand summary of health care benefits must be given to eligible participants at least 30 days before your plan year begins Your insurer health reimbursement arrangement provider or third party administrator usually provides this Verify your employee waiting period meets new requirements A group health plan cannot make new employees wait more than 90 days for health insurance coverage as of Jan 1 2014 Even though the employer mandate was delayed large fully insured employers should use 2014 as a trial year Set up your tracking procedures for employee hours especially those who work part time so you can spot any problems Because of the delay the government will likely be less tolerant of any mistakes in 2015 Health care compliance will continue to be a major concern for businesses You need to make time to understand how the ACA will impact your company even if it takes outside expertise to manage all your obligations Insights Health Care is brought to you by HealthLink WEBSITE To learn more about the impact of the Affordable Care Act and other key health care business trends visit www healthlink com key_ business_ trends asp INSIGHTS HEALTH CARE MARK HAEGELE Director sales and account management HealthLink 314 753 2100 mark haegele@ healthlink com