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Health Care Reform Resource Page

To avoid penalties and put in place effective health benefit strategies under the Patient Protection and Affordable Care Act (PPACA or ACA), employers must comply with the law's numerous and complex requirements.  


 Latest Articles


Congress Votes to Repeal Small Group Market Expansion
Midsize employers with 51 to100 employers will not be forced into the small group insured market under legislation passed by Congress on Oct. 1, a move welcomed by employers and business advocates.

ACA Reporting Requirements: Tips for What’s Ahead
Through the end of 2015 and into the first half of 2016, employers will continue to tackle the Affordable Care Act’s new reporting requirements and begin planning for the “Cadillac” tax. Here is a simplified cheat sheet.

Transitional Reinsurance Fee Deadlines Approaching
Several deadlines for the Affordable Care Act’s 2015 transitional reinsurance fee are fast approaching, with enrollment counts for determining the 2015 reinsurance fee due by Nov. 16.

Smaller Hikes in Premium Rates Forecast for 2016
Health plan premiums rate increases for 2016 will remain relatively modest while still outpacing overall inflation. Plan design changes can help control costs.

Proposed Rule Expands Transgender Health Coverage
A proposed rule by the Department of Health and Human Services bans blanket health plan exclusions of gender transition services, but leaves questions about the scope of required coverage.

Prepare Now for ACA Subsidy Appeals
Some employees will wrongly receive federal subsidies to buy coverage through a public exchange, triggering penalties against their employer. With just 90-days to appeal, employers should be prepared with a procedure to identify and handle certification notifications.

Transition Relief Ending for Minimum-Value-Lite Plans
An IRS proposed rule confirms that transition relief provided to employers that offered health plans that met Affordable Care Act minimum value requirements but failed to provide “substantial” hospitalization coverage is ending on Dec. 31, 2015.

Reminder: Medicare Part D Notices Due Oct.15
Employers whose health plans include prescription benefits for those who are Medicare-eligible must notify these individuals by Oct. 15 whether their drug benefit is “creditable coverage” equal to or better than a standard Medicare Part D drug plan.

Law Excludes Veterans with Coverage from Mandate; Questions Remain
New legislation lets employers exclude full-time employees with veterans’ health coverage from the ACA’s 50-or-more full-time employee threshold count.  But does the veterans-coverage exclusion also apply to the ACA’s reporting and other requirements?

IRS Seeks Comments on ‘Cadillac Tax’ and Account-Based Plans
The IRS is accepting comments through Oct. 1 on new guidance that addresses calculating the value of health savings accounts, flexible spending accounts and health reimbursement arrangements for the excise tax on high-value plans.

Business–Labor Coalition Seeks to Repeal ‘Cadillac Tax’
The "Alliance to Fight the 40," a diverse coalition of business and labor, has launched an effort to repeal the 40 percent excise tax on high-value health plans set to take effect in 2018.

Reducing Hours to Avoid ACA Obligations Violates ERISA, Suit Alleges
A class action lawsuit should concern employers that have, or might, cut back employee hours to avoid providing health coverage under the Affordable Care Act.

Employers Split on What Insurer Consolidation Portends
Mergers among the biggest names in the health insurance industry will provide enlarged firms with greater economies of scale. But will this translate into better deals for employers and plan participants?

Penalties Doubled for Not Filing ACA Information Returns
Congress has doubled the penalties on employers that fail to file correct Affordable Care Act information returns to the IRS, or that fail to provide employees with correct payee statements. One issue: what constitutes a “good faith” effort to comply?

Health Costs Projected to Rise 6.5% for 2016
A new report identifies those factors expected to either reduce the rate of growth for health care costs in 2016 or, conversely, to boost the spending trajectory.

Supreme Court: No ACA Compliance Reprieve
The decision in King v. Burwell makes clear that employers should take all necessary steps to maintain compliance with the Affordable Care Act’s coverage and reporting requirements—and not delay doing so in the hopes of a last-minute penalty reprieve.

Self-Insurance Growing, but Not So Much at Small Firms
Among smaller employers, self-insurance may become a more attractive means to mitigate regulatory cost increases. But they are not yet following the self-insuring lead of larger firms.

Final Rule Issued on Summary of Benefits and Coverage
Federal departments issued a final rule regarding the health care Summary of Benefits and Coverage and uniform glossary that must be provided to employees.

Coding Helps with Reporting Offers of Heatlh Coverage
Simplified reporting procedures may be available for an employer that has, throughout the calendar year, offered affordable health coverage providing minimum value to at least 98 percent of its employees for whom it is filing a Form 1095-C.

Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016

Guidance Addresses ACA Reporting Requirements

Groups Urge IRS to Exclude HSAs from Excise Tax

IRS Issues 2016 Health Savings Account Limits

2016 Will Be Costly for Compliance, Employers Say

Survey: Employers Likely to Outsource ACA Reporting


 Compliance Reminders


 SHRM Webcasts




Upcoming SHRM Education

2015 SHRM Annual Conference
June 28-July 1 | Las Vegas, Nev.




All Health Care Reform Compliance Q&As

For additional information on implementing the Patient Protection and Affordable Care Act, please contact the SHRM Knowledge Center.




Think Strategically First
Gary Kushner encourages HR to think strategically first and then tackle compliance second with regards to the Affordable Care Act.

SHOP Exchanges
Gary Kushner tells employers what they should know about the Small Business Health Option Programs.

Srategies to Avoid
Gary Kushner gives HR professionals five health care strategies that will not work. Also, three HR practitioners share insights on how their companies are adapting to reform.

Drop Health Care?
Does it make sense for employers to eliminate health care benefits? That will depend on a company’s business model and strategies for rewards and retention, argues Gary Kushner.

Doing the Math
Eliminating health care is not a simple decision, says Gary Kushner, CEO of Kushner & Co. To prove his point, he walks viewers through a scenario that presents potentially unanticipated costs for employers.




 Cost & Coverage


 Topic Index




Online Calculators:

Pay or play interactive tool. Via Unum.

Pay or play decision tree. Via Unum.

Estimated-penalty calculator. Via Littler.

Full-time employee worksheet. Via BenefitMall.

Subsidy calculator. Via Kaiser Family Foundation.

Actuarial value calculator / Minimum value calculator. Via Centers for Medicare and Medicaid Services.

Penalty Checklists:

Employer Shared Responsibility Penalties: A Checklist for Employers. Via Snell & Winter LLP.

Consequences of ACA Noncompliance for Group Health Plans. Via Buck Consultants.

Compliance Guides:

Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016. Via Buck Consultants.

Complying with and Leveraging the Affordable Care Act. A SHRM toolkit (members only).

Out-of-Pocket Limits for 2014 and 2015; Preventive Services Requirements. Via Segal Consulting.

Compliance Checklist for Plan Sponsors.  Via Snell & Wilmer LLP.

The 95% Coverage Rule—The Critical Details. Via Moulder Law.

Applying PPACA Market Reforms to HRAs, FSAs and Other Health Accounts. Via Towers Watson.

DOL Plan Audits: Are You Prepared?  Via McKenna Long & Aldridge LLP.

DOL's Self-Compliance Tool. Via the Department of Labor.

ACA Notice Requirements. Via Segal Consulting.

State-Specific Employer Guidance. Via

Triggering Loss of 'Grandfathered' Status. Via Sibson Consulting.

DOL Health Care Reform Webpage. Via U.S Department of Labor. Website. Via U.S. Department of Health & Human Services.

Small Business Health Care Tax Credit. Via IRS.

SHRM Member-Only Excel Spreadsheets:


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