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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

 

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.

SHRM Statement on Ruling in King v. Burwell
Other challenges in the ACA remain for employers.

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.

Health Plans Must Pay PCORI Fees by July 31
Under the Affordable Care Act, health insurers and self-insured group health plans are responsible for paying an annual fee by July 31 to fund the federal Patient-Centered Outcomes Research Institute (PCORI).

Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016
Recent guidance confirmed that for plan years beginning in 2016, nongrandfathered self-funded and large group health plans must apply an embedded self-only out-of-pocket maximum to each individual enrolled in family coverage.

SHRM Opposes Expansion of Small-Group Market
Joining with 18 other employer organizations, the Society for Human Resource Management (SHRM) is supporting legislation to leave the size of the small-group market for health insurance up to the individual states.

Guidance Addresses ACA Reporting Requirements
To help employers in completing the ACA-required information returns, the IRS released more detailed reporting guidance.

Insurers Expect Larger Premium Rise for 2016
Health care insurers foresee overall claim costs increasing by 7 to 10 percent into 2016, signaling a sharper uptick in premium rates next year without plan design changes.

Groups Urge IRS to Exclude HSAs from Excise Tax
Business groups are asking the IRS to exclude employee health savings account (HSA) and flexible spending account (FSA) contributions from the reach of the "Cadillac" excise tax on high-value health plans, which takes effect in 2018.

2016 Will Be Costly for Compliance, Employers Say
The ACA has brought increased compliance and reporting costs to many employers, but the majority believe the largest cost increases are yet to come.

IRS Issues 2016 Health Savings Account Limits
Next year there will be no change in HSA contribution limits for individuals but family limits will rise. And no change in the minimum required deductible for linked health plans, but out-of-pocket maximums will go up.

Survey: Employers Likely to Outsource ACA Reporting
ACA reporting requirements are leading employers toward outsourced solutions. The type of vendors being considered vary based on employer size and workforce factors.

 

 Compliance Reminders

 
 

 SHRM Webcasts

 
 

 EDUCATION

 

Upcoming SHRM Education

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

 

 SHRM Q&As

 

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.

 

 SHRM VIDEOS

 

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.

 

 TIMELINES & OVERVIEWS

 
 

 Cost & Coverage

 
 

 Topic Index

 
 

 TOOLS

 

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:

Penalties & Reporting for Violations of ACA Requirements. Via McKenna Long & Aldridge LLP.

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:

HHS Finalizes 2016 Out-of-Pocket Maximums and Transitional Reinsurance Contribution Rates

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 Business.USA.gov.

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

DOL Health Care Reform Webpage. Via U.S Department of Labor.

Healthcare.gov 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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