Insights: Article

The Health Care Reform Toolkit for Employers

By Ross Manson

January 13, 2017

As health care reform becomes reality, it is important to keep abreast of new developments and changes in order to comply with federal regulations. This may seem like a daunting task given the extensive requirements. To help, Eide Bailly has created a toolkit to provide you with information on the regulations, deadlines and links to forms that need to be completed. We have also created a series of short informational videos to help prepare you for questions and outline actions that you may need to take.

As an employer, you will be faced with important decisions for your operations. Below are some resources available to keep you informed.

The Health Care Reform Toolkit includes:

Overview
 - Health Care Reform: You Have Choices
 - What Am I Required to Do?

Deadlines
 - Funding Patient-Centered Outcomes Research Reporting: Deadline: July, 31, 2013
 - All Employers Must Notify Employees of Marketplace: Deadline: October 1, 2013
 - Employer responsibility penalties now effective January 1, 2015

Education
 - Question & Answer: Get the answers to your questions
 - Blog, Website & Video Series: short informational videos discussing topics from how public health marketplaces will work to how owners of multiple businesses will be impacted
 - Free Webinars and Workshops: Advanced Health Care Reform
 - About Health Insurance Marketplaces
 - CMS’s Center for Consumer Information and Insurance Oversight
 - Health Insurance State Marketplaces
 - The Affordable Care Act, Section by Section

Tools
 - Health Plan Design and Administration
 - Eide Bailly’s Employer Health Reform Analytics


Overview

Health Care Reform: You Have Choices
The Patient Protection and Affordable Care Act requires almost all individuals in the United States to have some form of health insurance by January 1, 2014. This act affects all businesses; however, large employers with 50 or more full-time equivalent employees will be required to:

  • Provide affordable health insurance coverage for all full-time employees,
  • Elect not to provide health insurance coverage, pay defined penalties, and send employees to a state, regional or federal marketplace to purchase insurance, or
  • Redesign your health benefits strategy based on new market opportunities.

For small employers with less than 50 full-time equivalent employees there are still requirements that apply to you!

What Am I Required To Do?

Requirement

Over 50

full-time equivalent employees

Under 50

full-time equivalent employees

Patient-Centered Outcomes Research Trust Fund Fee

X

X

Reinsurance Fee
(Applies in 2014)

X

X

Non-Discrimination Rules
(Waiting for final guidance)

X

X

Notify Employees of Marketplace

X

X

Provide affordable health insurance coverage for all full-time employees

X

Not subject to the penalty for not offering affordable health care to full-time employees



Deadlines

Funding Patient-Centered Outcomes Research, July 31, 2013, Reporting Deadline
The Patient Protection and Affordable Care Act established the Patient-Centered Outcomes Research Trust Fund (the PCORTrust) to carry out the provisions of the Act relating to comparative clinical research to help health care providers evaluate the effectiveness and risks of medical treatments and procedures. To fund the PCORTrust, a new fee is imposed on a “specified health insurance policy” or an “applicable self-insured health plan” and is payable for each policy or plan year ending after September 30, 2012, and before October 1, 2019, and is reportable on IRS Form 720 (Quarterly Federal Excise Tax Return). According to the instructions for Form 720, the new fee is required to be reported annually, and paid, via the second quarter Form 720 by July 31 of the calendar year immediately following the last day of the policy or plan year to which the new fee applies.

All Employers Must Notify Employees of the Marketplace Before Oct. 1, 2013
Under the Patient Protection and Affordable Care Act (PPACA) a provision was implemented that requires employers to notify employees about the federal health insurance Marketplace (formerly called an "Exchange"). The Department of Labor has released information stating that employers need to notify their employees about the Marketplace by October 1, 2013. ALL employers subject to the Fair Labor Standards Act are required to provide a notice to ALL employees about the existence of the federal Marketplace. The notice must be provided in writing and inform employees of coverage options, contact information and a description of services provided by the new Marketplace.

  • View SampleThis link opens a PDF document. Employee Notification Form for National Health Care Exchanges (Coverage)
  • View SampleThis link opens a PDF document. Employee Notification Form for National Health Care Exchanges (No Coverage)

Extended – Employer Responsibility Penalties Now Effective as of January 1, 2015
The Department of Treasury announced in July that enforcement of the Affordable Care Act employer mandate will be delayed from its original deadline of January 1, 2014 to January 1, 2015. The 12-month delay also applies to reporting requirements for employers to provide information on health insurance coverage, who obtains the coverage and what is offered to employees.


Education

Question & Answer
Over the course of the past year, Eide Bailly has shared its knowledge of Health Care Reform with 5,000 participants in more than 75 presentations. The participants have asked a variety of questions, as the information is complex and the decisions businesses need to make are very real. Click here to review the Q & A.

Eide Bailly Blog, Website & Video Series
Eide Bailly has also created a Health Care Reform brochure and fact sheet. You can view our blog, website and YouTube channelThis link takes you to an external website. for up-to-date information on Health Care Reform.

Advanced Health Care Reform Webinars and Workshops
We invite you to visit our Events page to participate in a free, upcoming Health Care Reform webinar or workshop. Click here for additional information and to register.

About Health Insurance Marketplaces
Starting Oct. 1, 2013, consumers across the country will be able to choose affordable health insurance options through the Health Insurance Marketplace. Some states have set up a state‑based Marketplace, while other states will work with the federal government in a State Partnership Marketplace. If your state does not develop a state-run marketplace, consumers will have access to a federally‑facilitated Marketplace. Click hereThis link takes you to an external website. to learn more about Health Insurance Marketplaces.

CMS’s Center for Consumer Information and Insurance Oversight
This website offers resources for consumer support and information to create a competitive private health insurance through the marketplaces. Click hereThis link takes you to an external website. to learn more about its programs and initiatives.

Health Insurance State Marketplaces
The Kaiser Family Foundation provides an up-to-date look at each state’s progress in setting up health insurance marketplaces, also known as exchanges. Click hereThis link takes you to an external website. to check on the status of the marketplace in your state.

The Affordable Care Act, Section by Section
Click hereThis link takes you to an external website. to read the details.


Tools

Employer Health Reform Analytics
Eide Bailly’s Employer Health Reform Analytics allows us to help you quickly and efficiently analyze which choice would make the most sense for your business and employees.

We utilize a proprietary calculator that clearly shows whether your costs for health insurance will increase or decrease, depending on the number of employees you have, their wages and the future cost of coverage. We can help you determine if it makes more sense to provide coverage for your employees; send them to the Marketplace and pay the mandatory fees; or develop a new hybrid plan. Click here to learn more about Health Care Reform Analytics.

If you have questions, need assistance or need additional information about how Eide Bailly can help, please contact your Eide Bailly service provider or call 855.220.8634.

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