Who Is Your ACA Quarterback?

By October 6, 2015 July 12th, 2019 Employee Benefits
Who Is Your ACA Quarterback

Procrastination, Uncertainty and Misinformation

You know that the Affordable Care Act (ACA) is here and more mandates are coming in January, but are you ready? Even employers who understand what needs to be done are feeling overwhelmed by the many facets of the law, leading to procrastination and a last minute rush to meet deadlines. According to Employee Benefit News, “Only 10% of some 480 employers in 36 industries responding to a recent poll have implemented an in-house or outsourced solution to comply with Affordable Care Act reporting requirements.”

Applicable Large Employers (ALEs) must offer Minimum Essential Coverage (MEC) to full-time employees and their dependents or face penalties. ALEs may still be liable for a penalty even if they offer coverage, if that coverage is not affordable or does not provide minimum value. ALEs with 100 or more full-time employees (including Full Time Equivalents, or FTEs) must comply as of January 1, 2015. Those with 50-99 full-time employees (including FTEs) may have to comply as of January 1, 2015, or, at the latest, January 1, 2016.

Failure to comply with the law can result in significant penalties. In addition, companies that do not meet the standards of the ACA may find themselves disadvantaged in retaining and attracting quality employees as their competitors conform to the changing landscape.

Confused Yet?

You should be.

There’s no denying that complying with the mandatory reporting requirements of the ACA can be daunting. What’s worse, many employers don’t know the questions to ask. Consider these:

  • Am I an Applicable Large Employer?
  • How do I determine who is a full-time employee for purposes of offering coverage?
  • Have employees been identified as variable, seasonal or full-time?
  • How do we determine what variable employees are eligible?
  • Have we properly accounted for union employees?
  • Have I established a measurement period for current employees and new hires?
  • Is the measurement period selected most beneficial?
  • Are we part of a control group?
  • Do I have the most economical plan solution to meet the mandate?
  • What technology am I going to use for tracking and reporting? Benefit administration? COBRA?
  • What is my 3-5 year strategic benefit plan?
  • Do I have the right team in place to guide me through this process?

You Need a Leader

Gone are the days where an employer could offer a health insurance plan to its employees and call it a day. Rather, the employer’s team of experts including the payroll vendor, accountant, legal counsel, and technology/software providers must all work together to ensure the employer satisfies all of the legal requirements of the ACA.

Who’s running this team while the employer is focused on running a business?

You need someone on your side who understands the regulatory complexities and knows how to coordinate all of the other players. This person must understand the long-term vision for your organization and, more importantly, make sure all the others understand the vision, too.

Go on the Offensive

You cannot win the game playing defense only. With an understanding of the full playbook, your insurance agent can be your quarterback, championing your team to victory over the ACA!

All insurance policies are different. Be sure to review your insurance policy for specific information about coverages available to you. Nothing in this post is meant to suggest a guarantee of coverage.