Even though we still hear political rumblings of repeal, the smart money seems to be on finding ways to boost accountability and engagement as full implementation of the law nears. While a strong majority of employers remain committed to maintaining their health benefit programs, there is plenty of concern about all the new regulations coming their way.
Thoughts On Pay or Play – One of the greatest challenges facing “large” employers, defined by PPACA as those with 50 or more employees, is the mandate. Research by Willis indicates that nearly 40% of 1,200 employers surveyed plan to drop grandfathered status in order to modify their plan designs.
For employers contemplating whether they should pay or play, it is important to note that while the cost of penalties might sound minimal compared to the cost of health benefits, the penalties will increase each year. Another consideration is that even though employee health benefit costs are a deductible expense, these penalties are not. Most employers (with 100 employees or less) are not considering the exchanges for existing plan participants at this time, however some are looking at this option for covered retirees.
Upcoming Deadlines – While employers were expected to notify employees about the existence of public exchanges by March 1, 2013, this deadline has been extended because the government has yet to issue a model notice. Assuming that the exchanges are running by October 1st as intended, employees will be most concerned about the continued availability of employer-sponsored coverage and if their interests will be best served by remaining in their current plan. Other PPACA requirements with implications in 2013 include:
90-Day Waiting Period: Some employers may need to monitor time sheets during 2013 in order to determine exactly who will be eligible for coverage in 2014. This relates to a new maximum 90-day waiting period for health care coverage that will be in effect next year.
Per-Employee Assessment: Beginning in July of this year, insurers and self-funded plans must begin reporting and paying a $1.00 per covered life assessment to the new Patient-Centered Outcomes Research Institute, intended to collect and publish information about patient treatment. This fee increase to $2.00 per covered life next year and then be adjusted for inflation for the remainder of a 7-year period.
As you begin to formulate a strategy for 2014, you’ll be on the right track if you emphasize accountability and wellness. Other priorities we’re helping our clients address include greater transparency with provider pricing, close coordination of health management programs and better communication to help employees make smarter health care decisions.
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In cooperation with NAEBA