Now that most employers have adjusted their mindsets from “wait and see” to “must do” – this may be a good time to focus on helping plan participants through 2014 and maintaining a strong health benefits program into 2015. Here are a few points to consider.
Employer Mandate – Employers with a combined total of 50 or more full-time and full-time equivalent employees that do not offer minimum essential health coverage to substantially all employees and their dependents may be subject to a penalty in 2015. Penalties will also apply if the coverage offered fails to meet required standards for affordability and actuarial value.
Look-Back Measurement – To determine which employees work an average of 30 hours per week, the federal government has introduced “look-back” measurement periods for ongoing and variable hour employees. We can help clients determine which measurement period is right for your organization.
Out-of-Pocket Maximums – Limits on out-of-pocket spending that include deductibles and co-payments go into effect in 2015. While limits include $6,350 for individuals and $12,700 for families, there are no caps in place for out-of-network doctors.
This item, along with discussions about changing the threshold for “full-time” employees from 30 to 40 hours, could be something to watch as more people realize that those with PPACA-approved plans could be without protection if they need to see an out-of-network specialist.
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In cooperation with NAEBA
Self Insured Plans | A Third Party Administrator 