Healthcare Reform – Review

The healthcare reform law is still evolving; but a lot has already been finalized. In our most recent one-hour webinar, Renee Bosley, Vice-President of Employee Benefits of the Leavitt Group, provided a detailed look at the newest healthcare reform regulations and shared tips for developing a compliance and preparation strategy.

If you missed the presentation, we’ve summarized a few of Renee’s key points below. Or, you can access a full recording of the healthcare webinar here.

Employers with 100 or more employees still have to comply in 2015 – but there are some changes.

  • Large employers must offer coverage to full-time equivalent employees (FT EEs).
  • Employers face potential penalties if they don’t offer “minimum essential coverage”(MEC) to substantially all of their full-time employees (FTEs).
  • If an employer offers MEC, but it is either not “affordable” or doesn’t provide “minimum value,” they face two types of penalties:
    • “Non-offering” employers must pay $2,000 x FT EEs minus 30.
    • If coverage is not “affordable” or doesn’t provide “minimum value,” the penalty is $3,000 for each affected EE.
    • No penalties are assessed unless at least one FT EE gets a subsidy.

Employers with 50-99 employees don’t have to comply until 2016 – but there are important certification requirements which must be met.

  • Employers must meet criteria and must file written certification (though the actual form has not yet been issued).
  • Certification requirements include:
    • Limited workforce size. Employer must have employed, on average, 50-99 full-time equivalent employees (including FTEs) in 2014.
    • No reduction in workforce or overall hours between February 9, 2014 and December 31, 2014 (although a reduction is OK if it was due to “bona fide business reasons”).
    • Maintenance of previously offered health coverage. The employer must continue and not materially reduce (through December 31, 2015) health coverage offered on February 9, 2014.

Special Rule: Temporary Staffing Agencies Can Offer Benefits

A staffing agency like PrideStaff can offer health coverage to temporary employees on behalf of the client employer if:

  • The temp agency is NOT the common law employer, and
  • The temp agency offers EE coverage in their temp agency plan, on behalf of the client employer.
  • It’s treated as coverage offered by the client employer (for pay-or-play purposes) only if the client employer pays a higher fee to the temp agency for an EE enrolled in health coverage than for the same EE if the EE did NOT enroll.

As our healthcare legislation is finalized, PrideStaff will continue to provide vital compliance information.