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Updated ACA Play or Pay Decision Guide for Employers

ACA 'PLAY OR PAY DECISION GUIDE BLR For Employers The Affordable Care Act (ACA), also known as the healthcare reform law, requires employers to share healthcare responsibility for their employees by either providing coverage or paying penalties. By 2015, any "applicable large employer" must decide if it wants to "play" by providing affordable, adequate coverage to substantially all of their full-time employees or "pay" assessable penalties. This Guide is intended to help you determine if you are an applicable large employer, if you will be subject to paying penalties, and what the actual costs of the penalties may be. POLL ? ? 73% of employers do not know enough about the play or pay mandate to make an informed decision. Source: HR.BLR.com Are you an applicable large employer? Are you confident that your organization employs 50 or more full-time emploveese > YES YOU are an applicable large employer. Jump to (below). NO How many full-time employees did you have in each calendar month in the preceding calendar year? A full-time employee is any employee who is employed on average during a month at least 30 hours of service each week. How many full-time equivalent employees (FTES) did you have in each calendar month in the preceding calendar year? Take the total hours of service in a month for employees who are NOT full time employees and divide by 120. # = X+Y CALCULATE 12 (Months) Are you an "applicable large employer"? If Z2 50 If Z < 50 YES NO The play or pay provision does not apply to you. Go to PENALTY #1 (Failing to Offer Coverage) Will you provide health insurance coverage to substantially all of your full-time employees and their dependents? Fast Fact NO 25% YES Has one or more of your full-time employees used financial assistance to obtain healthcare coverage through an exchange? You are not subject to PENALTY #1. of employers have considered dropping their healthcare benefits due to the ACA. Go to NO YES PENALTY #1 You are not subject to PENALTY #1. You are subject to PENALTY #1. Annual penalty is $2,000 for each full-time employee over 30* (AT THE CURRENT TIME.) *The first 30 full-time employees are not counted in figuring the penalty. EXPERT EXPLAINS PLAY OR PAY WATCHTHE VIDEO! In a related video, BLR Legal Editor Jessica Webb-Ayer explains the ACA Play or Pay decision in further detail for employers, including explanations of terms such as "affordable" coverage and "minimum value." Watch the video here: http://ow.ly/I0EID You Tube K PENALTY #2 (Providing Insufficient Coverage) Is the coverage you offer “affordable*? * see video for definitions of these terms. Fast Fact 38% YES of employers think their healthcare costs will increase significantly in 2014. Does the coverage you offer provide “minimum value" *? NO NO YES Has one or more of your full-time employees uUsed financial assistance to obtain healthcare coverage through an exchange? You are not subject to PENÁLTY #2. NO YES PENALTY #2 You are not subject to PENALTY #2. You are subject to PENALTY #2. Annual penalty is the lesser of the following two options: 1. $3,000 for each full-time employee who received financial assistance to obtain healthcare coverage through an exchange; or (AT THE CURRENT TIME.) DEADLINE 2. The amount that could apply under PENALTY #1. for employers to decide whether to play or pay: 2015 ARE YOU PREPARED? Several other significant provisions of the ACA are scheduled to take effect in 2014. These include: Individual mandate Large employer automatic enrollment requirement Insurance exchanges for individuals and small businesses Guaranteed issue, renewability, and rating variation requirements Preexisting condition exclusions Limits on čost sharing and deductibles Wellness incentives And many more... R Conglance Foon Healtheare Aeform Cantnt BLR's HR Compliance Focus, Healthcare Reform Countdown to 2014, describes all of the provisions in detail. http://ow.ly/kUhXk BLR Sources: HR.BLR.com, 2013 Health Insurance Survey Disclaimer: The information provided here does not represent legal or any other type of professional advice and should not be used as a substitute for legal advice from a qualified attorney licensed in your state. For the latest compliance information on the ACA, follow Us on Twitter: @BLR_HR Copyright © 2013 BLR®–Business & Legal Resources. All rights reserved. PART PART •E= •E= •E=•= •E •=•=•E=•=•= II II II TIP TIP

Updated ACA Play or Pay Decision Guide for Employers

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Updated infographic on ACA Play or Pay provision: Find out if you're an applicable large employer and covered under the health care reform law.

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BLR Inc.

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Education
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