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The Affordable Care Act (ACA) Shared Responsibility Mandate

The Affordable Care Act (ACA) Shared Responsibility Mandate . Shared Responsibility Mandate. If employer offers coverage, must be offered to 95% of full-time employees Must be Affordable Must meet Minimum Value Standards Use Safe Harbor guidelines to determine track time of . Coverage.

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The Affordable Care Act (ACA) Shared Responsibility Mandate

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  1. The Affordable Care Act (ACA)Shared Responsibility Mandate

  2. Shared Responsibility Mandate • If employer offers coverage, must be offered to 95% of full-time employees • Must be Affordable • Must meet Minimum Value Standards • Use Safe Harbor guidelines to determine track time of

  3. Coverage • Defined as: • 95% of full-time employees • Full-time is defined as average of 30+ hours per week • Includes employee’s children to age 26 • Spouses or domestic partners not required • Must have the opportunity to enroll at least once per year

  4. Affordability • Affordable coverage is coverage that is 9.5% or less of household income • Federal government offered 3- Safe Harbors to employers • USG is using the Federal Poverty Line Safe Harbor: Must offer coverage with an employee premium that is 9.5% or below the Federal Poverty level • 2014 Federal Poverty level is $11,680; • 9.5% of $11,680 is $1,110 or a monthly premium of $92 • USG High Deductible Health Plan monthly premium is $47 • Under Safe Harbor, employee is not eligible for subsidy in the exchange market and USG would not be subject to penalties

  5. Minimum Value • 60% minimum plan value based on ACA rules definition of “essential health benefits” • Healthcare Plan’s actuary has confirmed all USG Healthcare plans meet Minimum Value coverage as defined by ACA

  6. Penalties for not meeting Shared Responsibility requirements • If don’t meet coverage requirements: • $2,000 times total number of FTEs – not counting first 30 FTEs if don’t meet coverage requirements • If don’t meet affordability requirements: • Up to $3,000 annually for each FTE receiving income based assistance for health insurance exchange coverage • Each USG institution’s management is accountable and responsible for achieving and maintaining compliance with the requirements under the Affordable Care Act • Each USG institution will be held financial accountable for non-compliance

  7. Tracking Time Worked- initiallyall employees not offered health insurance • Safe Harbor Tracking Method • Look-back or measurement period (3-12 months), this is the period of time in which hours will be tracked for part-time employees; standard year after year • After the measurement period, employers have the option to have an administrative period (up to 90 days); this period is used to determine eligibility and facilitate enrollment of any employees who meet eligibility • Stability period – period during which part-time employees who met eligibility may elect to participate in the healthcare plan (6-12 months) • Hours worked for faculty must be calculated based on the academic year to determine eligibility unless they work during the summer

  8. Example Tracking Periods

  9. Reporting • Employers are required to report their employer provided health coverage data to the Federal Government

  10. Three Major Impacts • Must revise the USG Employee Category Policy and the definitions of employment and employee types • Develop a Conversion Chart for Credit hours to hours worked for part-time faculty • Set up tracking method to determine health benefits eligibility for part-time workers

  11. Final Guidance Released February 10, 2014 • Further Guidance on types of employees and hours of service • 2015 Transition Tracking Period Provisions • Transitional 6 month tracking period • Must begin

  12. Definitions from Guidance • Seasonal • Variable Hour • Adjunct Faculty • Rehired employees

  13. Student Employees

  14. Proposed Definition of Student Employees • Currently not exempt under ACA • Proposed solution is to revise the Employee Category Policy: • Students must work part-time except during the summer and holidays and may not exceed 1300 hours in any consecutive 12-month period • International students and work study students must work no more than 20 hours per week

  15. Next Steps • Collect feedback from this group and from system-wide VPAAs, CBOs, and CHROs, last week of February or first week of March • Finalize documents and distribute system wide mid-March • Training sessions first two weeks in April

  16. Send suggestions/comments to VPAA listserv

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