Now that the Supreme Court has upheld the Patient Protection and Affordable Care Act (the “Affordable Care Act”) and the November elections have passed, it is clear that health care reform is here to stay (at least for the foreseeable future). Employers, particularly those who have waited on the Supreme Court decision and the results of the November elections to see whether the Affordable Care Act would endure, should now take action to comply with the Affordable Care Act, including action to:

  • Establish Health Care Reform Team.

Establish a team consisting of specialists from within the employer’s human resources, benefits, payroll, legal, finance and accounting departments, as well as from outside health care insurers, administrators, consultants and legal and accounting providers.

  • Develop Action Plan.

Develop a detailed action plan and timeline to address health care reform requirements imposed upon employers, including analyzing the law, current health care plans and available alternatives and deciding how to comply with the new law in the near term and long term.

  • Become Familiar with Health Care Reform Law.

Become familiar with the requirements of the Affordable Care Act and guidance that is expected to be issued in the near future regarding a number of open issues, including for example guidance on employer automatic enrollment requirements for employers with 200 or more employees and nondiscrimination rules for insured group health plans.

  • Review Current Plans.

Review and evaluate current plan documents, policies and related materials for the employer’s group health plans (including medical, dental, vision, flexible spending and health savings account arrangements) and their costs to determine whether any changes are advisable or desirable to comply with the new law.

  • Evaluate Health Care Reform Alternatives.

Evaluate various health care reform alternatives, including whether to:

  • Maintain grandfathered plan status (to the extent available) or adopt a group health plan that conforms to all of the requirements of the new law.
  • For 2014 and later years, satisfy the employer mandate by providing employees with health insurance through an employer-sponsored plan or paying a penalty.
  • For 2018 and later years, reduce plan benefits to ensure that the plan is not a “Cadillac” plan or pay the 40% excise tax.
  • Comply With New Law.

Comply with the various requirements of the Affordable Care Act that are already effective or become effective over the next few years, including for example:

  • Effective in 2012, new Form W-2 reporting, claims and appeals procedures, medical loss ratio rebates, 100% coverage for women’s preventive health care services and summary of benefits and coverage requirements;
  • Effective in 2013, health flexible spending arrangement limits, loss of employer deductions for subsidized retiree prescription drug expenses, collection of increased FICA tax and notice of exchange options;
  • Effective in 2014, employer mandate provisions and new requirements for grandfathered and non-grandfathered plans; and
  • Effective in 2018, “Cadillac” tax provisions.

Click here to view table.