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The Results Are In 2012

HighRoads can help you prioritize and execute the items of importance to your business, it's time to focus on what this means for you and your employees. What can you expect in the next four years from the Administration and its agencies, and what should your human resources department be focused on?

With President Obama's re-election, the Administration will return its focus to implementation of the Patient Protection and Affordable Care Act (ACA). We expect many regulations and guidance documents that have been delayed over the last several months to be issued in the coming weeks. Of particular note for employers are the requirements with upcoming implementation dates, such as any modifications to the Summary of Benefits and Coverage (SBC) and employer penalty "shared responsibility" requirements.

Until the Inauguration in January, Congress will be in what is commonly referred to as the "Lame Duck" session. The Lame Duck session of Congress will need to deal, in some way, with the "fiscal cliff" that will occur on January 1, 2013: the expiration of the Bush tax cuts; legislation to avert cuts in Medicare payments to physicians; and overriding the sequestration order that would otherwise cut government spending across the board. It may be that Congress merely defers action on this legislation by delaying the effects for a couple of months. Alternatively, Congress may make a substantive effort to address these fiscal problems. In either case, we expect most of the action over the next few months will be in the Agencies, implementing the ACA and preparing for upcoming deadlines in early 2013.

• Make sure you have drafted and completed your SBCs, as required by the law and in accordance with the regulations and guidance issued jointly by the Departments of Health and Human Services, Labor, and Treasury (collectively, "the Departments") in early 2012.
  • Remember, the SBC requirement applies to employers and health insurance issuers beginning with the first open enrollment period associated with the first plan year that begins on or after September 23, 2012.
  • The Departments have indicated that they will use discretion in enforcing the SBC requirements, but it is crucial that employers make a good faith effort to comply with the regulations that the Departments have issued.
• Understand the employer-provided health coverage informational reporting requirements of the ACA. The ACA requires employers to report the cost of health care coverage under an employer sponsored group health plan on the Forms W-2.
  • Under IRS guidance, employers generally must begin this reporting with the 2012 calendar year (i.e., Form W-2 generally furnished to employees in January 2013), though transition relief may be available for certain employees with respect to certain types of coverage.
• Understand the ACA’s employer shared responsibility provision, which may impose an "assessment,"" or payment penalty if:
  • an employer does not provide affordable health insurance to its full-time employees beginning in 2014 and
  • an employee purchases a plan on an Exchange and is certified to receive an applicable premium tax credit or cost-sharing reduction.

These are just a few of the provisions for employers to be aware of in the upcoming months. For more information on ACA implementation and for your compliance needs, please do not hesitate to contact us. HighRoads can help you prioritize and execute the items of importance to your business.