Practice Areas

Affordable Care Act Compliance Update (April 2013)

April 2013

By: Peter E. Hansen, Esq.

ACA Guidance Released

The federal government has been busy over the last few weeks, releasing a significant amount of proposed regulations, final rules, and guidance relating to the Affordable Care Act (ACA). Much of the guidance directly applies to employers, summarized below:

  • Whistleblower complaints - Employers may not discharge or "retaliate" against any employee for reporting alleged violations of the ACA, refusing to participate in any action the employee "reasonably believed" to be a violation of the ACA, or for receiving a federal health insurance income tax credit or cost-sharing reduction. ("Retaliate" generally means taking an "unfavorable employment action," e.g., demotion, discipline, denial of a promotion, towards the employee).
  • Minimum value requirements - Employers with 50 or more full-time and full-time-equivalent employees must provide healthcare coverage that is expected to cover at least 60% of costs.
  • Hours of service requirements - Employers may continue to use hours-of-service requirements to enroll in a healthcare plan, but the hours-of-service requirement may be no more than1,200 hours.
  • Waiting period restrictions - Employers may continue to use waiting period restrictions to enroll in a healthcare plan, but the waiting period cannot extend beyond 90 days (note - employers may not make coverage effective "the first day of the month" following the 90-day waiting period).

ACA Compliance Review

With the January 1, 2014 compliance deadline for many of the most significant provisions of the Affordable Care Act (ACA) drawing near, it is critical that employers understand their obligations under the law and bring their benefit plans into compliance. To assist our clients in meeting this important obligation, we have created a unique, Regulation Compliance Program to help employers of all sizes achieve compliance in an easy, efficient manner.

Under this program, for a modest flat fee, Wessels Sherman benefits law practitioner Peter E. Hansen will personally meet with your organization to assess how the ACA will affect your operation, and help create a detailed, individualized "ACA Review" based on your workforce size, industry and existing health plan. Your ACA Review will include:

  • Overview of the ACA and your specific obligations under it
  • Assessment of your notice and distribution requirements, and recommendations for compliance
  • A determination of your organization's coverage obligations
  • Recordkeeping requirements
  • "Play or Pay" mandate action plan to minimize exposure

During your meeting, Mr. Hansen will also address any specific questions you may have, and help clarify a broad variety of issues he has seen many employers struggle with as they work to understand and comply with the ACA. If you have questions or would like to schedule your appointment, please contact Mr. Hansen at (262) 560-9696, or pehansen@wesselssherman.com.