As the Affordable Care Act inches closer to its January 2014 fruition, many employers sponsoring group health care plans are scrambling to prepare for the upcoming changes. To help employers focus and prioritize, Leslie Anderson and Barbara McGeoch of Mercer's Washington Resource Group compiled a list of the top 10 areas needing extra consideration and planning before the mandate's full implementation.
- Decide whether to "play," which would provide employer-sponsored coverage to full-time employees, or "pay" employer-shared-responsibility penalties of about $2,000 per uninsured employee.
- If playing: Analyze the affordability and minimum value of coverage and determine whether, when and how to start counting the hours an employee worked. If paying: Establish how full-time employees will be identified for shared-responsibility reporting and penalty assessment.
- Understand the public exchanges and how they will affect the employer's particular workforce and plan design. Strategize some ways to best interact with the exchanges and communicate the service to employees.
- Review plan terms for 2014 compliance (considering 2014 mandates and current plans that may no longer be permitted), and implement required plan design changes.
- Consider increasing wellness program incentives.
- Amend plan documents to reflect changes to eligibility, plan design and wellness incentives. Terminate arrangements no longer permitted (e.g., mini-med plans).
- Prepare and distribute required employee communications such as summaries of benefits and coverage, exchange notices, summary plan descriptions and summaries of material modification.
- Pay first comparative effectiveness research fees by July 31, 2013, and budget for future reinsurance fees.
- Plan for new federal reporting.
- Revise Health Insurance Portability and Accountability Act privacy and security policies and procedures before the Sept. 23, 2013, deadline for compliance with final regulations.
Mercer has a Web page to help companies keep up-to-date about health reform requirements.