In our last post, Employers with less than 101 employees and the ACA’s Fair Health Insurance Premium rules , we discussed the challenges employers with less than 101 employees that sponsor non-grandfathered fully insured plans will face in 2016. And we cited that one way these employers can escape these onerous rules is by self-funding their plan. In this follow-up post, we’ll briefly discuss why the Affordable Care Act’s new taxes on fully insured plans increases the financial benefits of self-funding.
First, what is self-funding? Continue reading »
- The Harvard study showed ”medical costs fall by about $3.27 for every dollar spent on wellness programs.”
- The RAND study concluded that “Participation in a wellness program over five years is associated with lower health care costs and decreasing health care use. The average annual difference is an estimated $157, but the change is not statistically significant.”
- The PepsiCo study demonstrated: “When we looked at each component [disease management and lifestyle management] individually, we found that the disease management component was associated with lower costs and that the lifestyle management component was not. We estimate disease management to reduce health care costs by $136 per member per month, driven by a 29 percent reduction in hospital admissions.” Continue reading »
Zack Pace: Offering Coverage to 70% of Your Full-Time Employees Does Not Eliminate Your 2015 Shared Responsibility Penalty Risk
If your business is subject to the Affordable Care Act’s (ACA’s) 2015 Shared Responsibility requirements and you do not currently offer coverage that is both adequate and affordable to 100% of your full-time employees, this post explains why the 70% relief provision offered in the final regulations does not eliminate your 2015 penalty risk.
Included in Treasury’s Final Guidance on Employer Shared Responsibility is relief stating that, generally, the “no coverage” penalty in 2015 will not be triggered if an employer offers Minimum Essential Coverage (MEC) to at least 70% of their employees working 30 hours or more per week (i.e. their full-time employees). This 70% relief only lasts one year and reverts to 95% in 2016. Continue reading »
One of the most confusing aspects of the Affordable Care Act (ACA) is its differing definitions of “large” and “small” employer. For example, “large” employers with 50 or more full-time employees + equivalents (FTEs) are subject to Shared Responsibility, while “small” employers with less than 101 employees are subject to the Fair Health Insurance Premium rules. What’s that you say, you have less than 101 employees, and you haven’t heard of the Fair Health Insurance Premium rules? If so, this post is for you.
First, what are the Fair Health Insurance Premium rules? Continue reading »
So what do employers have to look forward to in the new year? It is an election year so while the rhetoric on the state and federal levels may increase, the likelihood of the enactment of additional employment laws is slim. The federal agencies will continue to pursue the initiatives which were started in 2013.
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