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The Who To Do of 2014 and beyond

Are you compliant with PPACA requirements? Do you know about the recent changes, and who you need to work with to file all the mandated paperwork to?

Included in this article are the top four action items that need attention, including; a detailed list of where to find the information, who to submit it to, and all appropriate deadlines.

2015 Transition Relief Rule

What: The Transition Relief Rule enables businesses with 50 or more employees to ease more graciously into the mandate to provide healthcare coverage. Originally the plan was to require all employers to cover 95% of employees in 2014.  The plan now includes benchmarks for 2015 and 2016.

By 2015 qualifying businesses are required to provide 70% of their full-time employees affordable healthcare coverage.

In 2016 employers will be required to provide affordable healthcare coverage to 95% of full time employees.

Who: Employees and human resources need to be aware of this benchmark, and work with their broker, or TPA to make a plan for implementation. Open communication is key to ensuring a timely and cost effective transition. If you miss important deadlines or benchmarks you will now incur large fines.

When: Call your insurance broker or medical administrator right away to discuss how your upcoming renewal will be effected by this change that goes into effect on January 1, 2015. Many plans roll into the new year on January 1, and many others renew on months throughout the year. For example, if your renewal date is September 1, 2014, how will the January 1 regulations effect how your policy is updated now?

One Month Orientation Allowed

What: Employers have a 90 day watching period for new full time hires before healthcare coverage requirements go into effect. The challenge comes from aligning the hire date, the 90 day benchmark, and insurance rules which mitigate opportunities to adding new members to the first of any given month. This new orientation period allows employers to add up to 30 days, so that the 90 day waiting period can begin on the first day of the month following the hire.

Who: This regulation is important for human resource managers. You can either be cognizant of the hire date to align with membership availability on your medical coverage, or you can inform your new hires to expect their healthcare coverage to go into effect, after the orientation month and the 90 day waiting period.

When: This regulation goes into effect immediately.


What: The Patient-Centered Outcomes Research Institute, PCORI, is a non-profit, non-govermental organization which was authorized by the Patient Protection and Affordable Care Act. This group provides research and council by studying patients’ plan of care and treatment effectiveness. The primary purpose of PCORI is to provide patient advocacy on plan management through research which identifies patient experience and medical care process over a wide range of providers and facilities. This nationwide research is funded by a small PCORI fee. In 2014 all plans are charged $2 per person and are included with your tax return.

Who and When: Human resources should work directly with your account to have this paperwork filed by July 31, 2014.

Form: You can click here to download paperwork, (Form 720, section 2, line 133.)

New ACA IRS Forms

What: There are new IRS forms, 6055, 6056, and an updated 1095, which are annual reporting requirements imposed by the Affordable Care Act.  The intent behind these two forms is to identify who has access to minimum essential coverage (MEC), what costs the employer took responsibility for paying, and if an individual or family is eligible for receiving premium assistance.   These forms are not yet finalized for use, but will be available and required starting in 2015, and will synchronize with the new form 1095.

Who: Human resources should seek counsel from your tax accountants with questions about the impact for your company.

When: 2015

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