The vote is in, and most of the Affordable Care Act has been ruled constitutional by the Supreme Court. Here’s what comes next for you, immediately and in the future.
In truth, of course, nothing changed, since the ruling essentially tells employers and employees to “continue to march” as they did when the Act was first passed. However, it is worth reviewing the checklist of upcoming requirements and deadlines — some of which got pushed into the background by the expectation that the law would be struck down:
- Employers will have to issue summaries of benefits and coverage during their first open enrollment on or after September 23, 2012
- Most employers will be required to report the cost of individuals’ health insurance on their 2012 W-2s
- Insurers will have to issue the first medical-loss ratio rebates this year
- Employers will need to amend their health FSAs to comply with the $2,500 limit on employee contributions by the end of 2014 plan year
- The state health exchanges are slated to be up and running in 2014
- Starting in 2014, insurers will no longer be allowed to restrict coverage for those with preexisting conditions
- Employers who do not offer sufficient levels of health insurance to their employees by 2014 will be forced to pay a penalty, and
- Employers in 2014 will be allowed to increase the value of the incentives they provide employees for participating in wellness programs to 30% of the cost of health coverage.
Looking ahead further to 2014:
The employer “play or pay” mandate: Probably more important — for employers anyway — than the individual mandate is the “play or pay” mandate, which will require large employers (generally, those with 50 or more full-time employees taking into account full-time equivalents) to provide adequate and subsidized group coverage to all full-time employees and their families beginning in 2014. If an employer fails to satisfy this requirement, it will be subject to a penalty — generally, $2,000 per full-time employee per year.
New nondiscrimination requirements: In 2014, most insured group health plans will be prohibited from discriminating in favor of highly paid employees. If an employer’s plan fails to satisfy this requirement, the employer will be subject to significant financial penalties. (Regulators will need time to prepare and issue guidance on this one, so it could kick in later than 2014). If you’re offering different plans, eligibility periods or premium subsidies to different groups of employees, the requirements could be meaningful for you.
Automatic enrollment: Most employers with more than 200 employees will be required in 2014 to automatically enroll new employees who are eligible for group health plan coverage, unless an eligible employee chooses to opt out. (Again, regulators are still preparing guidance, so enactment could come later than 2014.)