New Obamacare rules: IRS won’t let wellness help with ‘affordability’

By Jared Bilski

A number of prominent wellness advocates, as well the ERISA Industry Committee, had previously asked the IRS to count incentives earned through wellness programs toward employers’ “affordability” calculations under the Affordable Care Act. The agency’s response: Nope.

Well, mostly no. With the release of the latest Obamacare regs, the feds have effectively said that wellness incentives won’t count toward determining whether employees have been offered “affordable healthcare coverage” unless the incentive is earned through a smoking-cessation program.

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4 keys to calculating full-time employees under Affordable Care Act

By Sheryl Southwick

Under the Affordable Care Act’s (ACA) shared responsibility provision, a large employer (who employs at least 50 full-time equivalent employees on average) must offer affordable medical coverage to at least 95% of its full-time equivalent employees and their dependent children age 26 or younger — or face stiff penalties.

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Tip Tuesday! Employer Mandate Delayed until 2016 for Employers with Up to 99 Employees

By Lisa Klinger

The Treasury Department issued a Fact Sheet  and Final Rules implementing Employer Shared Responsibility under the Affordable Care Act (ACA).  SOME HIGHLIGHTS ARE: 

• Employers with fewer than 100 employees get a 1-year delay:  They will not have to comply until 2016, rather than 2015.

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3 new benefits plans not subject to Obamacare

By Jared Bilski

The DOL, HHS and Treasury just rolled out some proposed regs that add a number of employer plans to a list of those that are exempt from health reform provisions as well as HIPAA requirements. Here’s a breakdown of what’s on that list. The latest federal guidance covered “excepted benefits,” which are specific limited-scope benefits that are exempt — or as the feds say “excepted” — from the insurance market provisions of Obamacare and the requirements of HIPAA. The following plans were added to the list of excepted benefits under the feds’ latest guidance:

• Self-insured dental and vision plans (even if participants aren’t required to pay a separate additional charge for them),
• A new category of limited wraparound group coverage of individual coverage (if special conditions are met), and
• Certain employee assistance programs (EAPs).

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Rules for Equal Coverage by Employers Remain Elusive Under Health Law

By Robert Pear

WASHINGTON — The Obama administration is delaying enforcement of another provision of the new health care law, one that prohibits employers from providing better health benefits to top executives than to other employees.

Tax officials said they would not enforce the provision this year because they had yet to issue regulations for employers to follow.

The Affordable Care Act, adopted nearly four years ago, says employer-sponsored health plans must not discriminate “in favor of highly compensated individuals” with respect to either eligibility or benefits. The government provides a substantial tax break for employer-sponsored insurance, and, as a matter of equity and fairness, lawmakers said employers should not provide more generous coverage to a select group of high-paid employees.

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What You Need to Know About the New Eligibility Waiting Period Provisions

By Bill Olson

The 90-day maximum for eligibility waiting periods is effective as of the start of the 2014 plan year.  As employers are beginning to implement this new requirement, many have questions. For instance, what should employers do if they hired an employee under the prior rules?  

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Tip Tuesday! Understanding the Difference between Minimum Essential Coverage, Essential Health Benefits, Minimum Value, and Actuarial Value

By Lisa Klinger

There are several terms in the Affordable Care Act that sound similar and therefore cause some confusion. Each term has a different meaning and different ramifications—for employers and individuals—in terms of penalties, taxes and subsidies.    This article defines four such terms and explains how each applies to individuals and to employers.   The four terms are “Minimum Essential Coverage,” “Essential Health Benefits,”  “Minimum Value” and “Actuarial Value.”

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