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Feb 2015 ppaca webinar seth perretta

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Feb 2015 ppaca webinar seth perretta

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Please join us for a G&A sponsored webinar with our outside counsel and nationally recognized expert on the Affordable Care Act, Seth Perretta of Groom Law Group, Chartered. Seth Perretta, who is located in Washington, DC and represents many employers and insurers (as well as the American Benefits Council (ABC) and America’s Health Insurance Plans (AHIP)), will provide an overview of what employers should be thinking about in 2015 with respect to the ACA. Seth will discuss, in part, the following:

Immediate issues of concern for employers who need to comply with the employer mandate as of January 1, 2015
Pitfalls for small employers with respect to the ACA, including compliance risks associated with small employers seeking to reimburse employees for their out-of-pocket medical expenses, including individual insurance premiums

The future of the high-cost “Cadillac Tax” provision and its likely effects on employer plans

The Supreme Court’s highly anticipated decision in King v. Burwell, and its potential to dismantle the ACA

Recent legislative activity related to health reform back in Washington, DC and the likelihood that this activity will lead to changes in the rules that govern your employer benefit plan offerings

Please join us for a G&A sponsored webinar with our outside counsel and nationally recognized expert on the Affordable Care Act, Seth Perretta of Groom Law Group, Chartered. Seth Perretta, who is located in Washington, DC and represents many employers and insurers (as well as the American Benefits Council (ABC) and America’s Health Insurance Plans (AHIP)), will provide an overview of what employers should be thinking about in 2015 with respect to the ACA. Seth will discuss, in part, the following:

Immediate issues of concern for employers who need to comply with the employer mandate as of January 1, 2015
Pitfalls for small employers with respect to the ACA, including compliance risks associated with small employers seeking to reimburse employees for their out-of-pocket medical expenses, including individual insurance premiums

The future of the high-cost “Cadillac Tax” provision and its likely effects on employer plans

The Supreme Court’s highly anticipated decision in King v. Burwell, and its potential to dismantle the ACA

Recent legislative activity related to health reform back in Washington, DC and the likelihood that this activity will lead to changes in the rules that govern your employer benefit plan offerings

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Feb 2015 ppaca webinar seth perretta

  1. 1. PPACA  Update   Seth  Perre.a   Principal     Groom  Law  Group,  Chartered  
  2. 2. 2   Today’s  Discussion   •  What  employers  should  be  thinking  about  in   2015:   •  Employer  mandate  and  related  tax  reporJng   compliance   •  Employer  exchange  noJces   •  PiKalls  for  small  employers,  including  new  rules   related  to  defined  contribuJon  health   •  Expected  Supreme  Court  decision  on  ACA  subsidies   •  Future  of  the  high-­‐cost  “Cadillac”  excise  tax   •  Current  legislaJve  acJvity  related  to  health  care  
  3. 3. 3   Employer  Mandate  Compliance   •  Does  it  apply  to  you?   •  Did  you  have  50+  FT/FTEs  in  2014?   •  If  yes  and  50-­‐99  FT/FTEs,  are  you  eligible  for   transiJon  relief?   •  If  yes,  do  you  qualify  for  non-­‐calendar  year   transiJon  relief?  
  4. 4. 4   •  Does  it  apply  to  you?   •  Did  you  have  50+  FT/FTEs  in  2014?   •  If  yes  and  50-­‐99  FT/FTEs,  are  you  eligible  for   transiJon  relief?   •  If  yes,  do  you  qualify  for  non-­‐calendar  year   transiJon  relief?   Employer  Mandate  Compliance  
  5. 5. 5   Employer  Mandate  Compliance   •  Does  it  apply  to  you?   •  Did  you  have  50+  FT/FTEs  in  2014?   •  If  yes  and  50-­‐99  FT/FTEs,  are  you  eligible  for   transiJon  relief?   •  If  yes,  do  you  qualify  for  non-­‐calendar  year   transiJon  relief?  
  6. 6. 6   Employer  Mandate  Compliance   •  Does  it  apply  to  you?   •  Did  you  have  50+  FT/FTEs  in  2014?   •  If  yes  and  50-­‐99  FT/FTEs,  are  you  eligible  for   transiJon  relief?   •  If  yes,  do  you  qualify  for  non-­‐calendar  year   transiJon  relief?  
  7. 7. 7   Employer  Mandate  Compliance   •  If  the  employer  mandate  applies  to  you,   have  you  taken  the  steps  to  be  compliant  as   of  1/1/15?   •  Which  compliance  method  are  you  using  (i.e.,   monthly  or  look-­‐back)?   •  Have  you  determined  which  employees  must  be   treated  as  a  full-­‐Jme  employee?   •  Have  you  offered  qualifying  coverage  to  your  full-­‐ Jme  employees?  
  8. 8. 8   Employer  Mandate  Compliance   •  If  the  employer  mandate  applies  to  you,   have  you  taken  the  steps  to  be  compliant  as   of  1/1/15?   •  Which  compliance  method  are  you  using  (i.e.,   monthly  or  look-­‐back)?   •  Have  you  determined  which  employees  must  be   treated  as  a  full-­‐Jme  employee?   •  Have  you  offered  qualifying  coverage  to  your  full-­‐ Jme  employees?  
  9. 9. 9   Employer  Mandate  Compliance   •  If  the  employer  mandate  applies  to  you,   have  you  taken  the  steps  to  be  compliant  as   of  1/1/15?   •  Which  compliance  method  are  you  using  (i.e.,   monthly  or  look-­‐back)?   •  Have  you  determined  which  employees  must  be   treated  as  a  full-­‐Jme  employee?   •  Have  you  offered  qualifying  coverage  to  your  full-­‐ Jme  employees?  
  10. 10. 10   Employer  Mandate  Compliance   •  If  the  employer  mandate  applies  to  you,   have  you  taken  the  steps  to  be  compliant  as   of  1/1/15?   •  Which  compliance  method  are  you  using  (i.e.,   monthly  or  look-­‐back)?   •  Have  you  determined  which  employees  must  be   treated  as  a  full-­‐Jme  employee?   •  Have  you  offered  qualifying  coverage  to  your  full-­‐ Jme  employees?  
  11. 11. 11   Employer  Mandate  Compliance   •  Have  you  considered  your  short-­‐term   employees  and  determined  whether  they   may  qualify  as  bona  fide  seasonal   employees?   •  Note:    If  have  lots  of  bona  fide  seasonal   employees,  should  probably  use  look-­‐back  versus   monthly  compliance  method  
  12. 12. 12   Employer  Mandate  Compliance   •  If  you  are  using  the  look-­‐back  method,  have   you  documented  which  posiJons  you  do  not   reasonably  expect  to  work  a  full-­‐Jme   schedule?   •  Otherwise,  you  may  lack  records  on  audit   necessary  to  show  that  you  didn’t  just  fail  to  offer   coverage  to  a  full-­‐Jme  employee  
  13. 13. 13   Employer  Mandate  Compliance   •  Don’t  forget  about  the  new  tax  reporJng  requirements   1.  Evidence  of  MEC  Enrollment  (applies  to  all   employers  of  any    size)   •  If  insured  MEC,  obligaJon  runs  to  carrier   •  If  self-­‐funded,  obligaJon  runs  to  plan  sponsor   2.  Evidence  of  employer  mandate  compliance  (only   applies  to  employers  subject  to  employer  mandate)   •  Tax  reporJng  occurs  in  1Q  of  2015  with  respect  to  the  2014  calendar   year   •  Make  sure  you  are  keeping  track  of  all  payroll  and  hours  data,  as  well   as  benefit  eligibility  and  offers  of  coverage  in  order  to  be  able  to  fully   tax  report,  as  required,  in  2015  
  14. 14. 14   Employer  Exchange  NoJces   •  ACA  requires  state  or  federal  exchanges  to  send  employers  a  noJce  indicaJng   that  one  of  their  employees  has  been  condiJonally  approved  for  federally-­‐ provided  premium  tax  credits  (PTCs)   •  NoJces  put  employers  on  noJce  that  they  be  liable  in  the  future  for  an   employer  mandate  “B”  penalty.   •  Employers  are  invited/encouraged  to  provide  informaJon  to  exchange  if  the   employee  was  offered  affordable,  minimum  value  coverage,  or  is  enrolled  in   minimum  essenJal  coverage  (regardless  of  affordability  of  minimum  value)   •  States  such  as  CT  and  NV  have  begun  sending  out  the  noJces.    Nothing  yet   from  HHS  for  federal  exchange  
  15. 15. 15   PiKalls  for  Small  Employers   x Don’t  forget  the  controlled  group  when  determining   whether  the  employer  mandate  applies   x Don’t  think  there  is  an  automaJc  one-­‐year  delay  from  the   employer  mandate  for  employers  with  50-­‐99  FT/FTEs   (because  there  isn’t  one!!)     x Don’t  forget  about  the  small  business  tax  credit  (but   note:    may  need  to  purchase  coverage  via  the  SHOP  if   want  to  claim  credit)   x Don’t  run  afoul  of  new  rules  prohibiJng  an  employer   from  using  tax-­‐free  dollars  or  taxable  wages  to   reimburse  an  employee  for  his/her  OOP  medical   expenses  or  individual  premiums  (unless  also  enrolled  in   employer-­‐sponsored  major  med)  
  16. 16. 16   PiKalls  for  Small  Employers   x Don’t  forget  the  controlled  group  when  determining   whether  the  employer  mandate  applies   x Don’t  think  there  is  an  automaJc  one-­‐year  delay  from  the   employer  mandate  for  employers  with  50-­‐99  FT/FTEs   (because  there  isn’t  one!!)     x Don’t  forget  about  the  small  business  tax  credit  (but   note:    may  need  to  purchase  coverage  via  the  SHOP  if   want  to  claim  credit)   x Don’t  run  afoul  of  new  rules  prohibiJng  an  employer   from  using  tax-­‐free  dollars  or  taxable  wages  to   reimburse  an  employee  for  his/her  OOP  medical   expenses  or  individual  premiums  (unless  also  enrolled  in   employer-­‐sponsored  major  med)  
  17. 17. 17   PiKalls  for  Small  Employers   x Don’t  forget  the  controlled  group  when  determining   whether  the  employer  mandate  applies   x Don’t  think  there  is  an  automaJc  one-­‐year  delay  from  the   employer  mandate  for  employers  with  50-­‐99  FT/FTEs   (because  there  isn’t  one!!)     x Don’t  forget  about  the  small  business  tax  credit  (but   note:    may  need  to  purchase  coverage  via  the  SHOP  if   want  to  claim  credit)   x Don’t  run  afoul  of  new  rules  prohibiJng  an  employer   from  using  tax-­‐free  dollars  or  taxable  wages  to   reimburse  an  employee  for  his/her  OOP  medical   expenses  or  individual  premiums  (unless  also  enrolled  in   employer-­‐sponsored  major  med)  
  18. 18. 18   PiKalls  for  Small  Employers   x Don’t  forget  the  controlled  group  when  determining   whether  the  employer  mandate  applies   x Don’t  think  there  is  an  automaJc  one-­‐year  delay  from  the   employer  mandate  for  employers  with  50-­‐99  FT/FTEs   (because  there  isn’t  one!!)     x Don’t  forget  about  the  small  business  tax  credit  (but   note:    may  need  to  purchase  coverage  via  the  SHOP  if   want  to  claim  credit)   x Don’t  run  afoul  of  new  rules  prohibiJng  an  employer   from  using  tax-­‐free  dollars  or  taxable  wages  to   reimburse  an  employee  for  his/her  OOP  medical   expenses  or  individual  premiums  (unless  also  enrolled  in   employer-­‐sponsored  major  med)  
  19. 19. 19   PiKalls  for  Small  Employers   x Don’t  forget  the  controlled  group  when  determining   whether  the  employer  mandate  applies   x Don’t  think  there  is  an  automaJc  one-­‐year  delay  from  the   employer  mandate  for  employers  with  50-­‐99  FT/FTEs   (because  there  isn’t  one!!)     x Don’t  forget  about  the  small  business  tax  credit  (but   note:    may  need  to  purchase  coverage  via  the  SHOP  if   want  to  claim  credit)   x Don’t  run  afoul  of  new  rules  prohibiJng  an  employer   from  using  tax-­‐free  dollars  or  taxable  wages  to   reimburse  an  employee  for  his/her  OOP  medical   expenses  or  individual  premiums  (unless  also  enrolled  in   employer-­‐sponsored  major  med)  
  20. 20. 20   Expected  Supreme  Court  Decision  on   ACA  Subsidies   •  SCOTUS  is  scheduled  to  hear  oral  arguments  in  a  case   called  Burwell  in  early  March   •  Case  addresses  whether  ACA  federal  premium  tax   credits  (PTCs)  are  available  on  the  federally-­‐facilitated   exchange   •  Case  could  have  HUGE  implicaJons  for  future  of  ACA   •  Depending  on  where  your  employees  reside:   •  Could  result  in  employees  losing  access  to  exisJng  PTCS   •  Could  result  in  employees  no  longer  being  subject  to  individual   mandate   •  Could  result  in  the  employer  mandate  no  longer  applying  to  you  as   an  employer  
  21. 21. 21   Expected  Supreme  Court  Decision  on   ACA  Subsidies   •  SCOTUS  is  scheduled  to  hear  oral  arguments  in  a  case   called  Burwell  in  early  March   •  Case  addresses  whether  ACA  federal  premium  tax   credits  (PTCs)  are  available  on  the  federally-­‐facilitated   exchange   •  Case  could  have  HUGE  implicaJons  for  future  of  ACA   •  Depending  on  where  your  employees  reside:   •  Could  result  in  employees  losing  access  to  exisJng  PTCS   •  Could  result  in  employees  no  longer  being  subject  to  individual   mandate   •  Could  result  in  the  employer  mandate  no  longer  applying  to  you  as   an  employer  
  22. 22. 22   Expected  Supreme  Court  Decision  on   ACA  Subsidies   •  SCOTUS  is  scheduled  to  hear  oral  arguments  in  a  case   called  Burwell  in  early  March   •  Case  addresses  whether  ACA  federal  premium  tax   credits  (PTCs)  are  available  on  the  federally-­‐facilitated   exchange   •  Case  could  have  HUGE  implicaJons  for  future  of  ACA   •  Depending  on  where  your  employees  reside:   •  Could  result  in  employees  losing  access  to  exisJng  PTCS   •  Could  result  in  employees  no  longer  being  subject  to  individual   mandate   •  Could  result  in  the  employer  mandate  no  longer  applying  to  you  as   an  employer  
  23. 23. 23   Expected  Supreme  Court  Decision  on   ACA  Subsidies   •  SCOTUS  is  scheduled  to  hear  oral  arguments  in  a  case   called  Burwell  in  early  March   •  Case  addresses  whether  ACA  federal  premium  tax   credits  (PTCs)  are  available  on  the  federally-­‐facilitated   exchange   •  Case  could  have  HUGE  implicaJons  for  future  of  ACA   •  Depending  on  where  your  employees  reside:   •  Could  result  in  employees  losing  access  to  exisJng  PTCs   •  Could  result  in  employees  no  longer  being  subject  to  individual   mandate   •  Could  result  in  the  employer  mandate  no  longer  applying  to  you  as   an  employer  
  24. 24. 24   Expected  Supreme  Court  Decision  on   ACA  Subsidies   •  SCOTUS  is  scheduled  to  hear  oral  arguments  in  a  case   called  Burwell  in  early  March   •  Case  addresses  whether  ACA  federal  premium  tax   credits  (PTCs)  are  available  on  the  federally-­‐facilitated   exchange   •  Case  could  have  HUGE  implicaJons  for  future  of  ACA   •  Depending  on  where  your  employees  reside:   •  Could  result  in  employees  losing  access  to  exisJng  PTCS   •  Could  result  in  employees  no  longer  being  subject  to  individual   mandate   •  Could  result  in  the  employer  mandate  no  longer  applying  to  you  as   an  employer  
  25. 25. 25   Future  of  the  High-­‐Cost  “Cadillac”  Excise   Tax   •  40%  nondeduc3ble  excise  tax   •  Doesn’t  take  effect  unJl  2018.    However,  the  tax  is  likely  to  affect  the  type   and  extent  of  benefits  that  are  offered  by  employers  in  2018   •  Applies  on  a  per  enrollee  basis  and  looks  at  enrolled  coverage   •  If  the  coverage  exceeds  $10,200  for  self-­‐only  coverage  or  $27,500  for  other   coverage,  then  any  excess  is  subject  to  the  tax  (with  limited  adjustments  for   certain  high-­‐risk  professions,  age  and  gender)   •  Also  this  excise  tax  and  the  employer  mandate  provisions  appear  to  be  on  a   collision  course  whereby  employers  may  need  to  eventually  choose  which   one  to  comply  with   •  Strange  bedfellows  –  all  stakeholders  (employer  groups,  unions,  elder  rights   groups,  etc.)  appear  to  want  the  tax  repealed  or  modified   •  Many  open  quesJons;  no  regulaJons  issued  yet;  regulators  are  just  now   beginning  the  rulemaking  process   •  LegislaJve  acJvity  likely  with  respect  to  the  tax  –  but  when  and  will  it  make  it   into  law?  
  26. 26. 26   Current  and  Expected  LegislaJve   AcJvity   •  Republicans  are  likely  to  conJnue  to  introduce  ACA  repeal   legislaJon   •  Depending  on  Burwell  outcome,  Republicans  (and  maybe   Democrats)  may  need  to  legislate  to  gap  fill   •  We  will  likely  conJnue  to  see  limited  bi-­‐parJsan  acJvity  on  the   margins   •  Medical  device  tax  repeal   •  Changes  to  full-­‐Jme  employee  definiJon  from  30-­‐40  hours/week   •  Cadillac  tax  changes?   •  Unclear/unlikely  that  any  of  this  legislaJve  acJvity  will  result  in   actual  laws/changes  to  the  benefit  of  employers  and   employees  
  27. 27. QUESTIONS?   G&A  Partners   info@gnapartners.com   (800)  253-­‐8562   *This webinar has been recorded and will be posted on the G&A website by Friday

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