Supreme Court health care decision sets off health benefits scramble

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in Centerpiece,Employment Law,Human Resources

U.S. Supreme CourtIf you've held off on implementing changes to your organization's health benefits until the Supreme Court rules on the health care reform law, it's time to get busy.

The U.S. Supreme Court today upheld the constitutionality of the Affordable Care Act (ACA), including its controversial heart — the "individual mandate” that requires almost all Americans to have health insurance coverage by 2014 or else pay a fine.

The Court's ruling puts to rest for now uncertainty about how health insurers and HR pros who handle health benefits should proceed. A long list of milestones for implementing the ACA were established when the law was enacted in March 2010, and they remain in full force.

"While we expect political debate to continue over health care reform, employers are advised to keep moving forward with implementing ACA and its governing regulations,” said Cara Woodson Welch, vice president of public policy at the nonprofit organization WorldatWork.

Several short-term deadlines are approaching:

This year

  • Starting Aug. 1, health insurers that don't spend at least 80% of the premiums they collect on health care delivery will have to issue rebate checks to policyholders. Your insurance carrier or broker will know how this ACA requirement will affect your employees.
  • For plan years beginning on or after Sept. 23, employers must provide employees with a plain-English "summary of benefits and coverage” (SBC) statement that explains their benefits and defines basic health insurance and medical terms. Your carrier or broker can point you toward government-approved templates and compliance advice.
  • Employers must begin planning right away to comply with a requirement to report the value of employees' health benefits on 2012 W-2 tax statements to be distributed early next year. The IRS is still working out the details. Consult your tax advisor to learn your compliance obligations.

2013
Next year's ACA requirements will be relatively easy on employers, with most regulatory attention focused on preparing to set up state insurance exchanges, which are supposed to allow many Americans to buy more affordable health insurance coverage.

2014
The real ACA action begins in 2014, when the individual mandate kicks in and state insurance exchanges go live. That's also when employers begin facing big penalties if they don't offer health insurance.

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