Summary of ACA Requirements for 2014 & 2015

Aca Dec Enews

Did You Know.... 

Employers still face Affordable Care Act Compliance Issues?

As a reminder, employers should have updated their employer-sponsored plans, summary plan descriptions, employee handbook, and other documents with the following 2014 changes to ensure compliance with the ever-evolving requirements of the Affordable Care Act (ACA).

2014 Changes

Waiting Periods

  • Group health plans may not impose a “waiting period” in excess of 90 days.

(Note: a three-month waiting period does not satisfy the Affordable Care Act's 90-day waiting period limitation.  An employer must count calendar days.)

No Pre-Existing Condition Limits

  • Health plans can no longer exclude people from coverage due to pre-existing conditions.
  • Therefore, an employer may stop providing the HIPAA certificate of creditable coverage after December 31, 2014.

Elimination of Annual and Lifetime Dollar Limits

  • No group health plan may impose an annual dollar limit on essential health benefits.

The Following Changes go into Effect in 2015

Large Employers Must Either Offer an Affordable Health Plan or Pay a Penalty

  • In 2015, employers with 100 or more employees will be required to offer minimum essential coverage to 70% of their full-time employees or pay a financial penalty.  After 2016, the percentage increases to 95%. 
  • Employers with 50 - 99 employees are not required to comply until 2016.
  • Employers with fewer than 50 employees don’t face any penalties.
  • Full-time employees are those employees who work an average of at least 30 hours per week.

Additional Reporting Requirements under IRS Code Sections 6055 and 6056

The reporting requirements are effective with health coverage provided on or after January 1, 2015 with the first reports due in early 2016.

  • Section 6055 requires health insurance insurers and employers sponsoring self-funded group health plans to report the minimum essential coverage provided by an employer and to the individuals to whom such coverage was provided.
  • Section 6056 requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the terms and conditions of the health insurance coverage the employer provides.

If you have questions or for more information, contact your HR One Consultant or call HR One's Human Resource Helpline at 1.800.457.8829.