Now is the time to focus on 2016 with respect to Affordable Care Act compliance. Additional reforms have taken effect this year for employers sponsoring group health plans, and there have been notable changes to existing provisions. To prepare for 2016, employers should review the upcoming requirements and develop a compliance strategy.
Here are some key items to track in 2016:
- Applicable Large Employers (ALEs) with 50 to 99 full-time/full-time-equivalent employees are now subject to penalties under the Employer Mandate.
- Transition relief ends:
- 95 percent (rather than 70 percent) of full-time employees must be offered coverage to avoid 4980H(a) penalties
- 30 employee reduction (replaces 80) must be used in the penalty formula for determining the 4980H(a) penalty amount
- Employer Mandate penalties increase:
- Subsection (a) – $2,160 annualized
- Subsection (b) – $3,240 annualized
- ALEs must complete and file with the IRS forms 1094-C and 1095-C by May 31, 2016 if filing hardcopy or by June 30, 2016 if filing electronically (employers with 250 or more returns must file electronically). Individual statements issued to employees and covered individuals must be distributed by March 31, 2016.
- Continue to provide the Notice of Marketplace to new hires within 14 days of their start date.
- If self-insured:
- Remit Patient Centered Outcomes Research Institute (PCORI) fee by July 31, 2016 for plan years that ended in 2015.
- Provide enrollment data to HHS by November 15, 2016 to determine the reinsurance fee for 2016. Payment will be due by January 15, 2017. If making the payment in two installments, the due dates are January 15, 2017 and November 15, 2017.
- Prepare a process for receiving and acting on Marketplace subsidy determinations (see MSEC’s January 2016 Bulletin article for more information on this topic).
- ALEs with 50 to 99 full-time/full-time-equivalent employees should ensure IT systems are in place to track employee hours of service. This is to provide appropriate offers of coverage to full-time employees and to avoid a potential penalty.
- Update plan documents to conform to ACA requirements (e.g. coverage in stability period allowed regardless of hours worked during the stability period).
- Continue to model and make changes to plan design to avoid the Cadillac tax even though the tax has been delayed until 2020.
Please contact MSEC if we can provide any assistance or answer any questions about past, current, or future ACA requirements.