With 2015 looming over us, many employers have been, are starting to, or should be thinking seriously about their small business health insurance. From rates to premiums to newly imposed penalties, there’s so much to navigate in this marketplace! But knowing what to expect and when to expect it is more than half the battle. This will help your small business successfully provide group health benefits to your employees and will ensure your operations continue to run smoothly.
So, to help you keep your small business health insurance offerings humming, the following is a list of major dates and deadlines that any business owner will want to mark on his or her calendar. Some are ACA-specific, while others are decade old reminders.
Small Business Health Insurance Reform: A Timeline of Dates to Know
Here are the dates your small business should keep in mind when it comes to small business health insurance:
Finalize eligibility rule changes for ACA employer mandate compliance
Employers with 100 or more full-time employees should finalize assessment of any eligibility changes and employee premium rates for purposes of ACA employer shared responsibility provisions. Beginning in 2015, those employers are subject to the penalties under the ACA's “play or pay” mandate.
Complete updating of business associate agreements
Confirm that business associate agreements have been updated to comply with final regulations issued in 2013 under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (the HITECH Act). The deadline reflects the 12-month extension previously granted.
Update plan documents to reflect eligibility changes
Incorporate any changes in definition of eligible employees into plan documents, summary plan descriptions, open enrollment materials, employee handbooks and other documents describing which employees are eligible to participate.
Update enrollment forms
Update enrollment forms used in open enrollment for mid-year hires and for changes in status to include a request for a taxpayer identification number (TIN) for each dependent. This is needed for the new informational reporting requirements under Internal Revenue Code Sections 6055 and 6056.
Finalize plans for identifying “full-time employees”
Applicable large employers (those with 50 or more full-time employees) should be finalizing plans for identifying employees who will be treated as “full-time employees” for purposes of the ACA's employer shared responsibility provisions. This will include implementing procedures for measuring hours of service and determining if a monthly approach or a look-back measurement period approach will be used for variable-hour and/or seasonal employees. If a look-back measurement period approach is used, the standard measurement period will need to be established, as well as other specifics.
For example, employers with calendar year plans using a look-back period approach will generally use a standard measurement period that begins and ends in October of each year, followed by an administrative period ending December 31, during which variable-hour and seasonal employees who earned at least 1,560 hours of service during the standard measurement period will be given an opportunity to enroll for the following plan year.
Distribute Medicare Part D Notice
Medicare Part D Notice of Creditable Coverage or Non-Creditable Coverage must be furnished before October 15 to all covered persons who are eligible for Medicare. This is an annual obligation that predates the enactment of the ACA.
File 5500 annual report
October 15 is the deadline for the 2013 IRS Form 5500 for calendar year plans that filed a timely request for an extension of time using IRS Form 5558.
Prepare for ACA informational reporting obligations
Compliance with the ACA's new informational reporting obligations associated with the individual and employer mandate should be worked on. Initial steps include reviewing payroll and HRIS recordkeeping systems to ensure that necessary data elements may be captured.
Obtain health plan identification number Health Care Reform: Upcoming Key Dates for Employer-Sponsored Health Plans Employers with large self-insured health care plans should begin the process of obtaining a health care plan identification number (HPID), required by HIPAA, so that the process can be completed by the November 5, 2014 deadline. HPIDs are issued by the Centers for Medicare and Medicaid Services (CMS). Small plans (those with less than $5 million in annual claims) have an additional year, until November 5, 2015, to secure an HPID. It appears that insurers generally will be obtaining HPIDs for insured plans.
Transitional Reinsurance Program filing due
November 15 is the deadline to electronically submit through www.Pay.gov the 2014 enrollment count and documentation and schedule reinsurance payments for the ACA Transitional Reinsurance Program. This annual fee for 2014 may be paid as a single installment by January 15, 2015, or in two installments. The rate for 2014 is $63 per year per covered life ($5.25 per month), and for 2015 it will be $44 per year ($3.67 per month). Insurers are responsible for paying the fee for insured plans. For self-insured plans, the employer is responsible for paying the fee, although arrangements may be made for the plan's third-party administrator to pay the fee on the plan's behalf.
Include required notices with open enrollment materials
Include in open enrollment materials a summary of benefits and coverage (SBC) for each health care benefits option. If the plan or a plan option is grandfathered, the open enrollment materials should also include a notice of the plan's continued grandfathered status. Consider also including with open enrollment materials other notices required to be furnished annually, including notices required under the Women's Health and Cancer Rights Act (WHCRA) and the Children's Health Insurance Program (CHIP). Note that the Department of Labor issued an updated model CHIP notice earlier this year that should be used. The updated notice includes information on the new health care insurance Marketplaces, also known as Exchanges, established by the ACA.
Ensure a record of each offer of coverage is maintained
For purposes of demonstrating compliance with the ACA's employer shared responsibility provisions, applicable large employers should ensure that a written record is maintained of all offers of coverage as part of the annual enrollment process, as well as in connection with mid-year hires and changes to benefits eligible status. This is because the potential penalties under the ACA's employer shared responsibility provisions are based upon whether an employer “offered its full-time employees (and their dependents) the opportunity to enroll” in minimum essential coverage. On audit, the government is expected to require proof that an offer of coverage was made.
SHOP exchanges open for small employers
Federally facilitated Small Business Health Options Program (FF-SHOP) for small employers to purchase group coverage through Healthcare.gov is scheduled to launch November 15. Early access prior to that date is currently planned for the following states: Delaware, Illinois, New Jersey, Missouri and Ohio. This provides an alternative forum in which smaller employers – generally those with fewer than 100 employees – may shop for group health care insurance coverage.
Distribute summary annual report
December 15 is the deadline for furnishing to participants the 2013 summary annual report (SAR) for calendar year plans filing their Form 5500 annual report under the extended deadline of October 15.
Finalize informational reporting data collection plans
By the end of December, employers should have finalized plans to collect for 2015 data required for IRS informational reports and returns under Code Sections 6055 and 6056. See our bulletin “Healthcare Reform: ACA Employer Information Reporting Requirements for Employers” for more information.
Finalize FSA $2500 annual limit amendment
December 31 is the deadline for adopting the required amendment limiting health care flexible spending account annual contributions to $2,500. This ACA limitation became effective January 1, 2013, for calendar-year plans, but the IRS has allowed employers until the end of 2014 to adopt the required conforming amendment.
Employer shared responsibility provisions effective
ACA employer shared responsibility provisions become effective January 1, 2015, for calendar-year plans based upon one-year delay in enforcement announced in July 2013.
Pay Transitional Reinsurance Program fee Payment of the ACA Transitional Reinsurance Program fee is due.
Include coverage information on Form W-2
The Forms W-2 issued to employees must include the aggregate cost of applicable employer-sponsored health care insurance coverage. This requirement was first effective for the 2012 Form W-2 issued in January 2013. An exception remains in effect for smaller employers that issued fewer than 250 Forms W-2 for the preceding year.
Conduct ACA employer shared responsibility reassessment
Large employers with 100 or more full-time employees should conduct a detailed analysis of whether any further changes should be made in plan eligibility rules to satisfy the 95 percent threshold in 2016 (up from 70 percent in 2015) under the ACA's employer shared responsibility provisions. Employers with 50 to 99 full-time employees who previously qualified for transition relief from the ACA employer shared responsibility provisions should finalize assessment of any eligibility changes and employee premium rates, for purposes of the ACA employer shared responsibility provisions. Beginning in 2016, those employers are subject to the penalties under the ACA's “play or pay” mandate.
PCORI fee due
July 31 is the annual deadline for payment of the Patient Centered Outcomes Research Institute fee (PCORI fee) of $2 per covered life for the preceding plan year.
At NARFA, our goal is to keep you up to date on the latest news in the automotive, roads, and fuel industry—including helping your small businesses with acquiring the best small business health insurance. To help, we create original content and we like to share useful information from other professionals that will help your business operate as efficiently as possible.
We encourage you to continue to visit our blog for more on everything we do and share, and we also invite you to contact us with any questions or needs your business may have—including purchasing small business health insurance for 2015. We look forward to hearing from you!
Editor’s Note: Credit for this timeline and list is owed to the Vedder Price and their September-released Newsletter/Bulletin titled, Health Care Reform: Upcoming Key Dates for Employer-Sponsored Health Plans.