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Smart Benefits: Employers Who Ignore Obamacare Will Pay

Monday, September 23, 2013

 

Obamacare brings with it a slew of new regulations that employers must meet – or face penalties of up to $100 per day for noncompliance. And that’s no easy task since there are many changes related to the healthcare reform provisions of the law.

Below is a partial checklist that shows just some of the PPACA concerns for employers.

• Provide timely employee notices (e.g. Notice of Exchange Opportunity by 10/1) and understand that some notices require distribution annually and to new hires, while others only need to be provided once

• Cover preventive care

• Offer dependent coverage to age 26

• Follow lifetime and annual limit restrictions

• Include an internal and external appeals process for claims disputes

• Make sure there is no rescission of benefits

• Distribute new summaries of benefits and coverages (SBCs) prior to renewals

• Follow new 90-day waiting period rules starting January 1, 2014

• Make sure incentive-based wellness programs follow new "health contingent" rules, if applicable

• Follow new plan design restrictions if you’re a small employer

It can be difficult for employers to keep track of all the requirements because the law is ambiguous at times, and guidance isn’t always available. But the responsibility for compliance rests with the employer, and if they don’t follow the law, they risk the fines: the Affordable Care Act carries a $100-a-day general noncompliance penalty.

 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

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