Smart Benefits: Employers Who Ignore Obamacare Will Pay
Monday, September 23, 2013
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.
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