The Affordable Care Act (a/k/a Health Care Reform, or the ACA) is complicated. While there is nothing in the ACA that requires any employer to provide group health care coverage to its employees, the failure to do so can come with a price. The ACA is a game changer – one that requires a different approach to compliance than in the past. As with any complex law, the devil is in the details. Some of those details have been omitted in order to help you focus on the big picture.
I. LOOK AT WHAT YOU ARE DOING NOW -
· Is your coverage the same as it was in 2010 and remains “grandfathered” or is it not grandfathered?
The “grandfathered” plan relates to the concept that “if you like the coverage you have today (in 2010), you can keep it,” and looks at the coverage you offered on March 23, 2010. If you provided a new program, increased cost-sharing, or modified coverage (within certain parameters), since March 23, 2010, your plan or some of your group health care options may have lost grandfathered status. Your plan’s grandfathered status dictates the specific ACA mandated benefits that must be provided. For example, once a plan loses its grandfathered status, it must provide coverage for certain preventive care benefits on a firstdollar basis. However, trying to retain “grandfathered status” may restrict you in shifting more costs to employees.
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Topics: Affordable Care Act, Collective Bargaining, Employer Mandates, Full-Time Employees, Grandfathered Obligations, Health Insurance Exchanges, Healthcare, Minimum Essential Coverage, Open Enrollment, Pay or Play, Penalties, Self-Insured Health Plans
Published In: Health Updates, Insurance Updates, Labor & Employment Updates
DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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