Minimum Value — Is It Affordable?


The signature achievement of healthcare reform is its supposed ability to ensure accessible and affordable care for all. Through the Medicaid expansion, exchange creation and employer requirements, the legislation was sold as creating a healthcare safety net for all, regardless of employment or financial means. Unfortunately, the third leg of that stool looks extremely wobbly. While employers are required… [Read More]

This Skeptic Is Still Hopeful about Healthcare Reform


As I write these blog entries, I often ask myself, “Am I one of those negative people? Do I always see the downside?”  For more than a year I have been writing with a cautionary, skeptical tone about whether the Obama Administration has bit off more than it can chew with federal healthcare reform. I really… [Read More]

The Insurance Exchange: If You Build It, Will They Come?

Recently the President and his head of HHS met with insurance industry executives to reaffirm the commitment to the insurance exchanges. The exchanges, a significant part of the ACA legislation, are intended to help individuals and small businesses more easily procure less-costly healthcare. Like many pieces of the ACA, exchanges are off to a rocky start. Many states have opted not to establish a… [Read More]

Limited Provider Network Plans May Help Employers Meet ACA Affordability Standard

While ACA is a very complicated piece of legislation, let’s try to simplify it. If employer-sponsored plans can meet two major provisions of the law—affordability and “minimum value”—a lot of the problems go away. Most experts feel that an employer will not have much difficulty meeting the minimum value provision, which is offering a plan… [Read More]

Thumbnail: What You Need to Know Now about Healthcare Reform

1. If you currently provide good healthcare benefits at a reasonable cost, you can probably breathe easy. Healthcare reform won’t be a travesty for your business. 2. If you do not provide benefits to all of your workers, now is the time to plan, since many costs are avoidable with proper planning. 3. If you… [Read More]

Unions: How Will They Fare Under Healthcare Reform?

One of the interesting side notes of healthcare reform is how it will impact collectively bargained entities. Representing millions of middle-income employees, unions largely supported healthcare reform in its early phases, recognizing the challenges their constituents—like Americans in similar situations—often face in securing affordable coverage. However, under pressure from price increases and coverage expansions, some… [Read More]

Will PPACA Reporting Requirements Keep You Up Nights?


You are going to hate section 6055 and 6056 of the IRS code. Under PPACA, beginning in 2015, employers will have a lot more compliance obligations. First, the easy stuff. Among other details, large employers will have to report to the IRS for every plan they sponsor: health insurance premiums or premium equivalents waiting periods… [Read More]

Communicate Value of Company Coverage as ACA Rolls Out


The Affordable Care Act offers employers a strategic communication opportunity: Highlight the good fortune your employees enjoy in not needing the ACA. Consider it. Employers have spent a great deal of time over the past several years delivering bad news to employees. In the context of the ACA, employer-sponsored health coverage gains a new, more… [Read More]

Think You Understand PPACA Affordability Standard?


In an effort to clarify PPACA affordability, the IRS released two new notices that are as clear as mud. The first notice explains that in order to meet the affordability standard, for employees earning less than 400% of the federal poverty level, an employer can charge up to 9.5% of wages for employee-only coverage. Coverage… [Read More]

Planning for Spousal Coverage under PPACA


With HHS defining “dependents” as children (“individuals under age 26″), employers have been handed a subtle planning opportunity. As we have been advising, there will be very interesting coverage strategies that will crop up as these regulations unfold. The law requires that coverage be offered to “dependents,” but as with many aspects of ACA, substantive… [Read More]