2015 is just around the corner. Are you ready?

Dorothy Summers

Most of the political discussion surrounding the Affordable Care Act (ACA) involves whether the law will be further delayed and/or repealed. While the government continues its in-fighting, the Obama Administration has pushed forward. In fact, in the first quarter of 2014, the government issued two significant pieces of final guidance related to implementing the major requirements of the law.

Employer Mandate Final Regulations
The first piece of guidance was the employer mandate final regulations. These “Pay or Play” rules provide some clarity as well as a deadline for compliance. For large employers—businesses with 100 or more full-time and full-time equivalent (FTE) employees—the deadline is January 1, 2015, or the month in which your health plan renews in 2015. While 2015 seems far off, the reality is that it is only nine short months from now.

Employers with between 50 and 99 full-time and FTE employees have a bit more breathing room—they have until 2016 to comply. Businesses with fewer than 50 full-time and FTE employees do not need to meet the Pay or Play requirements.

So, are you ready to act on the government’s final guidance? Are you certain? Count your employees to determine if you are a large employer and subject to the employer mandate in 2015. If you qualify as a large employer in 2015, take the following steps:

  • Determine whether health coverage is offered to at least 70% of your full-time employees and their dependents.
  • Review whether the plan being offered to at least 70% of your full-time employees and their dependents provides minimum value by using one of the three available methods: the minimum value calculator; safe harbor checklists; or actuarial certification.
    • Confirm the information provided from the fully insured carrier on the Summary of Benefits and Coverage
  • Assess the affordability of your lowest-cost single health coverage under one of the IRS’ affordability safe harbors using the W-2, rate of pay, or the federal poverty line.
  • Provide required information regarding plan coverage and participation in accordance with information return requirements, and file the report in 2016 using 2015 data.

When the government announced last summer that it was delaying the employer mandate, many employers let out a sigh of relief. They relaxed. However, now it’s time to pick up the pace again. Before you know it, 2015 and 2016 will be here and the ACA will be an everyday reality for employers.


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©2015 Corporate Synergies Group, LLC. No part of this material may be republished or distributed without prior written consent.
  • author's avatar

    By: Dorothy Summers

    As a Senior Compliance Consultant at Corporate Synergies, Dorothy Summers works closely with clients to identify areas of non-compliance involving health and welfare plans, including ERISA health plans, COBRA, HIPAA privacy and security, and the Affordable Care Act. She assists in developing a strategy to bring benefit programs into compliance.

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    Pay or Play in 2015: 3 questions to answer today

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