Regardless of possible outcomes in Washington, employers still need to look at current operating strategies to make sure they’re compliant with looming ACA requirements that are still law of the land.
For example, the deadline for using the new summary of benefits and coverage template is fast approaching, Christine Pothm, a partner with the firm Vorys, Sater, Seymour and Pease, said Monday at EBN’s Benefits Forum & Expo in Boca Raton, Fla. Issued April of last year, the DOL shortened the SBC to five pages, and added important questions regarding deductibles, out-of- pocket limits and network providers.
“Make sure you’re making a quick comparison and you’re using the new one,” she advised. “There is a penalty associated with not using the correct template that is coming up.”
Pothm also noted changes brought about by the 2016 21st Century Cures Act that’s important for employers. First, it allows for what’s called a qualified small employers health reimbursement rearrangement. The IRS and DOL came out and said stand-alone HRAs are no longer permissible because they violated provisions in the ACA.
The second change was it provided additional marching orders to the IRS, DOL and HHS regarding mental health parity. The result of that regulation is “a lot of guidance issued from the tri-agencies,” she noted, adding that on the DOL’s site, under mental health parity, there are a number of 1-4 page summaries.
“I would encourage employers, if you haven’t seen the info, they’re great short little documents to see whether your plan is compliant,” Pothm added. “This is one of their top areas they’re looking at for enforcement.”
Employers also need to be aware of the DOL’s audits of group health plans, she said.
“They are cross training all agents to handle both retirement and group health plans,” she warned. “Typically if a retirement plan is pulled for audit, most likely they’ll add your group health plans to what they’re looking at.”
“Regardless of what Congress does, we still have a very active administration,” added John Hickman, partner at the international law firm Alston and Bird.
The current hot-ticket item is the Graham-Cassidy bill, a proposal crafted by Sens. Bill Cassidy (R-La.), Lindsey O. Graham (R-S.C.) and Dean Heller (R-Nev.) that essentially turns control of the healthcare markets over to the states.
Although the sticking points aren’t in the employer benefits arena, the bill does nix the employer mandate and includes HSA expansions, Hickman noted.
Reporting issues still wouldn’t be taken away in this bill, he warned, and employers will still have to comply with the ACA’s reporting requirements this year.
But, assuming the bill fails, there are still a number of potential stand-alone fixes, Hickman said.
For example, there is the bipartisan support of repealing the excise tax that we may see come down the line. “It’ll be an interesting time going forward,” he noted.