What Additional ACA Surprises Will the Administration Unveil Over the Holidays?

December 20, 2013

The Administration’s history of rolling out significant Affordable Care Act changes and rules around holiday periods has repeated itself with at least one new rule, and expectations are the final employer penalty and IRS reporting regulations could be posted over the next two weeks.  This week, HHS announced that anyone whose plan was canceled because it did not meet the ACA’s mandates can purchase a catastrophic health plan in the public exchanges if they want to, or get a hardship exemption from the individual mandate, and DOL posted a new proposed rule that will help employers clarify when vision and dental benefits and certain Employee Assistance Plans would not be subject to the ACA’s health insurance market reforms.  Specifically, the DOL proposed rule would:

  • Eliminate the requirement that participants pay an additional premium or contribution for limited-scope vision or dental benefits to qualify as excepted benefit;
  • Treat EAPs that meet four proposed criteria as excepted benefits; and
  • Treat "wraparound" coverage meeting certain conditions as excepted benefits, BUT the coverage could not be used to satisfy a large employer’s requirement to offer affordable, minimum value health benefits.

The final IRS reporting rule will likely require employers to make costly changes to their HRIS and payroll systems, and the final employer penalty rule could settle among other things: the definition of seasonal employees; what special rules, if any, should be put in place to determine the full-time status of short-term employees; and how the employer penalty should apply to high-turnover positions.