With all of the changes in health insurance and the discussion of the ACA, it is hard to track what will be happening next. One item related to flexible spending accounts (FSAs) may have gotten lost in the noise. Late in October, the White House issued an informational fact sheet that sets out a significant change with FSAs. The “use-it-or-lose-it” nature of contributions has been modified by Treasury to allow a limited rollover of unused funds:
- as of this time, employers with plans that lack a grace period may elect to allow participants to roll over up to $500 of unused funds at the end of the 2013 plan year; and
- beginning plan year 2014, employers may allow participants to roll over up to $500 of unused funds at the end of the plan year.
Several media outlets are reporting the decision by the Seventh Circuit Court of Appeals this week finding that the requirement in the Affordable Care Act that group healthcare plans must cover contraceptives violates the Religious Freedom Restoration Act. This opinion does not strike down the requirement in all applications. The two companies who are parties to the case are closely held entities with Catholic owners. The 2-1 decision blocks the contraceptive mandate for those two companies.
Today marks the beginning of open enrollment in the ACA Health Insurance Exchanges. Also, employer notices with information about the Exchanges must go out today. Forms are available for employers to use.
The White House has an interactive map and information available to the public about the Exchanges. Click here to see the website: State-by-State Monthly Marketplace Premiums
The deadline of October 1 for employer ACA notices is almost upon us. October 1 is also the date that the ACA Health Insurance Marketplace will become operational. Open enrollment begins October 1 with coverage starting January 1, 2014.
As that happens, more information is being made available. The federal government–calling the Exchanges a simple and affordable way to get insurance coverage under the ACA–is promoting the system through several sources.
According to a White House release, “A new report shows that the Marketplace will give uninsured Americans access to affordable health insurance — and finds that average premiums are even lower than experts initially projected. For instance:
- A working family making $50,000 a year can get health insurance for less than $100/month.
- A 27 year-old making $25,000 a year could get coverage for an average of $93 a month.”
September 23, 2013. Today is the day that many of those who use protected health information (PHI) must comply with new Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules, which went into effect 180 days ago.
If you use PHI in your work, hopefully by now you are aware of those changes. For the first time, Privacy and Security rules apply not only to covered entities and business associates, but also to subcontractors who provide services to those business associates. This includes the security breach notification requirements when PHI is compromised.
An HHS press release earlier this year noted, “Some of the largest breaches reported to HHS have involved business associates.” With the expanded scope of the rules, look for more enforcement actions in the future.
The IRS has an on-line resource with links that outline key tax issues facing small employers (those with fewer than 50 employees) and large employers (those with 50 or more employees).
The site is available by clicking here: http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-for-Employers.
By October 1, 2013, employers must provide a written “Exchange Notice” under the Affordable Care Act (ACA) to employees. The employer must give this to all current and new full-time and part-time employees and seasonal employees. This notice is required even if you provide health insurance.
The notice tells employees of the option to purchase health insurance coverage through an insurance exchange. The notice also outlines benefits and consequences of choosing that coverage.
The U.S. Department of Labor has guidance for contents of the notice, which as a threshold, must include the following:
- The contact information of the health exchange available in the state;
- The services provided by the exchange available in the state; and
- Possible eligibility for premium tax credits or cost sharing reductions when health coverage is purchased on the exchange.
The HIPAA Omnibus Final Rule changes go into effect on September 23. Covered entities have been required to provide Notice of Privacy Practices for several years. Those notices need to be revamped. The Final Rule clarifies and expands the obligation to report breach of protected health information (PHI) to patients. Covered entities must specifically notify patients of a right to be informed of breach. More importantly, there will now be a rebuttable presumption of breach unless the covered entity can show through a four-factor test that there is a low probability of PHI compromise.
There are also requirements for the notice of disclosures to health plans, marketing and sale of PHI, and the right to opt out of communications.
These are considered material changes, thus it is important to revise the notice to reflect the changes and make it available.
There has been more political jockeying this week related to the ACA. A week after the White House announced that it would delay implementation of the play-or-pay rule for large employers to provide health insurance coverage by one year, House Republicans have called for a similar delay in the individual mandate. The mandate is expected to play a significant role in getting uninsured people signed up for health coverage. Outside of a few limited categories of people, the mandate applies to most everyone in the United States.
There is no indication that such a delay will occur. Jay Carney, spokesman for the Obama administration, responded, “A piece of legislation like [the ACA], to be responsibly implemented, needs to be implemented in a flexible way.”
In a surprising announcement this week, the Obama administration delayed implementation until 2015 of the requirement that large employers provide coverage for workers. The Affordable Care Act establishes penalties for companies with more than 50 employees that fail to offer affordable health insurance. Those penalties were set to commence in 2014 but are now delayed.
On the White House blog, Valerie Jarrett wrote yesterday about simplified reporting procedures, “[W]e believe we need to give employers more time to comply with the new rules. Since employer responsibility payments can only be assessed based on this new reporting, payments won’t be collected for 2014. This allows employers the time to test the new reporting systems and make any necessary adaptations to their health benefits while staying the course toward making health coverage more affordable and accessible for their workers.”