Here are the dates your small business should keep in mind when it comes to small business health insurance:
Transitional Reinsurance Program filing due
November 15 is the deadline to electronically submit through www.Pay.gov the 2014 enrollment count and documentation and schedule reinsurance payments for the ACA Transitional Reinsurance Program. This annual fee for 2014 may be paid as a single installment by January 15, 2015, or in two installments. The rate for 2014 is $63 per year per covered life ($5.25 per month), and for 2015 it will be $44 per year ($3.67 per month). Insurers are responsible for paying the fee for insured plans. For self-insured plans, the employer is responsible for paying the fee, although arrangements may be made for the plan’s third-party administrator to pay the fee on the plan’s behalf.
Include required notices with open enrollment materials
Include in open enrollment materials a summary of benefits and coverage (SBC) for each health care benefits option. If the plan or a plan option is grandfathered, the open enrollment materials should also include a notice of the plan’s continued grandfathered status. Consider also including with open enrollment materials other notices required to be furnished annually, including notices required under the Women’s Health and Cancer Rights Act (WHCRA) and the Children’s Health Insurance Program (CHIP). Note that the Department of Labor issued an updated model CHIP notice earlier this year that should be used. The updated notice includes information on the new health care insurance Marketplaces, also known as Exchanges, established by the ACA.
Ensure a record of each offer of coverage is maintained
For purposes of demonstrating compliance with the ACA’s employer shared responsibility provisions, applicable large employers should ensure that a written record is maintained of all offers of coverage as part of the annual enrollment process, as well as in connection with mid-year hires and changes to benefits eligible status. This is because the potential penalties under the ACA’s employer shared responsibility provisions are based upon whether an employer “offered its full-time employees (and their dependents) the opportunity to enroll” in minimum essential coverage. On audit, the government is expected to require proof that an offer of coverage was made.
SHOP exchanges open for small employers
Federally facilitated Small Business Health Options Program (FF-SHOP) for small employers to purchase group coverage through Healthcare.gov is scheduled to launch November 15. Early access prior to that date is currently planned for the following states: Delaware, Illinois, New Jersey, Missouri and Ohio. This provides an alternative forum in which smaller employers – generally those with fewer than 100 employees – may shop for group health care insurance coverage.
Distribute summary annual report
December 15 is the deadline for furnishing to participants the 2013 summary annual report (SAR) for calendar year plans filing their Form 5500 annual report under the extended deadline of October 15.
Finalize informational reporting data collection plans
By the end of December, employers should have finalized plans to collect for 2015 data required for IRS informational reports and returns under Code Sections 6055 and 6056. See our bulletin “Healthcare Reform: ACA Employer Information Reporting Requirements for Employers” for more information.
Finalize FSA $2500 annual limit amendment
December 31 is the deadline for adopting the required amendment limiting health care flexible spending account annual contributions to $2,500. This ACA limitation became effective January 1, 2013, for calendar-year plans, but the IRS has allowed employers until the end of 2014 to adopt the required conforming amendment.
Employer shared responsibility provisions effective
ACA employer shared responsibility provisions become effective January 1, 2015, for calendar-year plans based upon one-year delay in enforcement announced in July 2013.
Pay Transitional Reinsurance Program fee Payment of the ACA Transitional Reinsurance Program fee is due.
Include coverage information on Form W-2
The Forms W-2 issued to employees must include the aggregate cost of applicable employer-sponsored health care insurance coverage. This requirement was first effective for the 2012 Form W-2 issued in January 2013. An exception remains in effect for smaller employers that issued fewer than 250 Forms W-2 for the preceding year.
March – June 2015
Conduct ACA employer shared responsibility reassessment
Large employers with 100 or more full-time employees should conduct a detailed analysis of whether any further changes should be made in plan eligibility rules to satisfy the 95 percent threshold in 2016 (up from 70 percent in 2015) under the ACA’s employer shared responsibility provisions. Employers with 50 to 99 full-time employees who previously qualified for transition relief from the ACA employer shared responsibility provisions should finalize assessment of any eligibility changes and employee premium rates, for purposes of the ACA employer shared responsibility provisions. Beginning in 2016, those employers are subject to the penalties under the ACA’s “play or pay” mandate.