There will certainly be some attention given to the current Insurance Marketplace (Exchanges) opening on October 1st. Estimations of over 17 million uninsured are expected to begin shopping for health insurance designed to comply with the Affordable Care Act.
As part of Act, all Americans will need to be insured starting in 2014, or pay a penalty. Companies with 50+ employees will be required to provide health insurance to their employees, while employees at smaller companies that do not provide insurance will need to purchase their own.
Individuals can begin the planning stages for their mandated insurance options by visiting their state insurance marketplace, commonly referred to as the “Exchange”. Small businesses can also utilize the exchanges to select a Carrier Option to offer their employees, known as Employer Choice. Using this option, the employer can choose one plan among selected insurers (carriers) or they can opt to select one of the “metal plans” (Platinum, Gold, Silver or Bronze) and then employees can choose among all the health carriers that offer coverage for that particular “metal” level.
In short, every small business is different and their needs are unique. Our approach is to inform businesses of their options. SHOP (Small Business Health Options Program) is located on the web! For more information on the Marketplace go to www.healthcare.gov. Payce will continue to provide updates as the Affordable Care Act is rolled out.
The impact of the Affordable Care Act on self-insured health plans (commonly known as Health Reimbursement arrangements or Medical Reimbursement plans) will now require payment of PCORI (Patient Centered Outcomes Research Institute) fees of $1 Per Member, Per Year (PMPY) from 2012 to 2018. The new annual excise tax must be reported on IRS form 720. This form is not a payroll tax form and therefore, will not be supplied by Payce.
Assessment of fees is based on the average number of lives covered in the plan for the prior year. The PCORI fees must also be calculated on each employee as well as spouse and any number of dependents associated with each employee. For the plan year 2012 the tax was due by July 31st. The fee will rise to $2 for 2014 PMPY. Although form 720 is filed quarterly, the PCORI fees are to be filed annually. Self-insured plans with fiscal year ending 1/31/13 through 9/30/13 will not file their first submission until 7/31/14. If you have a self-insured plan feel free to contact your accountant for more information on PCORI fees and form 720 preparation.
What is Unemployment Integrity? According to the Trade Adjustment Extension Act of 2011 state Unemployment agencies must not be able to relieve employers of unemployment benefit charges to their accounts if the following occur:
In plain terms, every employer should answer the state requests for information on previous employees immediately, even if there is no contest to the claim. The federal requirement for compliance supported by this Act will be in full force and effect by October 21, 2013. If a “pattern of failure” continues it could result in flat rated penalties to the employer on the first occurrence and escalated fees thereafter. If lack of response continues, the employer can be held liable for charges paid and/or loss of all further appeal rights.
If you would like assistance with Unemployment claim management please contact your Payce specialist today.
As part of the Patient Protection and Affordable Care Act, seasonal employees working 120 days or less are not expected to be offered health insurance coverage. The Act provides an exception for employers of seasonal workers who perform services such as retail workers employed during the holiday season or agricultural workers. Here is how the calculation works:
If the employer’s workforce exceeds 50 full time employees for 120 days or less per calendar year and if, the employees in excess of 50 were seasonal, then the employer is not considered an “applicable large employer”.