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In like a lion or a lamb? ACA compliance begins

Jan. 1, 2015, has come and gone. With respect to employee benefits, it will likely be remembered as the first day of Affordable Care Act (ACA) compliance for many employers.

If the past year has been any indication, employers will continue to struggle with the specifics of compliance, but for the time being, the initial considerations are more focused on “where are we now” and how we manage going forward. So let’s look at some of the keys for where employers should be.

First — assuming that if an employer had more than 100 full-time employees in 2014, and has a calendar year plan — the employer should be offering creditable coverage to full-time employees. That would be those working 30 or more hours per week over the preceding measurement period that carried through the end of 2014. Second, this means that employers would be in the first stability period as well, and that those employees to whom coverage was offered as a result of satisfying the hourly requirements of the measurement period have that coverage and continue to be eligible for that coverage for a period of at least six months and no shorter than the measurement period. Third, for those employees subject to measurement periods (those variable hour employees), they would now be in their second measurement period to determine whether they will be eligible for coverage for the 2016 plan year.

This overlap of the first stability period and the second measurement period is key because over the next year employers have to remember that both apply. As we move through 2015, an employee who achieved full-time status during the 2014 measurement period may begin to average fewer than 30 hours per week over the 2015 measurement period. But that does not mean they lose coverage. They may lose eligibility for coverage in the 2016 plan year (which is why it is important to track their hours over the 2015 second measurement period), but they maintain that eligibility for the 2015 first stability period because of their status in the 2014 initial measurement period.

Also see: House bill ties veteran hiring to ACA mandate relief

As employers hire in 2015, the decision will be whether the new hire is a variable hour employee subject to a measurement period (which means eligibility to participate in the health plan would be delayed), or whether the new hire is brought on as a full-time employee. Remember that new hires that are hired on a full-time basis generally have to be eligible for coverage within 90 days of the date of hire. Therefore, an additional consideration moving forward in 2015 is what status new employees are given as it relates to their eligibility. Plus we have to keep track of the number of employees we have for each month so that we can ultimate report that at the end of 2015.

The good news is that, at least through the close of 2014, no new regulations or restrictions were passed that significantly alter this basic framework. Employers should start off 2015 with three basic considerations:

  • Make sure to offer and maintain coverage to those who are eligible.
  • Make sure to treat new hires correctly.
  • Make sure to count employees in accordance with the instructions for form 1094-C (even though they are still in draft form).

Employers who start 2015 with a focus on these three action items will be better prepared for compliance throughout the year.

Keith R. McMurdy is a partner with Fox Rothschild focusing on labor and employment issues

Posted 2:18 PM  View Comments

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