ACA: What’s Changed and What’s Coming for Employers

Despite a country that started out the year virtually split down the middle on approval levels for the Affordable Care Act, and a lack of action by the 115th Congress over its two-year term, 2018 turned out to be a watershed year for change in this foundational healthcare law.

Despite a country that started out the year virtually split down the middle on approval levels for the Affordable Care Act, and a lack of action by the 115th Congress over its two-year term, 2018 turned out to be a watershed year for change in this foundational healthcare law.

To say there have been ups and downs when it comes to the ACA over the past two years is probably an understatement. With that said, where does that leave us as we begin the year of 2019?

At the close of 2018, the IRS extended the deadline to publish forms 1095-c from January 31, 2019 to March 4, 2019 and made virtually no changes in reporting requirements from the previous year. Two of the new reporting provisions introduced for RY2017/FY2018 are still in effect. Employers should ensure that their ACA compliance platforms have been updated to include Line 14 codes 1J and 1K along with a safe harbor for Line 15 errors.

ACA Compliance Schedule for 2019

• February 1, 2019: Employers may start receiving Exchange Notices related to the 2018 tax year.
• March 4, 2019: Deadline to publish 1095-c forms to employees.
• April 1, 2019: Deadline to file 1095-c and 1094-c forms to the IRS.
• July 31, 2019: Deadline to file form 720 PCORI (Patient-Centered Outcome Research Institute) and remit program fees due for all self-insured plans.
• Coming Soon: Many employers will need to address two healthcare changes: an increase in premiums for 2020 renewals and a choice of new plan designs.

Steps Employers Should Take Now

While the 115th Congress was unable to repeal and replace the Affordable Care Act, the Executive Branch has been busy designing alternatives to ACA compliant plans. As a result, ALEs (Applicable Large Employers) find may find themselves with a bit of a juggling act; they’ll need to 1) continue to comply with the employer mandate and ACA compliance reporting rules as they exist today, while also 2) possibly respond to proposed Employer Shared Responsibility Payment (ESRP) assessments from prior years and 3) keep an eye to the future while evaluating new and more creative health plan redesign options available to them in 2019 for the first time.

As far as what to do to keep those balls in the air, we’ve got some insight:

• Continually re-evaluate the quality of your contracted ACA compliance services. Employers’ implementation of ACA systems can range from standalone products with integration programs requiring constant maintenance to validate data transfer all the way to fully integrated HCM (Human Capital Management) systems, including HR, Benefits, and ACA Compliance.

  An HCM solution, like Ascentis, monitors updates to ACA regulations in real time, enabling you to keep up with changes in the law, enhance recordkeeping, and provide support for future Exchange audits and/or ESRP assessments.

• Re-examine all ACA-related recordkeeping practices.
  The key to defense against a proposed ESRP assessment includes:
  • Copies of monthly and annual Measurement Period Reports
  • Records of employee communications, including: eligibility dates and notices, enrollment and waiver dates and confirmations, spousal waiver dates and confirmations and paperless 1095-c elections for each reporting year
  • Copies of 1094-c/1095-c audit reports, clearly noting both system-produced values for all fields and any overrides made by administrators
  • Electronic log of annual IRS filing, including disposition for each .XML submission, confirmation numbers and date/time of submission
  • (For self-insured plans) Records of requests for dependent social security numbers
  • COBRA records
• Ensure you have the data you need to support health plan re-design projects.
  Beyond basic demographic information about eligible employees and their dependents, key metrics like enrollment and waiver rates, the popularity of enrollment options within medical plans and the uptake of ancillary or voluntary benefit plans will be important. Even data from outside an employer’s HCM suite can play a key role in plan re-design. This data might come from TPAs (Third Party Administrator), brokers or insurers, and may only be available on an aggregate or statistical basis – not attributed to individual employees.

  For example, to seriously consider a move to an Excepted-Benefit HRA in 2020, an employer may want to evaluate the utilization rates for ACA-mandated, no-charge, wellness and preventive services.

• Expect the unexpected and embrace it.
  Like it or not, our current state of healthcare plan regulation is more politically-driven than at any time in history. Decisions about the validity of various plan designs are being made at the federal level, and then sometimes being promptly blocked or reversed at the state level. Regardless of its origin, the political divisions over healthcare policy are showing no signs of cooling off, and employers should be ready to deal with the changes that can be brought in shifts in political party control in D.C. and some state capitals.

  Even the current environment as of this writing, in which a partial government shutdown threatens to cause significant delays in ACA filing deadlines and processing periods, is emblematic of the patience, vigilance, and need for attention to detail required of all benefits professionals throughout 2019 and beyond.

To learn more about the evolving laws and how to make smart decisions in this current healthcare benefits environment, register for our free HR webinar, ACA Compliance 2019: What’s Changed, What’s New, What’s Different, on Thursday, January 17 at 10:00am PT.

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About the Author

Bob Greene currently serves as Channels Manager and Sales Trainer at Ascentis. Bob’s 39 years in the human capital management industry have been spent in practitioner, consultant and vendor/partner roles. As practitioner, he managed payroll for a 5,000 person bank in New Jersey. As consultant, he spent 8 years advising customers in HRMS, and payroll and benefits system design as well as acquisition strategies. Bob also built a strategic HCM advisory practice for Xcelicor (now Deloitte Consulting.)

As vendor/partner, he has had prominent roles in sales support, marketing and product management at several companies and currently Ascentis. Bob recently re-joined the Editorial Board of IHRIM’s Workforce Solutions Review journal, as Contributing Editor. His experience also includes two years as Adjunct Lecturer in HRIS at Benedictine University in Lisle, Illinois. In addition to his 39 years of experience, Bob also holds a BA in English from Rutgers University.