ACA Compliance

Staying Compliant with new Affordable Care Act (ACA) Provisions

From our archives: please be aware that this post was written in 2018. Information about this topic may have changed.

The future of healthcare in the United States is generating a great deal of anxiety among individuals and employers. The most recent and prominent Congressional proposals have included repealing and replacing the Affordable Care Act (ACA), repealing without replacing, and a repeal of only select ACA provisions.

Healthcare for the country’s 323 million people is an intricate issue, and as such, is an ongoing and highly politicized one. Issues like a possible repeal of the individual mandate and funding cost-sharing reduction payments for lower-income Americans have generated strong debate that crosses party lines. Since early September, a group of U.S. Senators and a bipartisan group of state governors have been working on new proposals to help stabilize and strengthen the ACA’s individual market, while their colleagues continue to advocate for repeal and replacement of the Affordable Care Act.

Despite uncertainty, many markets have shown signs that they are stabilizing, and others have overcome difficult challenges to ensure that coverage has been available throughout 2017. Nearly every state that previously expected to have “bare counties” has since been covered by insurers who made new market commitments for 2018.

Marketplace open enrollment for 2018 has begun and in most states will run from Nov. 1 through Dec. 15. Savvy employers should take the following steps to prepare for the upcoming year:

Be Sure to Stay Compliant
On and off exchange, staying compliant with the rules and regulations is as important today as it was in previous years. Employers also want to be sure to have either a staff member or a consultant who is paying attention, has ACA expertise, and can anticipate changes and offer guidance through the next months and years.

File 1095s On Time
It is important for employers to continue filing 1095s as they have since the inception of the ACA’s reporting requirements:

  • File 1095s accurately and on time.
  • One substantive change that has occurred for calendar year 2018 (filing year 2017) is 1095-B or 1095-C forms must be provided to individuals by March 2, 2018, a 30-day extension from the original due date of January 31.
  • While Multiemployer Transition relief was effective in 2015, it remained on the 1094-C forms in 2016 to accommodate non-calendar year plans. In 2017, the relief is no longer applicable.

Stay on Top of the Basics
Ensure tracking and reporting is accurate, and that you remain aware of upcoming changes:

  • Count employees consistently. Ensure that criteria for employees’ part-time or full-time classification is documented, and that decisions about counting methodology are recorded.
  • Track offers of coverage.
  • Keep an audit trail and internal controls.
  • Know that Patient-Centered Outcome Research Institute fees (an excise tax filed on IRS Form 720) will sunset after Oct. 1, 2019.

There will be no major changes to the ACA or its employer reporting obligations in 2018, providing companies take the time to evaluate and review challenges and lessons learned from prior years. Employers would be wise to test the integrity of their internal reporting systems, identify any gaps through a self-audit, and talk to vendors about new or enhanced solutions that may be available to make compliance and reporting tasks easier, faster, and more reliable.

While clarity on the future of the ACA may seem elusive, it is important for employers to stay focused and meet their compliance obligations — and to keep in mind that, at least for now, the ACA is here to stay.