As an employer, you’re likely parsing through the Affordable Care Act in an effort to make sure you’re compliant. During this process, it’s helpful to know which government agencies are good resources to assist you with questions you might have about the requirements. If you’re an applicable large employer, you must understand ACA rules and filing requirements as they relate to your employer-sponsored health insurance plan.
Lean on the following organizations as you look for answers:
Internal Revenue Service (IRS)
The IRS offers published guidance on the Affordable Care Act’s employer shared responsibility provisions (also known as the employer mandate). Applicable large employers, which are defined by the number of employees, must provide ACA-defined minimum essential coverage for their employees or face certain penalties.
The IRS provides a comprehensive FAQ pertaining to the employer mandate. You’ll also want to understand the Form W-2 reporting requirements on the health coverage you provide. In general, the IRS breaks down complex ACA provisions into explanations that will help you navigate your ACA requirements.
U.S. Department of Health & Human Services (HHS)
The HHS is responsible for implementing certain aspects of the Affordable Care Act that relate to both public health plans and employer-mandated coverage. Take advantage of the information provided by HHS, such as an FAQ on ACA requirements, that affect your health care decision-making.
U.S. Department of Labor (DOL)
The U.S. Department of Labor regulates the protections provided in the ACA with respect to coverage provisions that constitute minimum essential coverage. These protections include dependent coverage up to age 26, essential health benefits that must be provided in your insurance policies and required health benefits for your employees. Additionally, the DOL provides an FAQ that discusses the types of arrangements acceptable under the ACA between employers and employees.
U.S. Department of the Treasury
On the Treasury’s site, you’ll find general information and fact sheets about employer-sponsored plans that meet the requirements of the ACA provisions. This information includes reporting provisions for employers who either self-insure or who provide employer-sponsored coverage purchased from a licensed insurance company.
The Treasury offers information on employer reporting options. As you push through the needed paperwork, double-check the Treasury’s breakdowns of the information you need to include (e.g., waiting periods, employer/employee plan cost-sharing amounts, advanced payments, etc.).
Centers for Medicare & Medicaid Services (CMS)
The CMS provides further information and clarification to employers concerning ACA requirements. Through the CMS, you can find guidance on topics like minimum essential coverage and resources to help you determine if your health plan meets this requirement. The site provides FAQs on various topics such as the health wellness program exception.
Look to these government agencies for simplified assistance on ACA requirements for health plans and reporting. The law’s provisions are complex enough that any source able to break them down is a major boon for your business. By using this information, your business will be well on its way to understanding — and meeting — ACA compliance.
This content is provided solely for informational purposes. It is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.
Donald Parker has more than 20 years of experience in the insurance and financial services industry with several Fortune 500 companies. He holds a life, accident and health insurance license in Virginia. He has been FINRA Series 7, 24, 63 and 65 registered and specializes in the areas of long-term care, senior needs, retirement and employee benefit planning.