Fees/Taxes/Deductions: A couple of new, ACA related taxes/fees apply in 2014 – the health insurance tax (or HIT), and the transitional reinsurance fee. The former is calculated at approximately 2.5% of annual premium, and the later, $63 per covered member, per year. Also, the Patient Centered Outcomes Research Institute fee (or PCORI) increases from $1 to $2 per covered plan member, per year. In addition, higher wage earners continue to face an increase in the amount of their Medicare payroll tax. And finally, affected employers need to include the cost of health insurance on employees’ W-2 forms.
11. Disclosure Notices/SBC’s: There are a number of ACA required disclosure notices and of course, the Summary of Benefits and Coverage (SBC), that may need to be reviewed, revised, and re-distributed to employees. In particular, if a plan continues to maintain grandfather status, the employer must provide a notice to all eligible plan members indicating this plan status. Also, if there are any changes to the benefit design of any offered plan option, a new SBC will need to be created and distributed to all plan eligible employees. Keep in mind that traditional benefit plan designs that include copays will need to start accumulating copays toward the plan out of pocket maximum in 2014. Such a change in and of itself will require a new SBC.
This list of compliance considerations and strategies is certainly not intended to be all inclusive, as there are potentially several more ideas worthy of consideration. I encourage readers and stakeholders to collaborate, research, and review creative ways to balance ACA compliance with benefits offerings and costs.