What Employees Should Know About the ACA


I am often asked by HR professionals, CEO’s, CFO’s, Executive Directors, etc. the following question – “what should I be telling my employees about the Affordable Care Act (ACA)”?  Between the 2,700 pages of the actual law, and the thousands of pages of regulations and guidance released to date, the question is very relevant, and extremely important.  While I firmly believe folks occupying roles with the aforementioned titles should receive a thorough initial overview of the ACA, and ongoing guidance and updates; rank and file employees need only get the absolute critical aspects.  So you might ask – “what are the critical aspects”?

My list of employee centric, critical aspects is based on the following questions/criteria:

  • How does the ACA directly impact me and if applicable, my family?
  • How does the ACA affect my employer the greatest, and what should I expect my employer to do, change, eliminate, etc.?
  • Will my employer continue to offer health insurance, and if so, how, and at what cost?
  • How will my annual benefit options/open enrollment be affected by the ACA?
  • Is the ACA going to be an ongoing consideration, or will some or all of it go away?

These are the key questions which, in my opinion, derive the ACA related messaging to employees.  So, here are what I believe to be THE MOST CRITICAL ASPECTS OF THE ACA, that employees should know and understand:

  1. The individual mandate – what it is; who it affects; calculating current and future penalties; government’s enforcement and collection of the penalties; how employers are going to assist their employees with compliance.
  2. The employer mandate – what, who, how, and the associated impact on employees and covered dependents in terms of full time status; part-time status; jobs; benefits eligibility; penalties, etc.
  3. Taxes and fees – what are they; which ones affect particular employers; how are they calculated and paid; and the impact on employees and covered dependents.
  4. Preventive care – what’s covered and how; why it’s important to use; the government decides what is considered preventive, NOT an insurance company or an employer.
  5. Changes – a thorough review of any changes being implemented (last year or this year); along with a list of items that were considered but not implemented (in other words, planting the seed).

A previous blog post listed some important ACA related compliance and planning issues for 2014 (and beyond) that employers should be considering and/or implementing (click – http://sstevenshealthcare.blogspot.com/2013/12/aca-compliance-checkup-2014-strategies.html )  These would be some of the things addressed in “no. 5. Changes” listed above.