Affordable Health Care Act Update
The Affordable Care Act (ACA) went into effect on March 23, 2010, and was confirmed by the U.S. Supreme Court on June 28, 2012. Several important provisions have already gone into effect, including requirements that will impact school districts and other education-related entities.
By January 1, 2016, employers with 50 or more full-time employees must offer plans consistent with the health care packages available through the government’s Healthcare Marketplace.
Bronze: Insurance covers 90 percent of covered expenses.
Silver: Insurance covers 80 percent of covered expenses.
Gold: Insurance covers 70 percent of covered expenses.
Platinum: Insurance covers 60 percent of covered expenses.
Full time status is now considered 30 hours or more a week, or 130 hours per month. To avoid a payment for failing to offer health coverage, employers need to offer coverage to 70 percent of their full time employees in 2015 and 95 percent in 2016 and beyond.
To determine compliance, employers are subject to an assessment of full time employment numbers. The assessment period can be cover anywhere from 90 days to one year. Teachers and other educational employees will not be treated as part-time for the year simply because their school is closed or operating on a limited schedule during the summer. In addition, KASB recommends our members resist reductions of hours to get under 30 hours a week or 130 hours per month.
If you have any questions, please contact KASB Assistant Executive Director for Insurance, David Shriver at firstname.lastname@example.org or 800.432.2471.
The Act went into effect on March 23, 2010, and was confirmed by the U.S. Supreme Court on June 28, 2012. Coverage of adult children to age 26, elimination of lifetime exclusions, prohibition on pre-existing conditions for children, and access to OB/GYN for women have already gone into effect.
Beginning October 1, 2013, all employers had to provide a notice of marketplace options to their employees explaining the health insurance marketplace (aka “exchange”). Every state must have a marketplace functional by that date, and, since Kansas did not choose to develop a state-operated marketplace, a federal site must be functioning. The notice was intended to explain important information about the advantages and disadvantages of buying health insurance through the marketplace.
The responsibility for giving the Marketplace Notice was that of the employer, not the insurance company. The notice must have been provided to all employees, both full-time and part-time, without regard to eligibility status for the health plan. The U.S. Department of Labor developed two versions of the Marketplace Notice which are available on the website (www.dol.gov/ebsa/healthreform/
). The Notice had to be in writing in a manner calculated to be understood by the average employee, either in writing or electronically if certain requirements are met.
As of January 1, 2014, all of the substantive requirements of the Act had to be in place, with the exception of the Free Rider Penalty which applies to large employers and has been postponed for full implementation until January 1, 2015.