ACA Employers Related Provisions and Their Status of Rollout - Coursework Example

ACA Employers Related Provisions and their Status of Rollout Introduction Either an individual or being an owner of a large or a small business, you may face the effects of the ACA (Affordable Care Act) tax provisions. President Barack Obama signed the Affordable Care Act into American law in the year 2010. There are a number of changes that have been made in the Affordable Care Act since it was made law in 2010. The purpose of this act is to ensure that all American citizens have access to AHI (Affordable Health Insurance). This law affects virtually all American citizens, including those who are in need of government assistance in order to afford a health insurance, those who can purchase the health insurance for their own, and both small and large business owners (Bluhm 23). The present paper highlights the employers’ related provisions of ACA and the status of rollout of these provisions. The American Affordable Care/Health Care Law has responsibilities and benefits for all employers. The size of the business helps in determining what the appropriate employer’s provision to ACA. However, if a business owner has no employees, the Affordable Care Act does not apply to such individual. The ACA employer provision and penalty, which were set to begin this year, are delayed until next year (Tate 21). The Affordable Care Act is a health care law that ensures that all employers who have more than fifty full-time equivalent employees (FTE) pay for health insurance for their employees a pay monthly “Employer Shared Responsibility Payment” for the employees federal tax return. For those employers who have employee who are less than 25 employees who work on full time basis who earn a maximum of $50, 000 averagely are the ones who are most likely to benefit from Small Business Health Care Tax Credit. This is under the condition that the business organizations meet a number of requirements. The first condition is that they will have to pay half of the insurance premium for those employees who work for them on full time basis. The credit might be even higher for business organizations with fewer employees. The small employers who have fifty-nine to ninety-nine FTE equivalent employees will start providing for health insurance for those employees starting 2016. On the other hand, large employees who have more than hundred FTE employees will start paying for their health insurance by next year. Since the year 2010, small employers who have less than twenty-five PTE employees started paying health care credits for their full-time employees (Bluhm 27). The mandate of the employers is also part of ESR (Employer Shared Responsibility) provision according to the Affordable Care Act. According to the Affordable Care Act, the employers should provide share responsibility to employees in order to reform as well as improving the quality, availability, and affordability of employees’ health insurance coverage in the entire United States. The employer mandate fee per year (officially referred to as Employer Shared Responsibility payments) is fee per employee for employers who have over fifty FTE employees and do not provide health coverage for the employees. The employer mandate depends on the number of Full-time equivalent employees and not just on full-time workers. The fee depends on whether an employer offers or does not offer affordable health insurance cover to his or her FTE employees that offer minimum value (Tate 27). If an employer does not offer affordable health insurance for his or her employees, then the annual fee is $2,000 for every employee (with the exemption of the first thirty full-time workers). If there is at least one full-time worker who gets tax credit because of affordable health insurance coverage, or the employee does not contribute to the sixty percentage of the total cost, then the employer is supposed to pay a lesser of three thousand dollars for every employee who is receiving a tax credit. The employer can either pay $750 for all employees for their FTE total. Unlike Employer’s contributions to employee’s premiums, the payments for Employer Shared Responsibility are tax-free (Bluhm 32). Provisions Employer notice to employees- according to the Affordable Care Act, employers who are covered by the FLSA (Fair Labor Standards Act) (in general, those businesses that have no less than one employee and earn $500,000 annually) must offer notification to all their full-time employees about the current Health Insurance Marketplace. According to the Affordable Care Act, employers must inform their employees they will be entitled to a premium tax credit after purchasing the health care coverage through insurance marketplace. Employers should also advise their workers that if they purchase the marketplace health insurance covers, then they would lose employers Affordable Care Act contributions for any health benefits that the employer may offer to other employees (Tate 33). Employers are supposed to offer this notice to their employees and teach them about the requirement of the new Affordable Care Act before enrollment. They should teach this in regardless of full-time or part-time rollout status. The U.S. Department of Labor has issued employers with two types of sample notices that they are supposed to use in order to comply with the new Affordable Care Act. One of the sample is for those employers who offer health plans for either all or some employees and the other one is for employers who offers no health plans for their employees. Medicare Advantage patch: in the year 2011 the government asserted that there need to be an advance draw on financial resources from a Medicare bonus programs so that it can cater for provision of extra payments to Medicare Advantage plans, in the bid to forestall cuts for a short while in benefits and therefore delaying early movement of MA plans from the program. Auto-enrollment provision-the employers who have more than two hundred (200) full-time workers, according to the Affordable Care Act provisions should automatically employ new full-time workers in the offered health benefit plans. Any of the automatic enrollment programs must include sufficient notice and employee’s opportunity to opt any coverage that the employee was routinely enrolled. Wellness- this permission allows employers to set up premium rebates or discounts as well as modifying deductibles or co-pays up to thirty percent for the purpose of encouraging the employees to participate in disease prevention or health promotion programs. The secretary has the authority of issuing regulations that allows financial inducements up to 50% (Tate 45). Essential Health Benefits (EHB) -Essential health benefits only apply to products that are sold in small group or individual markets, both outside and inside state insurance exchanges. Even though large group plans should not provide essential health benefits, these groups are prohibited to impose annual and lifetime limits on all essential health benefits they offer to the employees. According to the Affordable Care Act, Essential Health Benefits consists of ten classes of benefits, which include emergency services, hospitalization, newborn and maternity care, ambulatory patient services, and prescription drugs among others (Bluhm 47). Employer role to offer health insurance-there is no mandate for employers to offer health insurance covers to employees. However, there is a mandate for employers who have more than fifty full-time employees (who work for thirty or more hours in a week) and the employer is supposed to include part-time workers in that number (determine by dividing the number of service hours of the non-full-time employees in a month by 120). If such employers do not provide employees with health insurance covers, they receive a fine, if the employees get a subsidy for health insurance coverage in the exchange (Bluhm 35). The assessment amount is calculated by subtracting thirty employees from the fifty or more full-time equivalent employees. Then for the number of employees that is above that thirty, the employer is supposed to pay an assessment fee (which is $2,000 for each full-time employee. For instance, an employer who has fifty-one full-time workers will subtract thirty employees to remain with twenty-one FTE employees. Therefore, the employer will have to pay a fine of $42,000 or 21×2,000 (Tate 35). According to Affordable Care Act, employers must provide a voucher that shows the amount the employer pays for the health care insurance. The qualification for the voucher is that the workers must be entitled to health insurance coverage under the employer plan. The set amount of premium contribution for the employer’s plan should be between 8% and 9.9% of the employee’s income. The total household income of the employees should not be more than 400% of the national poverty level. The employees will then be able to use this voucher to purchase health insurance covers in exchange of the employer’s lieu sponsored plan (Bluhm 45). Cafeteria plans- this plan is applicable to employers who have less than hundred employees. According to Affordable Care Act, such employers re supposed, in despite the fact that a qualified employee is making any salary deduction contributions, to contribute a certain percentage (that is more than 2%) to compensate the employees or a certain amount that is more than a lesser of 6%. This provision also excuses employers who provide contributions for workers under an uncomplicated cafeteria arrangement from pension plans and requirements for nondiscrimination applicable to key and highly compensated employees (46). All the workers who had more than 1,000 working hours in the previous year before the plan, are entitled to take part and every entitled employee can according to terms and conditions, select any available employee benefits, which are under the plan. Ant-discrimination-employers who ensure provision of health insurance coverage to their employees are prohibited from restricting health insurance coverage eligibility depending on the salaries and wages of the full-time workers. Any health or wellness promotion that is under the Affordable Care Act may not need collection or disclosure of any information that relates to firearm possession or lawful use. The government has ensured amendment to the Fair Labor Standards Act (FLSA) to make sure that employers do not discriminate full-time employees in terms of compensations, conditions, terms, or any other employment privileges (Bluhm 67). According to the Affordable Care Act, employee discrimination is illegal and there are penalties set for those employers who are found discriminating employees. Affordable Care Act Roll Out status for the provisions Much of the discussion of the health care policy in the year 2013 centered about the Obama administration’s failed rollout of the Affordable Care Act. This act entails that American Citizens should be able to purchase health insurance covers even the low-income earners. As most people understand that, with matters concerning health care for citizens, it is not easy to separate the decisions of the administration policy from political considerations. Congressional Democrats have discouraged the Obama administration’s policy from modifying many Affordable Care Act provisions (68). These rollout measures included postponing the implementation of the Affordable Care Act that requires employers who have more than fifty employees to be providing health insurance covers to their work. Another measure includes scaling back the enforcement of employee income verification obligations, and possibly most controversially, passing an automatic allowance for those citizens whom their plans had been cancelled due to failure of meeting the requirements of the coverage to be able to purchase the health insurance covers without payments for the personal mandate tax (78). Although this Act seems to answer many health care problems in United State, it has brought havoc for the insurer hence resulting to increment of health care insurance premiums. The Obama administration is still facing legal challenges discouraging implementation of the Affordable Care Act. Most of the Law comes from attorney Oklahoma who argues that the Act only offers subsidies and tax credits to individuals who purchase the health insurance covers from state-run-exchanges. Oklahoma claims that the congress intents to limit financial supports as a benefit for the states, creating their exchanges (Tate 49). These challenges force the administration to join hands with the Congress in order to be able to address all the problems. There are currently remarkable parallels in the United States that are between Medicare part D and Obamacare. For instance, in Washington, there is no one who would support the Obama administration towards implementation of the Affordable Care Act. The federal government in the United States is paying for its bill, meaning that U.S. citizens should credit the implementation of the Affordable Care Act. The human and health service Department in United States is operating under the current insurance market places, meaning that those individuals who do not have employer’s benefits are supposed to purchase the health insurance covers on their own. This is one of the rollouts that is affecting many Americans since many of them are unable to log on into the system and other have troubles of setting up the accounts (56). Conclusion In conclusion, the implementation of the Affordable Care Act has and will continue to benefit employees in America. This is because the American Affordable Care/Health Care Law has responsibilities and benefits for all employers. According to the Affordable Care Act, both small and large business owners must be paying for health care insurance coverage for their full-time employees (67). In addition, the Affordable Care Act states that the employers should provide share responsibility to employees in order to reform as well as improving the quality, availability, and affordability of employees’ health insurance coverage in the entire United States. Work cited Bluhm, William F. Group Insurance. , 2012. Print. Tate, Nick J. Obamacare Survival Guide. West Palm Beach, FL: Humanix Books, 2012. Print. Read More