ACA's "Pay-Or-Play" Penalty Delayed Until 2015

15 July 2013 Labor & Employment Law Perspectives Blog

Last week, in a move welcomed by many employers, the Obama administration announced that it would delay implementation of certain key provisions of the Affordable Care Act (ACA) until 2015. These provisions, which were originally scheduled to take effect in 2014, include the following:

1. The requirement that employers of 50 or more full-time employees offer an acceptable level of health care coverage to their full-time employees (those working an average of 30 hours or more each week) or pay annual penalties of $2,000 for every full-time employee except the first 30 full-time employees (aka the “play-or-pay mandate” or “shared responsibility requirement”)

2. Information reporting requirements for insurers, self-insured employers, and other parties under IRC § 6055 regarding what health care coverage is offered to full-time employees.

According to the announcement, this delay is the result of the administration’s recognition of business concerns about the “complexity of the requirements and the need for more time to implement them effectively,” as well as the fact that the “vast majority” of employers affected by these requirements “already provide health insurance to their workers.” In its announcement, the Treasury Department also indicated that more formal guidance would be forthcoming this week.

While this one-year delay is likely a welcome reprieve that may alleviate some of the pressure for large employers, it is important to note that the remainder of the ACA’s 2013 and 2014 requirements are still set to take effect on schedule. These requirements include, but are not limited to:

1. The individual mandate requiring nearly every U.S. citizen to have basic health coverage or pay a penalty

2. The implementation of health insurance exchanges

3. The Patient-Centered Outcomes Research Institute (PCORI) filing and fees due from insurers and self-insured employers on July 31, 2013 and annually thereafter

4. The requirement that employers notify their employees of their coverage/enrollment options and the existence of the health insurance exchanges by October 1, 2013

5. The elimination of pre-existing condition exclusions, limits on waiting periods and annual dollar limits, and other design rules scheduled to take effect in 2014

6. The final wellness plan rules, which become effective in 2014

Accordingly, employers should continue their preparations for these upcoming changes and should be sure to seek advice from their labor and employment or employee benefits counsel regarding these requirements and any future developments regarding the ACA’s provisions.

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