Segal Benz Blog

Just when you thought you knew what was up: July 4th holiday brings health reform-related fireworks | Segal Benz

Written by Admin | July 10, 2013

How was your Fourth of July weekend? Did you freak out as you made potato salad, wondering what implications the latest health care reform news had on you and your summer plans? We were marinating on it, too.

1. Administration delays employer mandate

At the end of June, we thought employers with 50 or more employees had to offer “affordable coverage” to all their full-time employees by January 1, 2014. As of today, employers have another year before the requirement kicks in. Does that change anything for you? If you provide health insurance today to your employees, probably not. But, if your organization planned significant changes to comply with the mandate—like shifting part-timer hours or extending eligibility to a new group of employees, you may be putting the brakes on those plans.

2. Marketplaces won’t verify personal data in real time

On Friday after the holiday, Washington announced that the marketplace application process would rely on self-reported information to determine the tax premium subsidy. Originally, the plan was for various government databases to connect to verify income at the time of application. When Americans file their taxes, the IRS can determine if household income and the availability of employer-sponsored coverage matches the application. If it doesn’t, the IRS could request repayment of any subsidies. The Internet lit up with editorial comments on potential fraud after the announcement.

But we take a more reasoned viewpoint: Helping employees understand their tax obligations is something we do all the time. Whether it’s how to properly submit HSA expenses, how to avoid tax penalties for early 401(k) withdrawals, what to do when stock options vest, just to name a few, HR is always helping employees follow the rules so that valuable benefits don’t get tarnished by “you-didn’t-tell-me-that” comments. Helping your employees understand that they have access to affordable coverage—LOUD and CLEAR—is even more important knowing there isn’t a safety valve built into the marketplace application process.

So, those were the surprise elements.

The advertising blitz has begun

We anticipated last spring that the advertising onslaught and media coverage would start this summer. Now, it’s July and we’re all getting a little hot under the collar watching it unfurl.

Americans in Oregon and Colorado are now seeing TV ads about their state marketplaces, and multimedia campaigns are planned across the country.

Confusion still reigns, but employees are better informed

All this focus on insurance options and political posturing doesn’t leave the average American better informed, particularly the uninsured. Only one in five recently polled by Kaiser Family Foundation knew about the exchanges. Yet, employees with workplace coverage know more: 50% can cite the monthly cost of coverage and two-thirds say their employer offers the best health insurance plan they can afford.

There will continue to be political maneuvering and, hopefully, reporters who want to provide just the facts. But this underscores your need to stay on top of the message.

Specifically, what now?

As far as we know, employers are still required to send notice of the exchanges by October 1. The news doesn’t modify our advice from earlier this summer.

Specifically, you need to drive home messages that put the notice in context. At the bare minimum, make sure employees know that the main takeaways from recent headlines are:

  • You don’t need to take any action related to the health insurance marketplaces.
  • Our plans exceed the minimum requirements.
  • Just pay attention to your benefit choices this fall.