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Davis Brown Employment and Labor Law Blog

Employment Law Blog: Five Things To Do Now to Prepare for Health Care Reform in 2014 - May 6, 2013

Davis Brown Health Law attorney Susan Freed has offered the following tips as a follow-up to her Employment Law Seminar presentation, Preparing for Health Care Reform in 2014: An Action Plan For Employers.


The Affordable Care Act’s 2014 reforms will impact employers of all types and sizes.  Regardless of whether you are large or small, public or private, there are five things you can do today to prepare for these upcoming changes.

  1. Know Who Your Team Is.  Every employer should have a team of people assisting it with implementing upcoming changes and those individuals should know who they are.  These include individuals inside the organization, such as your human resources manager and chief financial officer, as well as outside advisors including your insurance agent, CPA and attorney.

  2. Determine How Many FTEs you Have.  Because employers with 50 full-time equivalents face penalties for not providing affordable, minimum value insurance an employer should know whether it is subject to these requirements or not.  Common law employees of the employer and any commonly controlled company must be counted.  Employers with temporary or leased employees will want to discuss with their advisors whether these employees will be considered “common law employees” for purposes of determining how many FTEs an employer has.  Employers with employees who are paid based on unique payment models (stipends, work product, etc) will want to discuss how to calculate these employee hours with their benefits advisors.

  3. Evaluate The Status Quo.   What do your health benefits currently look like? How much do they cost?  What portion of single and non-single coverage are you paying for? What percentage of your workforce is eligible and participating? Is everyone eligible for the same plans/benefits?  What are your deductibles and out of pocket maximums? What ancillary products do you currently offer? 

  4. Sit Down With Your Agent.  If you haven’t taken the time to meet with your insurance agent since the beginning of the year you should do so.  Take this time to share with him or her your concerns and challenges, ask questions, and get ideas.  Agents can give you ideas on ways to change your current benefit offerings, such as introducing a new plan design, incorporating wellness incentives, or changing your contribution strategy, and the potential cost impact of such changes.

  5. Prepare for New Insurance Fees.  Self-funded employers will need to prepare for paying and reporting both the Patient Centered Outcomes Research Fee and Transitional Reinsurance Fee.  These employers should contact their Third Party Administrators for assistance.  Fully-insured employers may see a new line item on their premium billings for these new fees.  These employers should discuss with their advisors for assistance in how to pay or allocate the fee among their insured employees.