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Common ACA Compliance Concerns

Feb 10 2016, by PEOPLE in Sales

ACA compliance is a tricky subject for most employers. Because there are so many nuanced rules and stipulations, employers are nervous about making a mistake. Here are some common ACA compliance concerns that employers are facing.

One major concern for employers involves wellness programs. Wellness programs are becoming increasingly popular in the workplace and studies have shown that they come with some amazing benefits. However, the EEOC has specific rules about voluntary participation and wellness programs under the Genetic Information Nondiscrimination Act. Employers who are interested in implementing a wellness program or already have one should take a close look at these rules and what they mean for ACA compliance.

One of the most frustrating aspects of ACA compliance involves the reporting documents. Employers need to learn about these forms and understand how they work in order to be able to explain them to their employees. Additionally, employers who have a variety of different types of team members, such as traditional employees as well as contractors, will need to know who needs which forms. If you’re having trouble with reporting documents, an ACA expert can help you understand the forms.

Actually reporting the information is another aspect of ACA compliance that employers cite as a major concern. Take a look at all of your data sources and systems to get as much information as possible about your covered individuals. If you’re an Applicable Large Employer, you’ll also need information on your coverage offers when you report on your 2015 coverage. Review the instructions for the 1094 and 1095 forms to help you form a process for fixing any errors that may have occurred.

Understanding the maximum out-of-pocket (OOP) for essential health benefits can also be a challenge for employers. Check out your self-only and other types of plans that are “non-grandfathered” to ensure that they hit the 2016 limits for in-network care. These limits fall between $6,850 and $13,700. Employers also need to look at family coverage and make sure that it satisfies the self-only OOP limit for each person as well.

Employer mandate compliance is another important aspect of ACA compliance that employers need to understand. In 2016, you’ll need to offer a minimum essential coverage at 95 percent if you have 50 or more full time or full time equivalent employees. Employers who want to avoid penalties can do so by providing a compliant offer of affordable minimum value coverage.

Lastly, employers need to be prepared for the possibility of an audit. Although this is the first year for ACA reporting, don’t expect a whole lot of leniency. If you can’t prove that you’ve made a good faith effort to comply with ACA requirements, you face the possibility of being audited.

There are many concerns floating around about ACA compliance due to the many rules and regulations that must be followed. It can be daunting for employers to dive into a totally new process but keeping yourself informed and seeking counsel from an ACA expert will help you stay on top of your ACA reporting.