Written by Mercer PeoplePro guest writer Barbara Jessen, Benefits Consultant
Open enrollment may be a misnomer — it's never really finished.
It's now time to review your plans and make sure they are in compliance with all the new regulations. Here are few items you will want to consider now as you move forward into 2017.
Notification of employees who enroll in public health exchanges
Notices from public health exchanges to employers will be mailed in batches listing employees who have received premium tax credits for at least one month in 2016. Employees who have access to affordable, Minimum Value coverage or are enrolled in Minimum Essential Coverage (MEC) are not eligible for credits. If your plan meets requirements, you may want to consider filing appeals to avoid employer assessment when you receive your notices.
Required changes in SBC's by April 2017
Changes are coming to the Summary of Benefits and Coverage (SBC) mandated under the ACA. These must have the same prescribed form and appearance as the agency model. The SBC model statement includes whether the plan provides MEC and meets the Minimum Value standard. It also explains each of these in relation to ACA individual coverage mandate and the employee's eligibility for subsidized exchange coverage. After 2017, a separate letter to employees explaining Minimum Essential Coverage and Minimum Value requirements will no longer be allowed.
Wellness Plan rules finalized
Beginning in 2017, new rules provide condition incentives for employee or spouse under ADA (Americans with Disabilities Act) or GINA (Genetic Information Nondiscrimination Act) and must be in compliance by the first day of your plan year. They also are required to meet EEOC specific design and notice standards.
These affect participatory outcome-based wellness programs involving medical exams, bio-metric tests, health risk assessments and disability-related inquiries. In order to meet affordability and Minimum Value standards, the employer could have a non-discriminatory program exclusively for tobacco use. Similarly, flex credits in a cafeteria plan can be used to reduce the required employee contribution if the flex credit can't be taken as a taxable benefit and used only for Medical.
SuperHuman Resources On Demand
With so many changes this can be horribly confusing but you're not alone. If you'd like some help unraveling all the new regulations, our PROs are standing by and ready to help. And because we understand that the resources of small and emerging businesses are stretched we're offering you a one-hour consultation, FREE. To set up your free consultation, contact Barbara Jessen or any of our PeoplePro specialists — help is only a click away.