The home heating oil industry has a long and proud history, and Fuel Oil News has been there supporting it since 1935. It is an industry that has faced many challenges during that time. In its 77th year, Fuel Oil News is doing more than just holding
Issue link: https://read.dmtmag.com/i/251536
26 FEBRUARY 2014 | FUEL OIL NEWS | www.fueloilnews.com BUSINESS OPERATIONS By JILL R. BERGMAN Healthcare Reform Preparing for 2014 (after Some Turmoil and Confusion in 2013) T he continuing implementation of the Affordable Care Act in 2013 certainly provided its share of drama. From employer mandate and reporting delays, to challenges with new marketplace notices that began on October 1, as well as witnessing coverage disruptions (primarily in the individual and small group markets) and the difficult rollout of the online marketplace website and systems. So if you're like many employers and business owners you're probably wondering what will the New Year bring? While I don't have a crystal ball and maybe we should be prepared to "expect the unexpected" neverthe- less; the ACA is the law of the land, and so here are five key ACA issues employers and business owners should consider as 2014 begins: Fees and taxes are here to stay, so plan and budget for these cost increases. All employers offering healthcare ben- efits will face the Patient Centered Outcomes Research Fund Fee initially set at $1 per member increasing to $2 and $2+ in the fol- lowing years. Insurance carriers calculate and pay the fee on behalf of employers that purchase insur- ance, however, employers with self-funded healthcare plans are responsible to calculate and pay the fee no later than July 31, 2014. A new $5.25 per member per month ($63 annual) reinsurance fee for 2014 will be assessed on employer health plans and is administered in a similar fashion as the PCOR fee (i.e. insurance carriers handle this function for employers with insured arrangements). The rein- surance fee will be calculated at the end of 2014 (payable in two install- ments in 2015) and is intended to help stabilize the uncertain risks insurance carriers will face in the new healthcare market- places. Third party administrators may perform this function for employers with self-funded healthcare benefit plans. And let's not forget that the ACA imposes new taxes begin- ning in 2014 on health insurance policies (including dental and vision). Employers are seeing costs increase an additional 3% - 5% as insurance carriers pass along their anticipated share of this tax which starts at $8 billion across the industry in 2014. You can't make employees wait more than 90 days for healthcare coverage. In general, employers offering healthcare benefits can't make any benefit-eligible employee wait more than 90 calendar days before coverage must begin. The 90-day waiting period doesn't apply to most stand-alone dental and vision plans. This provision becomes effective on the 2014 plan anniversary date. Employer "pay or play" mandate for large employers may be delayed; however, it certainly isn't doomed. We learned just before the July 4th holiday that the IRS would not impose penalties in 2014 on large employers that either (a) don't offer coverage to full-time employees and dependents (annual pen- alty is $2,000 per full-time employee in excess of 30); or (b) offer coverage to full-time employees and dependents that doesn't provide minimum value (plan covers at least 60% of the costs) or is not affordable (employee contribution for single coverage exceeds 9.5% of an employee's wages) to any full-time employee who then receives subsidized coverage from the marketplace (annual penalty is $3,000 per subsidized full-time employee). While large employers (50 or more full-time equivalent employees in the prior calendar year) caught a break for 2014, smaller employers nearing the 50 FTE benchmark should calculate their workforce size each month in 2014 (according to ACA rules) to determine if the 50 FTE annual threshold will be satisfied triggering mandate eligibility for 2015. Business owners and companies who have an ownership interest in more than one enterprise may need to consider the total popu- lation across all entities to determine if the employer mandate will apply (to each company in the controlled group). All employers should carefully review benefit plan strategies to help minimize cost increases as well as potential and costly ACA risks. It should be noted that the penalty amounts are scheduled to increase in 2015 for inflation. Establish measurement and stability periods to help deter- mine who is an ACA full-time employee. The ACA considers a full-time employee to be someone working 30 or more hours of service per week (or 130 hours in a calendar month). When an employer cannot reasonably determine if an employee is a Jill R. Bergman