Obamacare Questions

How does ACA employer shared responsibility (pay-or-play) work for new companies?

Foreign company starts operations in the US mid-year 2014 with just a few employees. Its operations ramp-up plan calls for under 50 em.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Can telemedicine benefits be provided only to employees living or working in certain states?

Let's say an employer has an extremely high utilization of emergency room services in certain states because, for whatever reason, the.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Can an employer set employee contributions at 9.5% of that employee's wages (with the employer paying the difference)?

If an employer wanted to set each participating employee's contributions at 9.5% of their wages, is that permissible under ACA? For ex.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Can employer contributions to health coverage vary based on length of service?

Suppose an employer currently offers a comprehensive group health plan only to management (i.e., a "management carve-out plan"). Suppo.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Can an employer offer a richer medical benefit to management and a less rich (but still minimum-value) plan to all employees?

If an employer currently offers a management carve-out plan and beginning January 1, 2015 that employer must offer coverage to all oth.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

If employee contribution is 9.5% of lowest-paid worker's wages, will the plan automatically be "affordable" under the ACA?

Employers are considering private exchanges and/or defined contribution-type arrangements. If the employer contribution is determined .... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Must telemedicine services be integrated into a plan's out-of-pocket maximum?

A vendor separate from the TPA administering the group health plan is offering telemedicine services for a fixed fee per visit. The te.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Does the ACA limit on out-of-pocket maximums apply to all plans of an employer or just one?

Does the ACA limit on out-of-pocket maximums apply to all plans an employer has, or just the lowest-cost minimum-value plan? I know fo.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Can employers charge eligible variable-hour employees more for health benefits?

Can a school district charge a different contribution rate to variable hour employees who qualify for medical coverage under PPACA but.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Do FMLA and USERRA apply to variable-hour employees deemed full-time by the ACA?

Is there any guidance on whether or not variable-hour employees deemed full-time under PPACA rules would also need to be extended bene.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Does elimination of an upfront benefit allowance impact grandfathered status?

Employer A offers a plan with an up-front benefit allowance of $500 (pays for first $500 of any care) with a $2000 deductible and $6,0.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Is an employer in the Houston metro required to provide SBCs in Spanish?

I've heard that summaries of benefits and coverage (SBC) required by the ACA might need to be translated into a non-English language, .... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

How does the Affordable Care Act treat workers with H-2b visas for purposes of the employer shared responsibility rules?

An employer with more than 50 FTEs (which is thus subject to the employer pay-or-play rules) also employs a number of workers with H-2.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

Is an employer required to permit HSA election changes monthly? If not required, is it allowed?

Here's the setup. Employer has an HSA benefit, and employee contributions to it are done through the company's section 125 cafeteria p.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

What pre-tax funding vehicles are there for employer contributions to group health coverage offered through a "private exchange"?

An employer wants to switch to a pure defined contribution approach for its health benefits in which it gives employees a fixed dollar.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek
  

When can a plan stop giving HIPAA certificates of creditable coverage?

With HIPAA pre-existing condition limitations being eliminated starting January 1, 2014, can I stop sending certificates of creditable.... Sign In For Access

M. Ployer

• Answered
  Erissa Geek