This document discusses communicating Affordable Care Act requirements to employees in a way that helps employers comply with regulations and improve employee relations. It outlines required communications around open enrollment, tax filings, life events and more. It also identifies opportunities to go beyond minimum requirements through validation surveys, assistance with enrollment decisions, and gathering employee opinions. Conducting these communications can help recruit and retain workers, engage employees in health costs, and realize savings.

1. Presenter:
Si Nahra, Ph.D., President
May 29, 2014
ACA Communications Requirements:
An Employee Relations Opportunity

2. Copyright Health Decisions, Inc.
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About Health Decisions, Inc.
Pioneering Specialists in
Group Health Care
Post-Payment Administration
For Over 25 Years
Respect for Existing Procedures
Emphasis on Customization
Focus on Solutions
Customer Philosophy

3. 2014 ACA Series
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Non-grandfathered, calendar year plans.
Comply not just because you have to.
Comply in a way that helps your plan.
FOCUS

4. Quick Review
What you should have done.
• Reporting to employees
– W-2 plan values
– Summary of Benefits and Coverage (SBC)
– Exchange Notices
• Benefits
– Selected Essential Health Benefits
– No cost sharing for federal preventive care benefits
– No pre-existing conditions
– No lifetime maximums
– Dependents covered until 26
– Clinical trial coverage
• Safe Harbors
– Minimum Value Safe Harbor
– Affordability Safe Harbor
• New Out-of-Pocket rules implemented
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ACA Compliance
Checklist
Sessions available now.
Call 734-451-2230
Ask for Leslie.
E-mail
leslie@healthdecisions.com

5. Employee Communications
• Required: Scheduled or Event Driven
– ACA
– DOL
– IRS
• Opportunities
– ACA Q&A to and from employees
– Spouse/Dependent confirmation
– Public Exchange Navigation
– COBRA Options
– Private Exchange Options
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6. Scheduled Communications
Event DOL
http://www.dol.gov/ebsa/
pdf/rdguide.pdf
ACA IRS
Oct
Open
Enrollment
SPD, SMM,
WHCRA, Wellness
Summary of Benefits
and CoverageNov
Dec
Jan Tax Filings W-2 benefit value
6055/6056 Notices
W-2 filing
6055/6056 filingFeb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Open
Enrollment
SPD, SMM,
WHCRA, Wellness
Summary of Benefits
and CoverageNov
Dec
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Communication “Silent Period”

7. Event Communications
Event DOL ACA IRS
New Hires: Eligible Enrollment Rights Notice Marketplace Notice
Affordability Confirmation
W-4
New Eligible Enrollment Rights Notice Marketplace Notice
Affordability Confirmation
New Enrollee SPD, etc. Summary of Benefits and
Coverage
New Dependent MCSO Notice SSN Collection
New Hire: Ineligible Marketplace Notice W-4
Employment Termination Certificate of Credible
Coverage
COBRA Election Notice
New COBRA Notices
Change in Employment
Status
“Trigger Events”:
Notice of Change in
Eligibility
Change in Coverage
Status
Claim Payment
Processing
EOB
Notice of Benefit
Determination
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8. Communications Opportunities:
Going Beyond Minimum Requirements
Event Communication Opportunity
Post Open Enrollment
Post Tax Filing
Validation survey to confirm eligibility and enrollment
with required response to engage employee
New Hire/ New Eligible Personalized offers of election assistance
Trigger Events Follow-up survey to confirm understanding and
decision
New Hires Not Eligible Market Options and Navigator Assistance
Termination COBRA/ACA coordination and Navigator Assistance
Claims Request sharing of EOBs to compare payments
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9. Communications Opportunities
Filling In the “Silent Period”
Event DOL ACA IRS
Oct
Open
Enrollment
SPD, SMM, WHCRA,
Wellness
Summary of Benefits
and Coverage
Nov
Dec
Jan Tax Filings W-2 health plan value
6055/6056 Notices
W-2 filing
6055/6056 filing
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Open
Enrollment
SPD, SMM, WHCRA,
Wellness
Summary of Benefits
and Coverage
Nov
Dec
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• ACA Family Elections and Attitudes
• Satisfaction with Current Coverage
• Reactions to Proposed Changes
• Attitudes towards Private Exchange
• Provider Ratings
• Other Topics of Interest to Management

10. Communications Opportunities:
Why Bother? Employee Perspective
• ACA confusion and misinformation creates employee concerns
you help alleviate.
• ACA notices need explanations you provide.
• ACA election assistance and Navigators reduce concerns,
costs and COBRA elections.
• Opinion surveys show you care and foster positive relations.
• Use of outside firm shows respect for privacy.
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11. Communications Opportunities:
Why Bother? Employer Perspective
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Recruit/Retain a High-Quality Workforce.
Gain a competitive advantage over other employers
drawing from same labor pool.
How:
• Offer support to ineligible workers.
• Partner with eligible workers.
• Realize Savings
• Eliminate ineligible dependents.
• Reduce employee calls, concerns and complaints.
• Re-direct COBRA costs and other elections as appropriate.
• Engage consumer in monitoring costs and plan performance

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For More Information
Contact
si@healthdecisions.com
734-451-2230
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