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Employer Mandate and Reporting Rules Delayed Until 2015
With a stunning, unexpected announcement yesterday, the Obama administration is delaying large employer
compliance with the Employer Mandate standards and its reporting rules until the 2015 plan year. The
Administrationโ€™s stated goals for this delay are additional time 1) for regulators to simplify employer reporting
requirements and 2) for employers to adapt health coverages and plan administration to satisfy the employer
mandate rules.
Specifically, the announcement provided the following guidance for employers with 50 or more full-time
employees (as defined by The Patient Protection and Affordable Care Act (PPACA)):
โ€ข The payment of any penalties related to the employer shared responsibility (mandate) requirements will not
apply until the 2015 plan year.
โ€ข The related reporting requirements similarly are delayed.
โ€ข The regulatory agencies will issue regulations next week that further explain this delay and the transition to
2015 compliance.
โ€ข Proposed regulations on the reporting requirements will be issued this summer in hopes employers will
voluntarily comply during 2014 and enable the Administration to simplify and fine-tune them for 2015.
The individual mandate feature of the law still applies, which interestingly may give employees more freedom
to choose between their employers' plan or the public health exchanges. However, it seems administration of
the federal subsidies through the public exchanges will be much more difficult without the employer mandate
reporting and compliance rules.
It also appears all other PPACA provisions for 2014, such as the employer fees, premium taxes, and additional
market and insurance reforms, still will apply.
The speculation for why the Administration is taking this step focuses on their realization that the law as
currently structured isnโ€™t achieving its objective of greater health insurance access from employer plans โ€“ too
many employers are reducing employee work hours, changing health benefits offerings and refining their
business models to avoid greater employee eligibility and the related potential additional costs from more
health plan participants. In addition, this delay takes some of the pressure off the governmentโ€™s implementation
timeline for the public exchanges and employer guidance on a number of looming health reform law provisions.
2
Here is the Administrationโ€™s announcement of the delay.
โ€œOver the past several months, the Administration has been engaging in a dialogue with businesses - many of which already provide
health coverage for their workers - about the new employer and insurer reporting requirements under the Affordable Care Act (ACA).
We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively. We
recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and
we want to make sure it is easy for others to do so. We have listened to your feedback. And we are taking action.
The Administration is announcing that it will provide an additional year before the ACA mandatory employer and insurer reporting
requirements begin. This is designed to meet two goals. First, it will allow us to consider ways to simplify the new reporting
requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are
moving toward making health coverage affordable and accessible for their employees. Within the next week, we will publish formal
guidance describing this transition. Just like the Administrationโ€™s effort to turn the initial 21-page application for health insurance into a
three-page application, we are working hard to adapt and to be flexible about reporting requirements as we implement the law.
Here is some additional detail. The ACA includes information reporting (under section 6055) by insurers, self-insuring employers, and
other parties that provide health coverage. It also requires information reporting (under section 6056) by certain employers with respect
to the health coverage offered to their full-time employees. We expect to publish proposed rules implementing these provisions this
summer, after a dialogue with stakeholders - including those responsible employers that already provide their full-time work force with
coverage far exceeding the minimum employer shared responsibility requirements - in an effort to minimize the reporting, consistent
with effective implementation of the law.
Once these rules have been issued, the Administration will work with employers, insurers, and other reporting entities to strongly
encourage them to voluntarily implement this information reporting in 2014, in preparation for the full application of the provisions in
2015. Real-world testing of reporting systems in 2014 will contribute to a smoother transition to full implementation in 2015.
We recognize that this transition relief will make it impractical to determine which employers owe shared responsibility payments (under
section 4980H) for 2014. Accordingly, we are extending this transition relief to the employer shared responsibility payments. These
payments will not apply for 2014. Any employer shared responsibility payments will not apply until 2015.
During this 2014 transition period, we strongly encourage employers to maintain or expand health coverage. Also, our actions today do
not affect employeesโ€™ access to the premium tax credits available under the ACA (nor any other provision of the ACA).โ€
We will provide additional information once the transition regulations are issued next week.

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Employer Mandate and Reporting Rules Delayed Until 2015

  • 1. Brought to you by Prescott Pailet Benefits & Independent Insurance Group Benefits, a Marsh & McLennan Agency Employer Mandate and Reporting Rules Delayed Until 2015 With a stunning, unexpected announcement yesterday, the Obama administration is delaying large employer compliance with the Employer Mandate standards and its reporting rules until the 2015 plan year. The Administrationโ€™s stated goals for this delay are additional time 1) for regulators to simplify employer reporting requirements and 2) for employers to adapt health coverages and plan administration to satisfy the employer mandate rules. Specifically, the announcement provided the following guidance for employers with 50 or more full-time employees (as defined by The Patient Protection and Affordable Care Act (PPACA)): โ€ข The payment of any penalties related to the employer shared responsibility (mandate) requirements will not apply until the 2015 plan year. โ€ข The related reporting requirements similarly are delayed. โ€ข The regulatory agencies will issue regulations next week that further explain this delay and the transition to 2015 compliance. โ€ข Proposed regulations on the reporting requirements will be issued this summer in hopes employers will voluntarily comply during 2014 and enable the Administration to simplify and fine-tune them for 2015. The individual mandate feature of the law still applies, which interestingly may give employees more freedom to choose between their employers' plan or the public health exchanges. However, it seems administration of the federal subsidies through the public exchanges will be much more difficult without the employer mandate reporting and compliance rules. It also appears all other PPACA provisions for 2014, such as the employer fees, premium taxes, and additional market and insurance reforms, still will apply. The speculation for why the Administration is taking this step focuses on their realization that the law as currently structured isnโ€™t achieving its objective of greater health insurance access from employer plans โ€“ too many employers are reducing employee work hours, changing health benefits offerings and refining their business models to avoid greater employee eligibility and the related potential additional costs from more health plan participants. In addition, this delay takes some of the pressure off the governmentโ€™s implementation timeline for the public exchanges and employer guidance on a number of looming health reform law provisions.
  • 2. 2 Here is the Administrationโ€™s announcement of the delay. โ€œOver the past several months, the Administration has been engaging in a dialogue with businesses - many of which already provide health coverage for their workers - about the new employer and insurer reporting requirements under the Affordable Care Act (ACA). We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively. We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so. We have listened to your feedback. And we are taking action. The Administration is announcing that it will provide an additional year before the ACA mandatory employer and insurer reporting requirements begin. This is designed to meet two goals. First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees. Within the next week, we will publish formal guidance describing this transition. Just like the Administrationโ€™s effort to turn the initial 21-page application for health insurance into a three-page application, we are working hard to adapt and to be flexible about reporting requirements as we implement the law. Here is some additional detail. The ACA includes information reporting (under section 6055) by insurers, self-insuring employers, and other parties that provide health coverage. It also requires information reporting (under section 6056) by certain employers with respect to the health coverage offered to their full-time employees. We expect to publish proposed rules implementing these provisions this summer, after a dialogue with stakeholders - including those responsible employers that already provide their full-time work force with coverage far exceeding the minimum employer shared responsibility requirements - in an effort to minimize the reporting, consistent with effective implementation of the law. Once these rules have been issued, the Administration will work with employers, insurers, and other reporting entities to strongly encourage them to voluntarily implement this information reporting in 2014, in preparation for the full application of the provisions in 2015. Real-world testing of reporting systems in 2014 will contribute to a smoother transition to full implementation in 2015. We recognize that this transition relief will make it impractical to determine which employers owe shared responsibility payments (under section 4980H) for 2014. Accordingly, we are extending this transition relief to the employer shared responsibility payments. These payments will not apply for 2014. Any employer shared responsibility payments will not apply until 2015. During this 2014 transition period, we strongly encourage employers to maintain or expand health coverage. Also, our actions today do not affect employeesโ€™ access to the premium tax credits available under the ACA (nor any other provision of the ACA).โ€ We will provide additional information once the transition regulations are issued next week.