I’m pleased to kick-off of our 10 Days of ACA series. We asked a panel of experts from across Mercer to reflect on health care reform developments in 2014 and look ahead to what the ACA will bring in 2015.
It’s hard to believe we have been forging through ACA compliance for over four years. 2014 has been a roller coaster ride as we absorbed the impact of many final rules and regulations, FAQs, and court decisions addressing various aspects of ACA compliance. Here is a high-level summary of what transpired:
- Final “pay or play” rules and final rules on excepted benefits.
- Guidance on a 90-day waiting period added option for new hire orientation period.
- ACA employer reporting rules, forms, and draft instructions.
- Annual reinsurance payment rules and fee for 2015.
- Clarification on COBRA and the ACA; updated model COBRA notices.
- Supreme Court allows religious relief from the contraceptive mandate.
- Split court decisions on challenged ACA subsidies limited to state-run exchanges.
- IRS expanded allowed cafeteria plan election changes.
- Guidance on out-of-pocket maximums.
- ACA minimum value plans must cover hospitalization.
- Health Plan ID filing and then delay.
- ACA reinsurance fee filing.
More importantly, what are we expecting in 2015? Some are hoping that the change in the House and Senate as a result of mid-term elections will lead to some “fixes” to the law. The most talked-about changes seem to be changing from a 30-hour to a 40-hour eligibility requirement and eliminating the medical device fee. We have to keep in mind that those types of changes impact funding and will require revenue from elsewhere to cover the gap, which might not be easy to find.
If we turn our focus to the regulators, my top-five wish list for guidance includes:
- Final ACA reporting forms and instructions.
- Rules on minimum value of employer-sponsored coverage and an updated HHS minimum value calculator.
- Guidance on nondiscrimination under the ACA.
- EEOC guidance on wellness incentives.
- Draft guidance and request for comments on the Cadillac tax.
Lastly, we have another Supreme Court decision to look forward to in the summer of 2015 that could have a significant impact on the future of the ACA. All signs indicate that 2015 will be jam-packed with ACA activity.