The Affordable Care Act (ACA), also known as Health Care Reform, has implemented sweeping changes that impact employer-sponsored group health plans. To keep our clients abreast of the major provisions of the ACA and its corresponding regulations, we provide cost-free tools and updates.  We also ensure that employers are provided with required notices, such as the SBC (Summary of Benefits and Coverage) and the Health Insurance Exchange Notice. For employer groups with 100+ employees, ACA reporting is required.  For this complex process, we provide clients with resources, whether through Ease or other programs.

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for retirement and health benefit plans.  While most small businesses (under 100 employees, per ACA) are not required to offer health benefits, this law establishes the standards for those companies who choose to do so.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law requiring certain employers to offer temporary benefits if they lose coverage under an employer’s group health plan.   Federal COBRA for employer groups with 20+ employees is generally best handled by a third-party administrator in order to meet compliance requirements. We work with a number of these TPA’s to find solutions for our clients.

A Premium Only Plan allows employees to have their portion of premium to be deducted on a pre-tax basis.  In turn, the employer can save about 7.65% (the FICA match) on every dollar the employee deducts.

Health Savings Accounts are a way to use tax-free dollars to pay for healthcare expenses.  The insured must have a compatible High Deductible Health Plan (HDHP) that specified “HSA compatible”.  Funds in an HSA belong to the employee and can roll over from one year to the next.

An HRA is a tax-free, employer funded plan that allows the employer to make funds available to employees for reimbursement of qualified healthcare expenses.

The Family Medical Leave Act applies to companies with 50+ employees.  These employers must provide an eligible employee with up to 12 weeks of unpaid leave during any 12-month period for certain reasons, including but not limited to birth of a child, adoption or foster care,  and caring for a family member with a serious health condition. California has similar and some additional laws.

The Health Insurance Portability and Accountability Act is best known as the provision that protects the privacy and security of an individual’s personal health information.

The Health Insurance Portability and Accountability Act requires certain employers to provide the Notice of Special Enrollment Rights Notice, the Wellness Program Disclosure, and the HIPAA Notice of Privacy Practices for Protected Health Information.

Certain Group health plans must provide notices, including the following (partial list):

• Women’s Health and Cancer Rights Act Notice
• Mental Health Parity and Addiction Equity Act Disclosure
• Employer CHIP Notices
• Michelle’s Law Notice
• Medicare Part D – Creditable (or non-Creditable) Coverage Disclosure Notices
• Sexual Harassment Training, required for employers with 5+ employees