All employers with 50+ employees need to comply with ACA (the Affordable Care Act or “Obamacare”). The first step in developing your ACA Compliance Action Plan is to take an honest look at how prepared you are right now to meet ACA requirements. This webinar (the first in our monthly series for 2014) helps you get prepared by addressing the following questions. (All require a “yes.”) • Have you complied with ACA regulations now in force? Do you know what they are for your plan? • Can you pass the minimum value and affordability tests? Have you performed the tests? • Do you have the data required to prepare employee and dependent rosters for the IRS? Do your payroll and enrollment rosters agree? • Are you prepared to both send required notices and receive required employee authorizations? Can you document two-way communications with your employees? View this webinar to learn how to take the first step in this important process of ACA compliance. To view the entire webinar, please go to: https://www4.gotomeeting.com/register/696925383 For more information, please visit: http://www.healthdecisions.com

1. Affordable Care Act (ACA) 2014 Compliance Plan Series
Session #1
ACA is here. Are you ready?
Presenter:
Si Nahra, Ph.D., President
January 30, 2014

2. About Health Decisions, Inc.
Pioneering Specialists in Group Health Care
Post-Payment Administration
For Over 25 Years
Customer Philosophy:
Respect for Existing Procedures
Emphasis on Customization
Focus on Solutions
© Copyright 2014
Health Decisions, Inc.
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3. 2014 ACA Series
Month
Current Focus
January
February
2014 ACA Plan Webinar Series
1/30: ACA is here. Are you ready?
What you should have done and in place now.
Prior Year
Close-out
2/20: ACA Foundation. Employee eligibility verification.
Opportunity for savings and employee engagement.
March
3/20: ACA Costs now and in the future.
How much and how to minimize or manage.
April
4/17: ACA Cost Sharing (Preventive Care and OOP Maximum)
Ticking time-bomb of liability.
Non-grandfathered plans.
Copyright Health Decisions, Inc.
1/2014
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4. What you should have done.
• 50+ FTE confirmation
• Reporting to employees
– W-2 plan values
– Summary of Benefits and Coverage (SBC)
– Exchange Notices
Copyright Health Decisions, Inc.
1/2014
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5. What you should have done.
• 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
Copyright Health Decisions, Inc.
1/2014
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6. What You Should Have in Place.
Start
NOW


Complete 
First
Quarter

Compile Needed Data Files
o Payroll Data (with history)
o Enrollment Rosters (with history)
o Paid Claims (transactions not summaries)
Assess Data files for accuracy and use
Reconcile payroll facts with enrollment facts
o Expect major inconsistencies
o Expect ineligibles
o Expect late terminations
Survey all employees
o Verify dependent eligibility for two ACA taxes in 2014
o Collect SSN for ALL employees, retirees, and family members
(2015 IRS reporting requirement)
o Confirm two-way communication for authorizations and “good
faith effort”
Copyright Health Decisions, Inc.
1/2014
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7. What You Should Have in Place.
Minimum Value Safe Harbor
http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/mv-calculator-final-4-11-2013.xlsm
http://www.cms.gov/CCIIO/Resources/Training-Resources/Downloads/mv-calculator-webinar-5-13-2013.pdf
Affordability Safe Harbor
Start with your lowest paid employee.
Confirm premium sharing amounts are less than 9.5% of W-2 income.
Note: Penalties for not meeting these requirements delayed.
But confirmation requests related to Exchange enrollments is not.
Copyright Health Decisions, Inc.
2/2014
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8. What You Should Have in Place.
• Confirm with each payer (medical and RX)
that they are enforcing new Out-of-Pocket
(OOP) limits.
• Establish how individual OOP levels will be
monitored and any over or under payments
addressed.
Copyright Health Decisions, Inc.
2/2014
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9. For More Information
Contact
si@healthdecisions.com
734-451-2230
Connect with me on LinkedIn
Add me to your circles on Google+
Like us on FaceBook
Follow us on Twitter
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