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Presenter:
Si Nahra, Ph.D., President
May 29, 2014
ACA Communications Requirements:
An Employee Relations Opportunity
Copyright Health Decisions, Inc.
05/2014
2
About Health Decisions, Inc.
Pioneering Specialists in
Group Health Care
Post-P...
2014 ACA Series
Copyright Health Decisions, Inc.
05/2014
3
Non-grandfathered, calendar year plans.
Comply not just because...
Quick Review
What you should have done.
• Reporting to employees
– W-2 plan values
– Summary of Benefits and Coverage (SBC...
Employee Communications
• Required: Scheduled or Event Driven
– ACA
– DOL
– IRS
• Opportunities
– ACA Q&A to and from empl...
Scheduled Communications
Event DOL
http://www.dol.gov/ebsa/
pdf/rdguide.pdf
ACA IRS
Oct
Open
Enrollment
SPD, SMM,
WHCRA, W...
Event Communications
Event DOL ACA IRS
New Hires: Eligible Enrollment Rights Notice Marketplace Notice
Affordability Confi...
Communications Opportunities:
Going Beyond Minimum Requirements
Event Communication Opportunity
Post Open Enrollment
Post ...
Communications Opportunities
Filling In the “Silent Period”
Event DOL ACA IRS
Oct
Open
Enrollment
SPD, SMM, WHCRA,
Wellnes...
Communications Opportunities:
Why Bother? Employee Perspective
• ACA confusion and misinformation creates employee concern...
Communications Opportunities:
Why Bother? Employer Perspective
Copyright Health Decisions, Inc.
05/2014
11
Recruit/Retain ...
Copyright Health Decisions, Inc.
05/2014
12
For More Information
Contact
si@healthdecisions.com
734-451-2230
Connect with ...
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Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity

The Affordable Care Act requires a range of communications with employees and their families (consumers). This webinar presents ways to use these new communication requirements as part of a strategy to engage consumers. ACA elevates the role of individual consumers in health care decision-making to new heights. Viewing employees and their families as decision-makers means employers will want to communicate with them and listen to them. Employers that embrace this new reality can increase their ability to attract and retain a high-quality workforce (the only reason employers offer health benefits).

To view the webinar, please go to: https://www4.gotomeeting.com/register/823073671

For more information, please visit: http://www.healthdecisions.com

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Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity

  1. 1. Presenter: Si Nahra, Ph.D., President May 29, 2014 ACA Communications Requirements: An Employee Relations Opportunity
  2. 2. Copyright Health Decisions, Inc. 05/2014 2 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. 3. 2014 ACA Series Copyright Health Decisions, Inc. 05/2014 3 Non-grandfathered, calendar year plans. Comply not just because you have to. Comply in a way that helps your plan. FOCUS
  4. 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 Copyright Health Decisions, Inc. 5/2014 4 ACA Compliance Checklist Sessions available now. Call 734-451-2230 Ask for Leslie. E-mail leslie@healthdecisions.com
  5. 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 Copyright Health Decisions, Inc. 05/2014 5
  6. 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 Copyright Health Decisions, Inc. 05/2014 6 Communication “Silent Period”
  7. 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 Copyright Health Decisions, Inc. 05/2014 7
  8. 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 Copyright Health Decisions, Inc. 05/2014 8
  9. 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 Copyright Health Decisions, Inc. 05/2014 9 • 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. 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. Copyright Health Decisions, Inc. 05/2014 10
  11. 11. Communications Opportunities: Why Bother? Employer Perspective Copyright Health Decisions, Inc. 05/2014 11 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
  12. 12. Copyright Health Decisions, Inc. 05/2014 12 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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