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Navigating the Pillars of
the Affordable Care Act
2
50
Employers with at least 50 full-time employees will be
required to pay a penalty if they fail to offer minimum
essent...
3
Three Things You Will Remember
! WHY IT’S IMPORTANT TO YOU
+ HOW ADP CAN HELP
? WHAT IS THE BUSINESS ISSUE?
WHAT IS THE BUSINESS ISSUE??
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.4
eligibility risk
Schedu...
HOW ADP
CAN HELP+
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.5
Reports are provided for illustrat...
HOW ADP
CAN HELP+
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.6
Seamless integration of Time &
Att...
WHY IT’S
IMPORTANT!
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.7
Empowers you to be proactive
in ...
WHAT IS THE BUSINESS ISSUE?
ELIGIBILITY
Accurately determine
employee eligibility &
assessment
?
© Copyright 2012 ADP, Inc...
9
Ability to categorize workforce
and establish measurement/look-
back periods to meet your
business requirement
Provides ...
10
Ability to pull total hours for
each employee to use in the
determination of full time
equivalency qualification
for AC...
11
HOW ADP
CAN HELP+Eligibility Tools
Eligibility Report provides an
easy way to look at employee
base as a whole and iden...
WHY IT’S
IMPORTANT!
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.12
Enables fair and consistent
mea...
WHAT IS THE BUSINESS ISSUE?
AFFORDABILITY
Select affordability
assessment method;
Employee premium
?
© Copyright 2012 ADP,...
14
HOW ADP
CAN HELP+Affordability Tools
Provide tools for the
practitioner to conduct
analysis of employees
purchasing emp...
HOW ADP
CAN HELP+
Affordability – Health Insurance
Costs for the W-2
© Copyright 2012 ADP, Inc. Proprietary and Confidenti...
16
HOW ADP
CAN HELP+Affordability Tools
Assist with identifying
plans that are minimum
essential coverage (60%+
of actuari...
WHY IT’S
IMPORTANT!
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.17
Mitigates risk related to cost ...
WHAT IS THE BUSINESS ISSUE?
ENROLLMENT
Manage end-to-end
enrollment of eligible
employees
“Play or Pay”
?
© Copyright 2012...
Allows employees to opt
out of medical plan with
required reason to ensure
employer has appropriate
tracking and auditing ...
20
HOW ADP
CAN HELP+Enrollment Tools
Provides tools to assist with
the annual reconciliation of
the penalty bill against
b...
Comprehensive
report with
employees’ plan
enrollment details.
HOW ADP
CAN HELP+Enrollment Tools
21
Comprehensive report
wi...
Provides proactive report to
show employee enrollment
status ensuring Employers
take action during their
Administrative pe...
WHY IT’S
IMPORTANT!
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.23
Empowers employees with ability...
WHAT IS THE BUSINESS ISSUE?
AUDITING & REPORTING
Standard compliance
reports for the
Affordable Care Act
?
© Copyright 201...
HOW ADP
CAN HELP+Standard Compliance Reports
25
Group Health Insurance
Costs reporting is available
to generate and review...
HOW ADP
CAN HELP+
Manage end-to-end
enrollment of
eligible employees
with comprehensive
enrollment details
on employees &
...
HOW ADP
CAN HELP+
ADP provides Practitioners with
self administered plans the means
to calculate the research fee
Patient ...
WHY IT’S
IMPORTANT!Auditing & Reporting
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.28
Aids ACA co...
29
Of the Affordable Care Act
ADDITIONAL PROVISIONS
Source: Mercer Select Health Care Reform Briefing, October 27, 2011
WHAT IS THE BUSINESS ISSUE?
DEPENDENT COVERAGE
Employe...
Ability to configure ADP platform to
apply age rules where applicable
Provide open and life event
enrollment tools to allo...
Reduces costs associated with
ineligible plan participants
Reduces premium overpayments
Helps ensure compliance with
cover...
WHAT IS THE BUSINESS ISSUE?
Insurers and self-insured group
health plans must provide
SBCs for annual enrollments
beginnin...
ADP supports delivery of SBC
electronically as well as obtaining
acknowledgement from employees;
client can also print har...
WHY IT’S
IMPORTANT!
Aids compliance with SBC
requirements
Reduces administrative burden of
communicating SBCs to employees...
WHAT IS THE BUSINESS ISSUE?
FSA ANNUAL LIMIT
maximum
Ability to determine the
amount an employee
can contribute to FSA
?
©...
HOW ADP
CAN HELP+
Provide one- stop shop for all
ADP Healthcare spending
accounts for 2013 open
enrollment
(FSA, HSA, HRA)...
WHY IT’S
IMPORTANT!
Aids compliance with
FSA requirements
Reduces administrative burden
of communicating FSA limits
to emp...
WHAT IS THE BUSINESS ISSUE?
Ability to be notified
of new statutory
regulations
?
© Copyright 2012 ADP, Inc. Proprietary a...
HOW ADP
CAN HELP+
Medicare Tax on Wages and
Unearned Income
© Copyright 2012 ADP, Inc. Proprietary and Confidential Inform...
WHY IT’S
IMPORTANT!
Increases employee satisfaction
with highly compensated/executive
associates on planning their taxes
I...
WHAT IS THE BUSINESS ISSUE?
Ability to
load notice
describing availability
of marketplace/exchange
coverage
?
© Copyright ...
ADP supports delivery of Notice
of Marketplace/Exchange
electronically as well
as obtaining acknowledgement from
employee;...
WHY IT’S
IMPORTANT!
Aids compliance with
marketplace/exchange notice
requirements
Reduces administrative burden
of communi...
WHAT IS THE BUSINESS ISSUE?
WAITING PERIODS
Ability to define when
an employee is
eligible to enroll in
employer group hea...
Provide new hire reports (up to 90
days) to validate employment status
& change triggers to ensure
appropriate benefits en...
WHY IT’S
IMPORTANT!
Helps mitigate excessive costs
based on employment status
Aids compliance with FLSA rules
Date of Hire...
48
ADP
Time and Labor
Management
ADP
Reporting and
Reconciliation
ADP
Payroll
ADP
Benefits
• Report on Hours of Service
in...
Why ADP . . .
Our goal is to minimize your administrative
burden across the entire spectrum of payroll,
tax, HR and benefi...
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Navigating the Pillars of the ACA - How ADP Can Help

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Navigating the Pillars of the ACA - How ADP Can Help

  1. 1. Navigating the Pillars of the Affordable Care Act
  2. 2. 2 50 Employers with at least 50 full-time employees will be required to pay a penalty if they fail to offer minimum essential coverage & a full-time employee obtains subsidized coverage from an exchange 60 Employers may be subject to a penalty if it decides to play because the coverage offered is either “unaffordable” or the plan is not designed to pay at least 60% of participants’ covered medical expenses 90 Employers have only 90 days to offer eligible employees health care benefits What Do These Numbers Represent?
  3. 3. 3 Three Things You Will Remember ! WHY IT’S IMPORTANT TO YOU + HOW ADP CAN HELP ? WHAT IS THE BUSINESS ISSUE?
  4. 4. WHAT IS THE BUSINESS ISSUE?? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.4 eligibility risk Schedule and manage hours of service to minimize WORKFORCE PLANNING ACA liability
  5. 5. HOW ADP CAN HELP+ © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.5 Reports are provided for illustration purposes and are subject to change Use the hours summary reports on a weekly and annual basis to determine whether schedule adjustments should be made for employees Workforce Planning
  6. 6. HOW ADP CAN HELP+ © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.6 Seamless integration of Time & Attendance with Payroll and HR allows access to a list of ACA eligible employees for improved scheduling and ACA benefits cost control Workforce Planning Automated scheduling makes it easy to identify when employees are approaching the ACA benefits threshold and adjust the schedule
  7. 7. WHY IT’S IMPORTANT! © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.7 Empowers you to be proactive in controlling benefit eligibility Minimizes your ACA liability Aids in aligning labor with demand to reduce costs without compromising customer satisfaction Workforce Planning
  8. 8. WHAT IS THE BUSINESS ISSUE? ELIGIBILITY Accurately determine employee eligibility & assessment ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.8 method(s) PART-TIME FULL-TIME
  9. 9. 9 Ability to categorize workforce and establish measurement/look- back periods to meet your business requirement Provides automation of measurement periods. This includes Standard, Administrative, & Stability periods for multiple Employee categories HOW ADP CAN HELP+Eligibility Tools
  10. 10. 10 Ability to pull total hours for each employee to use in the determination of full time equivalency qualification for ACA Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations HOW ADP CAN HELP+Eligibility Tools Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations.
  11. 11. 11 HOW ADP CAN HELP+Eligibility Tools Eligibility Report provides an easy way to look at employee base as a whole and identify who has reached eligibility requirements
  12. 12. WHY IT’S IMPORTANT! © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.12 Enables fair and consistent measurement/look-back periods for all employees Minimize costs without compromising productivity and service Helps you comply with government requirements & regulations Eligibility PART-TIME FULL-TIME
  13. 13. WHAT IS THE BUSINESS ISSUE? AFFORDABILITY Select affordability assessment method; Employee premium ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.13 of Box 1 W-2 earnings not to exceed % 9.5
  14. 14. 14 HOW ADP CAN HELP+Affordability Tools Provide tools for the practitioner to conduct analysis of employees purchasing employee only coverage compared to 9 ½% of earnings
  15. 15. HOW ADP CAN HELP+ Affordability – Health Insurance Costs for the W-2 © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.15 © Copyright 2012 ADP, Inc. Proprietary and Confidential Information. ADP gives the ability to determine which benefit plans should be included in the Group Health Insurance Costs calculation for the W-2
  16. 16. 16 HOW ADP CAN HELP+Affordability Tools Assist with identifying plans that are minimum essential coverage (60%+ of actuarial value)
  17. 17. WHY IT’S IMPORTANT! © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.17 Mitigates risk related to cost of benefits and employee burden levels Aids in evaluating affordability and minimizes potential penalties to employer Reduces administration burden in determining wage levels Affordability % 9.5
  18. 18. WHAT IS THE BUSINESS ISSUE? ENROLLMENT Manage end-to-end enrollment of eligible employees “Play or Pay” ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.18
  19. 19. Allows employees to opt out of medical plan with required reason to ensure employer has appropriate tracking and auditing tools 19 HOW ADP CAN HELP+Enrollment Tools
  20. 20. 20 HOW ADP CAN HELP+Enrollment Tools Provides tools to assist with the annual reconciliation of the penalty bill against benefits and W-2 data, enabling client to request W-2 corrections or initiate penalty appeals process
  21. 21. Comprehensive report with employees’ plan enrollment details. HOW ADP CAN HELP+Enrollment Tools 21 Comprehensive report with employee and dependent plan enrollments; including auditing data like age limit and overage dependent details
  22. 22. Provides proactive report to show employee enrollment status ensuring Employers take action during their Administrative period. 22 HOW ADP CAN HELP+Enrollment Tools
  23. 23. WHY IT’S IMPORTANT! © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.23 Empowers employees with ability to select appropriate plans for lifestyle Communicates to employer why employee has opted out of benefits Helps mitigate potential penalties to the employer Enrollment
  24. 24. WHAT IS THE BUSINESS ISSUE? AUDITING & REPORTING Standard compliance reports for the Affordable Care Act ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.24
  25. 25. HOW ADP CAN HELP+Standard Compliance Reports 25 Group Health Insurance Costs reporting is available to generate and review the costs associated with each employee by benefit plan
  26. 26. HOW ADP CAN HELP+ Manage end-to-end enrollment of eligible employees with comprehensive enrollment details on employees & dependents Play or Pay Preparation Report 26
  27. 27. HOW ADP CAN HELP+ ADP provides Practitioners with self administered plans the means to calculate the research fee Patient –Centered Outcomes Research Fee Report 27 Patient-Centered Outcomes Research Fee report provides the detailed information on fees owed by each benefit plan provider towards the Patient- Centered Outcomes Research
  28. 28. WHY IT’S IMPORTANT!Auditing & Reporting © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.28 Aids ACA compliance efforts to government agencies Improves accuracy and reduces risk of penalties Reduces administrative burden of ACA auditing and reporting
  29. 29. 29 Of the Affordable Care Act ADDITIONAL PROVISIONS
  30. 30. Source: Mercer Select Health Care Reform Briefing, October 27, 2011 WHAT IS THE BUSINESS ISSUE? DEPENDENT COVERAGE Employers must expand coverage for qualifying dependent children up to age 26 ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.30
  31. 31. Ability to configure ADP platform to apply age rules where applicable Provide open and life event enrollment tools to allow dependent children up to age 26 access to health and welfare plans Provide benefit plan setup template to track dependent age requirements HOW ADP CAN HELP+Dependent Coverage © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.31
  32. 32. Reduces costs associated with ineligible plan participants Reduces premium overpayments Helps ensure compliance with coverage regulations WHY IT’S IMPORTANT!Dependent Coverage © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.32
  33. 33. WHAT IS THE BUSINESS ISSUE? Insurers and self-insured group health plans must provide SBCs for annual enrollments beginning on or after 9/23/12 +BENEFITS ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.33 SUMMARY OF BENEFITS AND COVERAGE (SBC)
  34. 34. ADP supports delivery of SBC electronically as well as obtaining acknowledgement from employees; client can also print hard copy HOW ADP CAN HELP+ Summary of Benefits and Coverage (SBC) © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.34
  35. 35. WHY IT’S IMPORTANT! Aids compliance with SBC requirements Reduces administrative burden of communicating SBCs to employees Empowers employees with access to coverage-related information +BENEFITS Summary of Benefits and Coverage (SBC) © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.35
  36. 36. WHAT IS THE BUSINESS ISSUE? FSA ANNUAL LIMIT maximum Ability to determine the amount an employee can contribute to FSA ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.36
  37. 37. HOW ADP CAN HELP+ Provide one- stop shop for all ADP Healthcare spending accounts for 2013 open enrollment (FSA, HSA, HRA), including single debit card and mobile access FSA Annual Limit © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.37
  38. 38. WHY IT’S IMPORTANT! Aids compliance with FSA requirements Reduces administrative burden of communicating FSA limits to employees Boosts employee engagement by improving communication MAXIMUM FSA Annual Limit © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.38
  39. 39. WHAT IS THE BUSINESS ISSUE? Ability to be notified of new statutory regulations ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.39 MEDICARE TAX ON WAGES AND UNEARNED INCOME
  40. 40. HOW ADP CAN HELP+ Medicare Tax on Wages and Unearned Income © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.40 ADP allows practitioners to generate a report in order to conduct analysis of payroll & deductions for high-income employees who may meet criteria for the new taxes Calculates the new Medicare tax for appropriate employees
  41. 41. WHY IT’S IMPORTANT! Increases employee satisfaction with highly compensated/executive associates on planning their taxes Improves accuracy and reduces risk of penalties Medicare Tax on Wages and Unearned Income © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.41
  42. 42. WHAT IS THE BUSINESS ISSUE? Ability to load notice describing availability of marketplace/exchange coverage ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.42 EMPLOYEE NOTICE OF MARKETPLACE/EXCHANGE
  43. 43. ADP supports delivery of Notice of Marketplace/Exchange electronically as well as obtaining acknowledgement from employee; client can also print hard copy HOW ADP CAN HELP+ Employee Notice of Marketplace/ Exchange © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.43
  44. 44. WHY IT’S IMPORTANT! Aids compliance with marketplace/exchange notice requirements Reduces administrative burden of communicating marketplace/exchange option to employees Employee Notice of Marketplace/ Exchange © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.44
  45. 45. WHAT IS THE BUSINESS ISSUE? WAITING PERIODS Ability to define when an employee is eligible to enroll in employer group health plans Date of Hire First of the Month following Hire Date X number of Days following Date of Hire ? © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.45
  46. 46. Provide new hire reports (up to 90 days) to validate employment status & change triggers to ensure appropriate benefits enrollment HOW ADP CAN HELP+Waiting Periods © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.46
  47. 47. WHY IT’S IMPORTANT! Helps mitigate excessive costs based on employment status Aids compliance with FLSA rules Date of Hire First of the Month following Hire Date X number of Days following Date of Hire Waiting Periods © Copyright 2012 ADP, Inc. Proprietary and Confidential Information.47
  48. 48. 48 ADP Time and Labor Management ADP Reporting and Reconciliation ADP Payroll ADP Benefits • Report on Hours of Service including Projected Scheduled Hours • View & Adjust Work Schedules • Ability to Set Threshold Notification for Total Hours of Service (January 2014) • Full – Time Status Reporting • Auto-enrollment Required in 2015 • Enrollment of Eligible Employees • Coverage Termination • W-2 Affordability Calculation • Data to/from Exchanges • Reporting to Federal Government • Reconcile Penalties Levied for Exchange Participation • Deductions and Other Earnings • W-2 Earnings • System of Record for Hours of Service • Look Back Approach Workforce Planning Eligibility & Enrollment Reporting/ Penalties Affordability EMPLOYERS Need an Integrated Approach to Manage the ACA
  49. 49. Why ADP . . . Our goal is to minimize your administrative burden across the entire spectrum of payroll, tax, HR and benefits, so that you can focus on running your business. “ #ADPHCM "We're proud of our payroll heritage" but #ADP is much more than payroll today -- global HCM leader in the cloud. NAOMI BLOOM, HCM INDUSTRY ANALYST IN FULL BLOOM “ With RSM McGladrey and ADP managing our most sensitive business information, I come away each day with a sense of confidence and internal control because I am managing the business, not the tasks. MIKE NICHOLAS, CHIEF FINANCIAL OFFICER RSM MCGLADREY “ “Committed to assisting businesses with increased compliance requirements resulting from rapidly evolving legislation. © Copyright 2012 ADP, Inc. Proprietary and Confidential Information. Marketplace Buzz 49

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