Fact or rumor? Answers to your ACA questions

by | Aug 5, 2013 | Uncategorized

As you may be aware, The Patient Protection and Affordable Care Act (PPACA) or (ACA) was signed into law in 2010 and will reach full implementation January 1, 2014. Because the regulatory guidance for this law is constantly changing there has been a lot of confusion surrounding the legislation. We want to communicate the basics and help you distinguish the facts from the rumors.

 

  • WorkSmart medical plans are in compliance with the ACA – FACT

WorkSmart has been working hard to ensure all medical plans are in compliance for 2014. We have consulted with a team of healthcare attorneys and actuaries to double and triple check that all of our clients will be covered.

  • Employers in a PEO relationship are automatically considered large employers under the ACA – RUMOR

For the purposes of ACA compliance, the number of Full Time Equivalent employees for client companies will be calculated based on the client site only. WorkSmart System’s number of employees will not affect the small or large employer status.

  • Adult pre-existing limitation exclusions will be eliminated – FACT

Starting 2014, health plans cannot limit or deny benefits because you have or have had a pre-existing condition. A pre-existing condition is a health problem found or treated before you signed up for coverage. This provision already applies to individuals under the age of 19 and will take effect January 2014 for those ages 19 and older.

  • Premiums will increase from 25-50% in the group insurance market and up to 118% in the individual market – RUMOR

While it is true that the fully insured (community rated) market is bracing for significant increases, we anticipate a normal renewal cycle. One of the reasons WorkSmart Systems operates a large self-funded medical plan is to protect us and our client companies from this impact. The ACA will raise medical costs and everyone will feel that impact. However, we are protected from the costs associated with the Health Insurance Tax (HIT) and community rating which will be the main drivers of these large premium increases.

 

We hope that this has helped clear up some of your questions regarding the ACA. The WorkSmart Systems team is happy to help with any additional questions as your company adjusts to new regulations. Reach us by emailing solutions@worksmartpeo.com. Share more Facts and Rumors you have heard on our Facebook and Twitter.

 

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