ACA Management - Benefits Discussion

Written by benefitexpress | June 19, 2015

Learn what hurdles employers are facing with management of the Affordable Care Act (ACA).

This video includes commentary from benefitexpress employees, including (from left to right):

  • Monica Hinchey - Vice President, Client Engagement, Marketing, and Channel Partners
  • Love Ann Dougherty - Director, Quality Control and Client Support
  • Susan Amos - Director, Product Management

Video Transcript:

"Let's talk about what are some of the hurdles in the management of the Affordable Care Act that employers are facing today."

"I think that one of the first issues is that they don't have an understanding of what data is going to be necessary. In all of our conversations, we get asked 'well do I have to send you hours or earnings'. And, in some cases they may not. If they fall under a specific Safe Harbor, we don't need to collect earnings every single pay period and measure against 9.5%."

"I think that they think that they're going to hand fill out the 1095-C forms. And they're not really sure how they're going to get that data, where they're going to get it, and the fact that there are deadlines to XML file formats, that most people don't really know what an XML file format is. I think that is confusing because it's driven by penalties."

"I think that they are challenged by identifying the best way to focus on the automatic eligibility assignment that needs to occur when individuals who are more variable hour, in nature, straddle that magical 30 hour limit, and how and when are they going to offer the benefits and under what circumstances do they need to tell the employee that they are terminating from benefits. And I agree with you, the form itself can be overwhelming for the employers because it's difficult"

"It's not just understanding the form, it's trying to identify where they're going to get the data. They have an HR system, which might have benefit elections. They've got a separate payroll system that has part of it. And the form is even more complex than that. It's not just who's covered on any given day, it's 'are they in their waiting period?'. If they weren't in their waiting period, then what category do they fall into?"

"There's a lot of categories."

"A lot of categories, and no guidance as to which one really should take precedence over another one."

"I think being able to efficiently and regularly evaluate the status of employees' hours and earnings, or eligibility maintenance, against who's truly covered and who isn't is ultimately... it's not so much the challenge as it is the goal, and that the employers need to be confident that that's being handled correctly."