THE AFFORDABLE CARE ACT
THE AFFORDABLE
CARE ACT:
What You Need to Know
W
ith all the media hype
surrounding the
Affordable Care Act
(ACA) over the years,
you may wonder if
you’re doing everything necessary to
remain in compliance—or whether you
still need to comply at all. The bottom line
is that the ACA is still the law of the land
and only a few things have changed in the
years since its inception back in 2010.
While the ACA certainly has its detractors,
the statistics show that it has provided
coverage to an estimated 20 million
Americans who were previously uninsured.
According to the Kaiser Family Foundation,
the number of uninsured adults aged
under age 65 decreased from 44.2 percent
in 2008 to 27.9 percent in 2018. Thanks
to the Hawaii Prepaid Health Care Act,
Hawaii maintains one of the lowest
uninsured rates in the country, decreasing
from 9.2 percent in 2008 to 5.7 percent
in 2018, according to the Open Data
Network.
The Kaiser Family Foundation also found
that enrollees considered a number of ACA
benefits “very important” to their families.
These include:
•
•
Access to Medicaid coverage: an
additional 12.7 million Americans
gained coverage.
•
Here is a snapshot of what has changed
over the past decade under the ACA. By
incorporating these items into your
planning, you can stay up to date with
current provisions and better anticipate
changes:
• The individual mandate requiring
ACA coverage has been repealed.
• The Cadillac Tax, which taxed the
most generous employer health
plan provisions, has been repealed.
• The Health Insurance Provider fee,
one of the many taxes included
to help fund the law, is in effect
for 2020 but will be eliminated in
2021.
•
•
Protections for pre-existing
conditions: allowing coverage for
54 million individuals who were
previously denied coverage due to
pre-existing conditions.
•
Preventive services covered at zero
out-of-pocket cost.
12
The Patient Center Outcomes
Research Institute fee, which helps
provide information to better
inform healthcare patients, has
been extended until 2029.
• Coverage must be offered to
employees working 30 or more
hours per week or 130 hours per
month (must be balanced with
Hawaii’s Prepaid Health Care Act
requirements).
• Dependents are eligible until the
age of 26.
•
• The Summary of Benefits and
Coverage must be distributed to
all plan participants.
• The Health Care Exchange
notice must be distributed to all
employees.
• Plan participants must receive
W-2 and 1094/1095 reports
(includes eligible employees who
have waived coverage).
If you have questions regarding the
ACA and how recent changes may affect
your company benefits program, please
contact your Atlas benefits consultant
or contact us at (808) 533-8651. +
The medical device excise tax has
been repealed.
To ensure compliance with the ACA for
your company, here are a few basics to
remember:
Extension of coverage to
dependents until age 26: an
additional 2.3 million Americans
gained coverage.
•
Elimination of annual and lifetime
limits, a welcome change for 59
percent of covered workers.
Employee premiums cannot exceed
9.5 percent of gross wages (1.5
percent if in Hawaii).
BY: BONNIE PANG,
SENIOR VICE PRESIDENT & MANAGER,
ATLAS EMPLOYEE BENEFITS
CONTINUE READING ON PAGE 28
Bonnie Pang is Senior Vice President
and Manager of Atlas Employee Benefits.
Bonnie joined Atlas in 2007 and led the
development of the Benefit Consulting
Practice to complement the already
successful Property and Casualty unit.
Bonnie has over 20 years of experience
in health insurance and employee
benefits, working with medium and
large employers in construction,
hospitality, law, grocery, retail, nonprofit,
transportation, and education.