Federal Agencies Delay Automatic Enrollment for Group Health Plans

iStock_nowlater.jpgRecall that the Patient Protection and Affordable Care Act (“PPACA”) – the health care reform legislation passed in 2010 – originally required that group health plans implement automatic enrollment in 2014.  The Internal Revenue Service, Department of Labor and Department of Health and Human Services have jointly issued, in the form of “Frequently Asked Questions” or “FAQs,” guidance that delays the implementation of the group health plan automatic enrollment requirement.  Employers (to whom the Fair Labor Standards Act applies and with more than 200 full-time employees) have reprieve regarding the original 2014 deadline until the DOL issues final regulations that provide automatic enrollment guidance.

The FAQs detail issues regarding the requirement for employers to provide coverage to full-time employees or be subject to a penalty assessment (the “employer shared responsibility provisions”).  The FAQs also provide guidance on how employers will determine whether employees are “full time employees” and how to use W-2 income rather than household income to determine whether coverage is “affordable coverage.”  The FAQs provide that the agencies will issue further guidance on the coordination of the employer shared responsibility provisions and the 90-day waiting period limitation (and even more specifically, the application of the waiting period limitation to part-time and seasonal employees).

This guidance provides specific examples that will assist companies in preparing for future compliance.  The agencies are accepting public comments on the guidance through April 9, 2012. 

What's the Fate of Obamacare. . . Unconstitutional?

iStock_thumbs.jpgThe advocates of Obamacare are all wondering what an important new court decision means for the sweeping health care reform passed in March 2010.  Late last week, the 11th Circuit Court of Appeals held a key provision of health care reform is unconstitutional, which could make the law difficult to enforce.  See decision here:  11th Circuit_Decision.pdf.  Obamacare contains a provision known as the "individual mandate," which requires individuals who do not have coverage through their employer to buy insurance or face an annual tax penalty which will be as high as $695 per year by 2016.

The 11th Circuit found that provision exceeds the constitutional authority of Congress, meaning that the federal government cannot force its citizens to buy insurance, and it cannot collect a penalty for citzens failing to do so. Many observers believe that if there is no penalty, there will be no incentive for uninsured individuals to obtain coverage.

 

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