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November 2013 Update: PPACA transition, ERISA & Size Reporting, FSA Rollover Rule

by BMC | Nov 2, 2013 | Updates

Health Care Reform (PPACA) Transition Update
POTUS Offer Trans Relief
Read the briefing from our business partner, Emerson Reid at the bottom of this post. The federal government is encouraging states to adopt a transitional policy which would allow a health insurance carrier, at its option, to continue group coverage that would otherwise be terminated or cancelled. This would allow affected small businesses to re-enroll for that coverage for 2014. However, not all states and insurance companies will permit coverage to continue. So far, there has been no determination in Pennsylvania from the state. We’ll keep you informed as we hear of updates.

Reporting ERISA Status & Group Size to Insurance Carrier by 12/31/2013
Insurance companies must identify each of their group customers as either a small or large group and verify the ERISA status of the group as part of implementation of the medical loss ratio (MLR) provision of the Affordable Care Act. You will be asked to identify your average number of employees. For 2012 and 2013 calendar years, small group has been defined as 50 or fewer; 51 or more for large group. As of 2016, 2-100 employees will be classified as a small group. Utilizing government criteria, the ACA defines an employee as any person for whom the company issues a W-2, regardless of part time or seasonal status or whether the individual has medical coverage. Most employers are ERISA groups while church organizations and government plans are ERISA-exempt.

Flexible Spending Account (FSA) Rollover Rule
Regulations issued by the U.S. Treasury Department allow you to amend your current plan in 2013, so long as it is amended prior to the end of the plan year. You do not have to wait until 2014 to permit rollovers. Be sure to let us know if you want to amend. We’ll take care of the plan amendment and provide notification to participating employees of the change that will give them more flexibility and more ability to use their elected amount.

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