Benefits Alert 2012-04
Trish Neely, CFCI
Chief Justice Roberts read the verdict at approximately 10AM this morning. Healthcare Reform, including the individual mandate is constitutional and the law stands. Surprisingly the Chief Justice sided with the liberal justices. In the 5-4 decision authored by the Chief Justice, the Court found that the individual mandate provisions of PPACA are constitution as a tax. “Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it.”
What happens next? We have upcoming elections so there may yet be changes to the law but as we suggested previously, the best course of action is not to hedge your bets on a hoped future outcome but rather continue down the path of compliance. For states it means they need to double their efforts to get the state Exchanges up and running.
Notice & Reporting Obligations
- Your payroll should now be set up to begin tracking the value of your employees’ health care coverage for purposes of reporting on W-2s for the 2012 tax year. See article in the January 2012 newsletter: Health Care Reform Forms W-2 Reporting Update
- If your health plan is a grandfathered plan don’t forget to include a statement with your enrollment materials that identifies your plan as such and provides a contact name for any questions or concerns. FBMC has model language for ERISA and non-ERISA plans – please contact your Account Manager.
- If you are changing from grandfathered status as part of your next open enrollment, there are some new requirements you will want your health plan to include in your updated plan document or Summary Plan Description. Where noted you will want to include this information as part of your enrollment communications:
- The plan no longer contains an exclusion for pre-existing conditions
- There are no co-pays or deductibles on preventive care
- Adult children must be covered under the plan to age 26 (regardless if other health coverage is available) – this should also be noticed to all enrollees as part of your enrollment communications
- Access to emergency care, selection of a primary care provider and access to Gyn/Obstetrics care does not require prior authorization – this should also be noticed to all enrollees as part of your enrollment communications