The Top 3.5 Changes in the Affordable Care Act

BeNeF14 Benefits

Affordable Care Act

By BeNeF14

The Affordable Care Act has brought about many changes to the Health Insurance arena in the New Year. Now that 2015 is in full swing, the staff at benefEx is here to inform you of all the changes that may or may not affect your company. We have comprised a 3.5 list of Health Care changes for your convenience.1. ERISA ComplianceERISA, or the Employee Retirement Income Security Act, is a federal law that regulates benefits in Group-sponsored plans on both the company and employee level. Under ERISA, the law requires specific plan features and funding information and in some cases mandates that employers submit detailed information.As Employers, you face strict deadlines for disclosing plan information to your eligible employees and all sponsors of ERISA plan must follow strict codes of conduct.

Failure to comply with the requirements that ERISA states can cost your company hefty penalties and even employee lawsuits.

2. HIPAA Compliance

The next issue that we need to talk about is HIPAA Compliance. HIPAA, short for the Health Insurance Portability and Accountability Act, protects the privacy of health information for the safety of patients when receiving healthcare. Did you know that giving someone’s address is considered a HIPAA breach of compliance and you can be fined for that?

HIPAA must be obeyed by covered entities (CE), which is anyone who operates in healthcare whether it is payment or treatment and business associates (BA) which is anyone that may have access to the treatment information.

3. Employer Mandate:

The Employer Mandate is referring to employers that have at least 50 full-time equivalent employees and full-time employees must work at least 30 hours and a week.

Are you still with us? Great. The employer must also offer coverage to its full-time employees. So far, so good, no penalties. If you’ve answered no to the last question and at least one employee received a premium tax credit in the exchange, you will be penalized.

Let’s keep going. Does your ER plan pay for 60% of covered healthcare expenses?

If you answered no, is it possible that your employees qualify for premium tax credit in the Exchange? If so, you will be hit with a penalty.

If your employer does pay for 60% of healthcare expenses, does your employer offer “affordable” coverage to its workers?

Again, if you answered no, is it possible that employees qualify for premium tax credit in the Exchange? If so, you will be hit with a penalty.

If you’ve answered yes to the providing of “affordable” coverage, congratulations, no penalties!

Are you completely and utterly confused? We figured as much. Contact us at benefEx as we are experts in all of these areas so you don’t have to be.

Oh and as for the .5 that we’re missing.

3.5 This could all collapse this year.

Everything we’ve told you could possibly go out the window with new laws and votes taking place in 2015.

The information we provided is not meant to scare to you, it’s meant to make you aware.

Like we mentioned earlier, contact benefEx, we’ve got you covered. Our telephone number is (973) 740-2500 or online at

Contact Us Today at 973.740.2500