What Employers Need to Know About the Affordable Care Act

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Post on 12-Apr-2017




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<ul><li><p>What Employers </p><p>Need to Know About </p><p>the Affordable Care </p><p>Act </p><p>Crystal Clear Rx </p><p>19753 East Pikes Peak </p><p>Avenue, Suite G-103 </p><p>Parker, CO 80138 </p><p>(303) 955-7827 </p></li><li><p>The Affordable Care Act (ACA) continues to attract intrigue despite its passing all the way </p><p>back in 2010.Although passed in that year, it was only in 2014 that a mandate came that </p><p>it be used by all American workers something that has brought confusion among </p><p>employers. </p><p>Employee Coverage of ACA </p><p>The ACAs provisions affect American company policies in employee coverage. Initially, it </p><p>served as a secondary and emerging health care option for American workers since ESI </p><p>or employer sponsored insurance. </p><p>Beginning 2014, employers were </p><p>required to inform employees that </p><p>the new health care insurance </p><p>marketplace has opened. In 2015, </p><p>employers with 50 employees or </p><p>more must offer employees health </p><p>coverage. </p><p>Failure to complydespite no </p><p>mandate given meant punishment </p><p>by way of fines. But this only applies </p><p>on one condition: if employees look </p><p>into the possibility of health </p><p>insurance despite earning so low that </p><p>they qualify for federal subsidies. </p><p>The coverage does not affect </p><p>workers working not more than 30 </p><p>hours a week. </p></li><li><p>Employers Have a Choice </p><p>The ACA is not pinning any responsibilities on companies with less than 50 workers. </p><p>However, if they voluntarily elect to give ACA coverage for their employees, the insurance </p><p>markets may point them where to shop. Employers with fewer than 25 staff members are </p><p>eligible for federal tax credits, so long as average wages fall below $50,000. </p><p>Stating thus, employers with fewer than 50 full-time employees are excused from the </p><p>employer shared responsibility and the employer reporting requirements. </p><p>Effect of ACA in PBM </p><p>In terms of prescription drug coverage, all private health insurance plans provided to </p><p>workers through their employer or purchased from a market must cover at least one </p><p>medication in 50 drug categories as demarcated by the U.S. Pharmacopeia. </p><p>A pharmacy benefit rule provision cites that each covered drug in the category must be a </p><p>biologically or chemically distinguished product. Qualified health plans must, too, make </p><p>provisions for enrollees to receive prescribed medication that are not on the standard </p><p>formulary. </p><p>The ACA has changed the health care provisions for employees. The challenge to employers </p><p>is to weigh how they can best manage their health care provisions without sacrificing the </p><p>business. </p></li><li><p>Resources: </p><p>http://crystalclearrx.com/content/pbm-services-consultants </p><p>http://www.insidecounsel.com/2014/07/01/affordable-care-act-what-employers-</p><p>need-to-know </p><p>https://www.federalregister.gov/articles/2014/03/10/2014-05051/information-</p><p>reporting-of-minimum-essential-coverage </p><p>http://crystalclearrx.com/content/pbm-services-consultantshttp://www.insidecounsel.com/2014/07/01/affordable-care-act-what-employers-need-to-knowhttp://www.insidecounsel.com/2014/07/01/affordable-care-act-what-employers-need-to-knowhttps://www.federalregister.gov/articles/2014/03/10/2014-05051/information-reporting-of-minimum-essential-coveragehttps://www.federalregister.gov/articles/2014/03/10/2014-05051/information-reporting-of-minimum-essential-coverage</p></li></ul>


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