Employer Mandate Delay No Free Pass

Chelsea Rice, July 22, 2013

Healthcare providers with high headcounts get a break—they won't have to supply affordable health insurance to their employees or face a fine—yet. But hospitals and health systems still have to be prepared to deal with health insurance exchanges on Oct 1.

HR executives gearing up for what is anticipated to be the biggest open enrollment season yet are breathing a sigh of relief.

On July 2, the Obama administration delayed the Patient Protection and Affordable Care Act's large employer mandate until Jan. 1, 2015. The delay puts off for one year the requirement that employers with more than 50 employees provide affordable health insurance or face a fine. Depending on the size of the business, the penalties could tally in the millions.

Since nearly all hospitals and health systems already offer health insurance benefits, the challenge leading up to the October 2013 enrollment period, and the reason business groups cheered the mandate's delay, centered on the provisions in the PPACA requiring insurers and large employers to report each eligible employee's coverage.

With employees poised to qualify for health benefits when they passed the 30-hour-work-week mark, hospitals and health systems had been scrambling to figure out new plan designs to incorporate the many part-time and per diem staff newly qualified for benefits.

"The 30-hour rule was going to require us to offer benefits to people who wouldn't have benefits historically. We were having employees getting premium pay in lieu of benefits because 450 employees were falling into statuses that we were making them benefit-eligible," says Brian Guyton, director of health benefits for Allegheny Health Network's 8,300 employees. "Of course, best practices would be aligning that with the open enrollment period, but there were a lot of problems with the timing of those windows."

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