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Life Health > Health Insurance > Health Insurance

For employers, PPACA smog thickens

By Allison Bell

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The Patient Protection and Affordable Care Act of 2010 (PPACA) “play or pay” provisions already apply to employers with 100 or more employees.

Employers with 50 to 99 employees are already supposed to be collecting the full-time equivalent (FTE) employee counts they need to comply with the PPACA coverage requirements in 2016.

See also: 27 PPACA reporting obligations employers need to know

But employers without floors full of top benefits lawyers and corporate tax accountants in their headquarters buildings are struggling to get a basic understanding of what they have to do to comply with PPACA.

Even lawyers, accountants, and benefits brokers who have memorized the Center for Consumer Information and Insurance Oversight (CCIIO) website directory structure, and know where to go on the Employee Benefits Security Administration (EBSA) and Internal Revenue Service (IRS) websites for the latest drips of PPACA guidance, are having trouble knowing what’s coming.

Jay Starkman is one of the experts. He’s the chief executive officer of Engage PEO, a professional employer organization (PEO). His company serves as the official employer, or co-employer, for other companies’ employees, and his company assumes as much responsibility for human resources functions and benefits programs as employers want to cede, and are legally allowed to cede.

Starkman has tried to make Engage PEO a source of PPACA expertise, and comfort.

In an interview, he said he is still hearing the same employer questions he was being asked a year ago: “What does it mean?” and “How do I comply with it?”

“People are just confused,” Starkman said.

For more of Starkman’s thoughts on PPACA uncertainty, read on.

Someone peeking through blinds.

1. Managers at midsize employers know that PPACA will affect them, but not necessarily much else.

In general, Starkman said, “I think the economy’s in a strong place right now.”

The kinds of employers that use his services were providing good benefits before PPACA came along, and they’re still providing good benefits, he said. 

Last year, for example, regulators and others suggested that many employers might try to put workers in plans that barely meet PPACA requirements, such as self-sponsored group plans that cover the PPACA preventive services package and little else, or PPACA plans that just cover enough of the actuarial value of the PPACA essential health benefits package to possibly qualify as minimum essential coverage (MEC).

See also: PPACA skinny plan war flares in California

In the real world, Starkman said, the employers that added the bare-bones plans have mostly been restaurants and other employers with large numbers of part-time employees.

“These are folks that didn’t have insurance in the first place,” he said.

Most of the employers that work with Engage PEO expect to have to comply with the PPACA mandates and simply want to know what they’re supposed to do, he said.

But figuring out what that, is challenging, he said.

Employers with 100 or more employees were already supposed to be counting FTEs in 2014, to come up with the numbers they need to apply the PPACA “shared responsibility” rules this year.

Even when employers tried to comply with the “look back period” counting rules, “many of them did it wrong,” Starkman said.

A determined man

2. Employers hate having to spend so much time thinking about health benefits.

At the kinds of employers that already offer solid benefits, “you just want to comply” with the law, Starkman said. “You don’t want to ‘build expertise.’”

See also: Health care reform FAQ: How does the employer mandate tax penalty work

A coal fire

3. The conflict between the employers that have traditionally provided good benefits and other employers may continue to torch any efforts to negotiate a stable, practical compromise until it burns itself out.

The employers that have provided and continue to provide good benefits may prefer the idea of members of Congress putting aside their differences and coming up with a system that’s less horrible than the alternatives, rather than prolonging uncertainty with efforts to create a great system.

But the kinds of employers that find offering good health benefits onerous are continuing to fight the PPACA coverage requirements with every tool at their disposal, and they are likely to keep fighting until they win, or until fighting the mandates appears to be futile, Starkman said.

“It’s a political issue,” Starkman said.

See also: Republican plan for PPACA subsidies won’t prevent ‘massive disruption,’ report concludes

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