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Posts Tagged ‘play or pay’

High Health Plan Deductibles Weigh Down More Employees

Wednesday, September 3rd, 2014

The New York Times reports:

“Anita Maina was working on an arts and crafts project she found on Pinterest — creating a table out of wood and cork — when she ripped off a fingernail while removing staples from a piece of wood.

“It is one of those things that really hurt, and I thought I should go to urgent care,” said Ms. Maina, 27.

But she ultimately skipped the visit since she had not met the $6,000 deductible on her health plan, and she knew she probably did not have much left in her health savings account, a type of tax-advantaged savings vehicle that is often used with high-deductible plans to help defray out-of-pocket costs.

Ms. Maina, an associate in a health and human services consulting agency, said her employer added the high-deductible plan earlier this year; though her monthly premiums are only $34, these plans require employees to pay for a greater share of their medical expenses upfront, before the plan starts making payments.


Obama administration delays another healthcare reform provision

Tuesday, September 3rd, 2013

HR . BLR . com reports:

“The Obama administration has revealed the delay of another Affordable Care Act (ACA) provision. The administration has postponed a consumer protection provision that limits out-of-pocket costs until 2015. Under the provision, the limit on such out-of-pocket costs was not supposed to exceed $6,350 for an individual and $12,700 for a family.


IRS Issues More “Play or Pay” Guidance

Monday, February 4th, 2013

Benefits in Brief reports:

“Shortly before 2012 came to an end, the IRS issued proposed regulations and Frequently Asked Questions concerning the employer “play or pay” provisions of the Affordable Care Act (“ACA”). More formally known as the employer “shared responsibility” requirement, these provisions require that large employers either “play” (by offering health coverage to their full-time employees) or “pay” (in the form of a substantial excise tax). The proposed regulations largely codify guidance provided through four separate Notices issued during 2011 and 2012, though with some important clarifications and modifications.


PPACA: Play or pay? 7 reasons why ‘pay’ is not the easy answer

Friday, January 25th, 2013

Employee Benefit Advisor reports:

“With every day that goes by, the nation’s employers move a step closer to having to make a decision: Do I play or pay?

Employers now have just a little more than one year to prepare themselves and their workforces for the arrival of the core of the Patient Protection and Affordable Care Act, which requires employers with 50 or more full-time employees to offer medical coverage or pay a penalty. Although a year might seem like ample time, the decision isn’t an easy one, and it’s fraught with financial, legal and competitive implications.

Some employers assert that the play-or-pay mandate will raise their costs and force them to make workforce cutbacks. As a result, a number are considering eliminating their health care coverage altogether and instead paying the penalty on their full-time employees. While the “pay” option might be worth considering, there are strong reasons why employers should look carefully at all of their options and do their best to calculate the actual outcomes of each.

Here are some of the issues employers should factor into their decision-making process: (more…)

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