Patient Protection and Affordable Care Act - Timeline of Upcoming Deadlines for Employer Compliance

October 2012

On June 28, 2012 the Supreme Court upheld the Patient Protection and Affordable Care Act (PPACA) as a tax and essentially all of its underlying provisions.  As such, many job creators are faced with upcoming deadlines to bring their group health plans into compliance. Below is a PPACA timeline that highlights these deadlines for employer compliance.

Individuals or businesses should consult with the IRS or a tax advisor concerning proper reporting and payment related questions.

2013
Flexible Spending Account (FSA) Annual Limit
Date: 1/1/13
Summary: Maximum dollar limit for each FSA account is $2,500 annually. For more information, please visit here.

Retiree Prescription Drug Expenses
Date: 1/1/13
Summary: Employers cannot take an additional deduction for subsidy amounts received for Part D prescription drug coverage provided to retirees.

Medicare Payroll Tax Increase
Date: 1/1/13
Summary: The Additional Medicare Tax applies to individuals’ wages, other compensation, and self-employment income for wages over $200,000 single and $250,000 married. For more information please visit here.

Employee Notice of Exchange
Date: 3/1/13
Summary:  Employers must provide a notice to employees of availability of State Health Insurance Exchanges.

W-2 Reporting Requirements
Date: 1/1/13
Summary:  Large employers with more than 250 W-2 form employees must report the value of health insurance coverage provided to employees on each employee’s annual W-2 form.  For more information, please visit here.

Quality of Care Reporting
Date: TBD, The deadline for issuing regulations was March 23, 2012 but they have yet to be issued and compliance is delayed until such time.
Summary: Employer group health plans must provide a report annually, disclosing information of plan benefits and reimbursement structures that improve health outcomes.

Nondiscrimination Rule
Date: Compliance is delayed until regulations are issued, which is expected before 1/1/14.
Summary: Fully-insured employer plans may not discriminate in favor of highly compensated individuals. For more information, please visit IRS Notice 2011-1.

Source:CRS analysis of P.L. 111-148 and P.L. 111-152.

2014
Employer Shared Responsibility
Date: Effective date is 1/1/14, but employers have a measurement period of up to 13 months to determine whether variable hour seasonal workers are full time and up to 3 months to enroll newly hired full-time workers. They do not pay a penalty during this time period.
Summary: Employers with 50 or more full-time equivalent employees must offer a minimum level of affordable healthcare coverage or pay a penalty if at least one of their workers enters the exchange and receives a premium credit.  For more information, please visit here.

Wellness Incentives
Date: 1/1/14
Summary: Employer plans may increase permitted wellness incentives from 20% of the cost of employee-only coverage to 30%.  The Secretaries of HHS, Labor, and Treasury have the discretion to increase the reward up to 50% if the increase is determined to be appropriate.

Waiting Periods
Date: 1/1/14
Summary: Employer group health plans may not impose waiting periods longer than 90 days. For more information, please visit IRS Notice 2012-59.

Preexisting Condition Exclusions (Regardless of Age)*
Date: 1/1/14
Summary: Employer group health plans may not impose preexisting condition exclusions. For more information please visit Interim Final Rules: 75 Federal Register 37188.
* This provision applies to children under age 19 for plan years beginning on or after September 23, 2010.

Annual Dollar Limits**
Date: 1/1/14
Summary: Employer group health benefit plans may not impose annual dollar limits on essential health benefits. For more information, please visit Interim Final Rules: 75 Federal Register 37188.
**Prior to 2014, plans can either choose not to impose annual dollar limits on EHB, or they can impose restricted annual limits.

Automatic Enrollment
Date: Compliance is delayed until regulations are issued; expected by 1/1/14.
Summary: Large employers (employers with more than 200 full-time employees) must automatically enroll new employees in employers’ group health plan.