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Healthcare Reform

Dear Partners


Below is useful information for the Marketplace (Exchange) DOL Model Notices.


Beginning October 1, 2013, the Affordable Care Act (ACA) requires employers subject to the Fair Labor Standards Act (FLSA) to provide a notice to current and new employees regarding health plan coverage options available through State/Federal Insurance Marketplaces, aka Exchanges. If you haven't already, you will want to share this with your employer groups.


Added Delays for Health Insurance Mandate

Provided by Nelson Financial Group

Monday, February 24, 2014


Nelson Financial Group is dedicated to providing our clients with answers. It is our job to inform you and help you understand the Affordable Care Act. When new clarification is given on health care reform, we relay that to our clients. Recently, final regulations were handed down by the Treasury Department.


Final Guidance Brings Another Delay


On February 10th 2014, the Treasury Department issued final regulations on the Employer Mandate. This finalization involves one of the biggest questions surrounding the Affordable Care Act: How is the Employer Mandate going to play out in practice?


Briefly stated, the Employer Mandate applies to employers with 50 or more full-time employees. This installment of healthcare reform requires employers to offer “affordable” healthcare coverage that meets the “minimum value” standard. Refusal of this mandate consequently results in monetary penalty to the employer. Initially, the Mandate was supposed to take effect this year, but it was delayed until 2015.


The new provisions now state that employers with 50 to 99 full-time employees will not face the penalty for not offering coverage to the full-time employees and dependents until the plan year beginning on or after January 1st, 2016. The finalization on the “Pay or Play” section of the Affordable Care Act notes that these medium sized employers will need to certify that they are not reducing the size of their workforce to stay under 100 employees.


This unexpected grace period for businesses between 50 and 99 employees was accompanied by clarity on how to calculate full-time employees. Until this news, the government had not defined exactly which workers should be considered full-time. For a more detailed reference on how to calculate full-time employees, please click here. Moreover, employers with 100 or more full-time employees (and their dependents) will not face penalties if they offer coverage to at least 70% of their full time employees in 2015. Ultimately these employers will be required to offer coverage to at least 95 % of their full-time employees beginning in 2016.


For any additional information or questions, please email NFG at email@nelsonfg.com.


Thank you,


Nelson Financial Group




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