ACA WATCH 2018

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DELIVERING COMPLIANCE CONFIDENCE IN AN ERA OF REPEAL AND REPLACE

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Annette Bechtold, SVP, Regulatory Affairs & Reform Initiatives

Annette describes how our dedicated team of compliance attorneys and experts are by your side during this era of repeal and replace to provide the guidance and support you need to protect your organization and your employees.

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Affordable Care Act (ACA) – Limits, Fees and Penalties Through 2019

The Affordable Care Act (ACA) contains a number of limits and penalties that apply to employers. These include the following provisions: Employer Shared Responsibility - (employer mandate) – requirement that applicable large employers (ALEs) offer affordable, minimum value coverage to substantially all full-time employees and their dependents.

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Affordable Care Act (ACA) – Limits, Fees and Penalties Through 2019

The Affordable Care Act (ACA) contains a number of limits and penalties that apply to employers. These include the following provisions:

 

Employer Shared Responsibility (Employer Mandate)

Requirement that applicable large employers (ALEs) offer affordable, minimum value coverage to substantially all full-time employees and their dependents.

  • Affordability - an offer is affordable if the employee’s contribution, toward the employee only rate, does not exceed a certain percentage of their compensation. Employers use one of the three allowable safe harbor compensation methods to determine affordability, e.g. W-2, rate of pay, or federal poverty line (FPL).
Plan Years 2019 2018 2017 2016 2015 2014
Affordability Safe Harbor Percentages 9.86% 9.56% 9.69% 9.66% 9.56% 9.50%
  • Penalties - for failure to comply with the Employer Shared Responsibility provision.
    • Tier 1- Failure to offer to substantially all full-time employees.
    • Tier 2- Failure to provide coverage that is affordable or meets minimum value (plan reimburses at least 60% of the cost of essential health benefits).
Employer Mandate Penalties – Calendar Year 2019 2018 2017 2016 2015 2014
Tier one: Failure to offer coverage or to offer to 95% of employees (70% for 2015) $2,500 $2,320 $2,260 $2,160 $2,080 $2,000
Tier two: Failure to offer coverage that is affordable and meets minimum value $3,750 $3,480 $3,390 $3,240 $3,120 $3,000

Market Rules

  • Flexible Spending Accounts - The maximum amount of annual pretax dollars employees may put aside through payroll deduction to pay for qualified medical expenses.
  • Health Savings Account (HSA) - An employee-owned bank account coupled with a qualified high deductible plan.

Listed below are the new limits, fees and penalties along with historical perspective.

Account Limits 2019 2018 2017 2016 2015 2014
Health Care Flexible Spending Account (FSA) $2,700 $2,650 $2,600 $2,550 $2,550 $2,500
Dependent Care Flexible Spending Account (FSA) $5,000 $5,000 $5,000 $5,000 $5,000 $5,000
Health Spending Accounts (HSA)
High Deductible Health Plan Annual Deductible Minimums Self-only: $1,350
Family: $2,700
Self-only: $1,350
Family: $2,700
Self-only: $1,300
Family: $2,600
Self-only: $1,300
Family: $2,600
Self-only: $1,300
Family: $2,600
Self-only: $1,250
Family: $2,500
Annual Out-of-Pocket Maximums Self-only: $6,750
Family: $13,500
Self-only: $6,650
Family: $13,300
Self-only: $6,550
Family: $13,100
Self-only: $6,550
Family: $13,100
Self-only: $6,450
Family: $12,900
Self-only: $6,350
Family: $12,700
Maximum Contribution Self-only: $3,500
Family: $7,000
Self-only: $3,450
Family: $6,850/ $6,900
Self-only: $3,400
Family: $6,750
Self-only: $3,350
Family: $6,750
Self-only: $3,350
Family: $6,650
Self-only: $3,330
Family: $6,550
Transportation Fringe Benefits
Parking $265/mo $260/mo $255/mo $255/mo $250/mo $250/mo
Mass transit $265/mo $260/mo $255/mo $255/mo $250/mo $130/mo
Fees – Paid by Health Plan – Per Covered Life 2019 2018 2017 2016 2015 2014
Transitional Reinsurance Fee n/a n/a $0 $27.00 $44.00 $63.00
Patient-Centered Outcomes Research (PCORI)
Plan years ending 1/1 - 9/30 $2.45 $2.39 $2.26 $2.17 $2.08 $2.00
Plan years ending 10/1 - 12/31 n/a $2.45 $2.39 $2.26 $2.17 $2.08

To stay up to date on the latest compliance news, updates and changes in regulation, visit the ACA Watch page or contact your OneDigital Consultant.

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