Overview of an Employer’s Challenges, Responsibilities, and Choices
Many employers have questions about how Health Care Reform will impact their plans over time and anticipate needing to make some decisions regarding their benefit plan designs, contribution strategies, and how to coordinate with the state Exchanges. There are a lot of factors that impact those decisions, including the challenging economy, rising health care costs, and all of the new Health Care Reform requirements that impact both employers and individuals. Some employers have questions about the various challenges they're now expected to manage. The bottom line is: What do you do with your health plan now? The good news is that you still have choices.
Click on any of the following to learn more about an employer's challenges, responsibilities, and choices resulting from Health Care Reform.
- Employer Challenges
The enactment of Health Care Reform created (or added) a number of challenges for employers:
- Plan compliance and keeping up with changes in rules
Employers have to learn about the new requirements, figure out how to comply, and monitor the changing rules. Click here for our Health Care Reform summary. - Administrative obligations
Employers must comply with burdensome new notice, reporting, and enrollment requirements. Click here to learn more about the new requirements. - High health care costs
Employers are concerned about managing health plan expenses in light of new mandates that are likely to increase costs, which add to ongoing cost pressures resulting from high health care inflation and a challenging economy. Click here for some cost management strategies. - Employer responsibilities and health plan choices
The complexity of Health Care Reform creates challenges for employers that are trying to understand their new responsibilities to provide health plan coverage, as well as their plan options. See below for more information, or click here to schedule a one-on-one meeting with an American Fidelity Health Care Reform specialist. - Employee communication
Organizational cultures that do not support flexibility or embrace change may be particularly challenged to explain (and justify) all of the plan changes caused by Health Care Reform. Click here to learn how American Fidelity can help with employee communication. - Limited Resources to deal with Health Care Reform
Few employers had budgeted the staffing resources necessary to address the multitude of issues and questions raised by Health Care Reform. American Fidelity is pleased to assist – click here to learn more about the services we offer.
- Plan compliance and keeping up with changes in rules
- Employer Responsibilities
Many factors may influence an employer's decisions regarding what type of group health plan to sponsor, whether to continue sponsoring a plan after 2014, how the plan design might change over time, what their employees will want and need in the coming years, and how to balance all of that with the challenging economy and ever-escalating health care costs. The following are some of those factors that employers may want to consider:
- Which of the Health Care Reform rules may increase the organization's costs or administrative responsibilities? Does the organization have the resources to manage those challenges?
- Is the organization able to make significant changes with relative ease? (Perhaps not if benefits are collectively bargained for example.)
- How would employees be impacted under each of the health plan choices being considered by the organization? For example, will they understand any changes that will be made, will they be eligible for federal premium assistance, will they be offered coverage that satisfies the individual mandate?
These are only a few of many factors you may want to take into consideration. It's important to understand how each of the new Health Care Reform provisions impacts the organization and the options for sponsoring a health plan going forward. We would be happy to explore these responsibilities with you - click here to learn about American Fidelity's Health Care Reform consulting services.
- Employer Choices - What do you do with your health plan now?
Generally speaking, there are four options for providing health coverage (or not) once all of the Health Care Reform provisions take effect:
- Maintain your current plan without significant changes
- Transition to a lower cost design, like a high deductible health plan
- Sponsor an Exchange plan
- Do not sponsor a plan – employees would be able to buy individual Exchange coverage
As one of your first steps to considering these choices, you may want to assess how your health plan costs are likely to be affected over the next several years by health care inflation and the various requirements of Health Care Reform, such as the Free Rider Penalty, and Cadillac Tax. Our Health Care Reform Calculators help you estimate the impact of all of these, or contact us to schedule a one-on-one appointment – we'd be happy to assist!
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Additional Resources
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Decision Making Assistance
You're not alone with Health Care Reform – American Fidelity is happy to be your guide -
Health Care Reform Calculators
To estimate the cost impact of Health Care Reform
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Free Rider Penalty Flowchart
To help determine whether an employer may owe a Free Rider Penalty
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American Fidelity Assurance Company does not provide tax or legal advice.
