Q. What is your area of expertise?
When I started with Warner 24 years ago, I focused on litigation for the first nine years, but also counseled clients on privacy law. When HIPAA privacy rules came out, I advised clients in HIPAA compliance. Because so many of our HIPAA clients were employers with self-insured health plans, my practice evolved into what it is today, a mix of privacy law and employee benefits work with a focus on health and welfare issues.
Q. What continues to be a hot topic for employers?
The Affordable Care Act (ACA) remains a hot topic for employers. Privacy law is another hot topic, especially concerning privacy contracting and security breaches.
Q. What is the Affordable Care Act (ACA)?
The ACA was designed to reform the health insurance industry to ensure that the majority of the U.S. population is covered by a health plan. Before the ACA, those without an employer-sponsored plan, and not eligible for Medicare, had issues obtaining medical insurance, but hospitals still had to treat them, generally at the expense of other insured individuals. The ACA changed underwriting rules to guarantee individuals’ access to health insurance. The ACA also provides subsidies for many individuals who purchase insurance on the individual market.
Q. How has the ACA affected employers?
Initially, the focus was on covering children through age 26, phasing out pre-existing condition exclusions and annual and lifetime limits and implementing preventative care cove-rage, etc. But more recently, the focus has shifted to the ACA’s Employer Responsibility rules. For employers with 50 or more full-time equivalent employees, this meant avoiding penalties by offering minimum value coverage to workers averaging 30 or more hours per week. This year, employers must comply with new reporting requirements.
Q. How do you help employers navigate the ACA?
The ACA is full of complicated rules, requirements and deadlines. I help employers understand how to comply with these rules, meet deadlines and avoid severe penalties.
Q. What do employers need to do in 2016 to remain compliant with the ACA?
For 2016, the major issue is the new reporting requirements and potential Employer Responsibility penalties. By the time this is published, employers should have filed their 1094-C reports with the IRS. But I’m hearing from a lot of companies about files that have been rejected, so many employers will need to address the rejections. Also, the IRS may start assessing penalties by the end of 2016 or early 2017, and there could be errors that employers will want to challenge.
Q. What is your best advice for employers concerning the ACA?
An employer offers a health plan to its employees because it helps the employer attract and retain a talented workforce. So even though the ACA has added complexity, the need to attract and retain employees (at a reasonable price) should continue to be the main driver in decisions an employer makes about its health plans.