The draft regulations are set to appear in the Federal Register. Comments will be due 60 days after the official publication date.

In some cases, workers who have group health benefits may still try to apply for the premium assistance tax credit.

If the worker turns out to have access only to low-value group health benefits, the worker will qualify for the tax credit, and the employer may have to pay a penalty. If the worker turns out to have access to minimum-value health benefits, the employer will avoid having to pay the penalty.

IRC Section 36B(c)(2)(C)(ii) states that an employer plan that meets the minimum-value standard must cover at least 60 percent of the "total allowed costs."

PPACA also has created a standardized "essential health benefits" (EHB) package. The package is supposed to include the benefits that a normal good small-group health plan covers, along with some extras required by Congress, such as dental benefits and eye benefits for children.

The U.S. Department of Health and Human Services (HHS) has said that it will assume that "total allowed costs" means the cost of covering the standard EHB package for the type of people who would be in a typical self-insured employer health plan.

But, in theory, as long as a large employer's plan covers 60 percent of the value of the overall cost of the EHB package, the plan need not actually cover all of the kinds of care included in the EHB package to meet the minimum-value standard, the IRS said.

But what should the large employer's plan really cover?  The IRS has come up with three sample plan designs that large employers could use to meet the minimum-value standard:

• A plan with a $3,500 integrated medical and drug deductible, 80 percent plan cost-sharing, and a $6,000 maximum out-of-pocket limit for employee cost-sharing.
• A plan with a $4,500 integrated medical and drug deductible, 70 percent plan cost-sharing, a $6,400 maximum out-of-pocket limit, and a $500 employer contribution to a health savings account (HSA).
• A plan with a $3,500 medical deductible, $0 drug deductible, 60 percent plan medical expense cost-sharing, 75 percent plan drug cost-sharing, a $6,400 maximum out-of-pocket limit, and drug co-pays of $10/$20/$50 for the first, second and third prescription drug tiers, with 75 percent coinsurance for specialty drugs.

To qualify for safe-habor treatment, the plans would have to cover the services that the IRS and HHS have included in a minimum-value calculator that the IRS and HHS have posted on the Web, the IRS said. 

Low-value plans The IRS suggested what it sees as a possible problem: A large employer might offer a low-value health plan, then try to get out of paying PPACA "no minimum-value health plan" penalties by keeping employees from applying for the premium assistance tax credit.

If an employer did that, regulators "may treat such arrangements as impermissible interference with an employee's ability to access premium tax credits," the IRS said.

HRAs, HSAs and wellness programs IRS officials also consider other minimum-value quirks, such as how employers ought to handle HRA and HSA contributions in plan value calculations, and how employers ought to treat wellness program incentives that could either cut cost-sharing amounts (deductibles and co-payments) or help reduce employees' share of the health insurance premiums.

Some commenters have suggested that all employer HSA or HRA contributions for the current year should count as plan value when an employer is trying to calculate a health plan's value.

Other commenters agreed that HSA contributions should count toward plan value, but they said that HRA contributions should count only if the employees can use the HRA contributions to help cover the cost of co-payments, deductibles and coinsurance amounts.

In the draft regulations, the IRS has proposed that an employer can include all HSA contributions for the current plan year in minimum-value calculations.

"Amounts newly made available under an HRA that is integrated with an eligible employer-sponsored plan for the current plan year count for purposes of [minimum value] in the same manner if the amounts may be used only for cost-sharing and may not be used to pay insurance premiums," officials said.

At least for 2014, the IRS has proposed setting one minimum-value rule for wellness programs with incentives that lower cost-sharing amounts (co-payments and deductibles) and a second rule for wellness programs with incentives that lower the amount workers pay for group health insurance plan premiums.

If an anti-tobacco-use incentive lowers cost-sharing amounts, an employer can ignore the effect of the incentive program on workers who love their cigarettes or cigars too much to qualify for the incentive.

When adjusting for the value of other wellness program cost-sharing incentives, the employer must assume workers will fail to qualify and determine whether the coverage of the workers who fail still meets the minimum-value standard.

If any wellness incentive program, including an anti-tobaco program, cuts the worker's share of the health insurance premiums, then, in 2014, the employer can assume that all workers will qualify for the premium-reduction incentive when calculating the plan value, officials said.