Following the failure to bring the American Health Care Act to a vote in the House of Representatives, many employers are asking, “What now?” Tom Price, the new Secretary of Health and Human Services (HHS), indicated that, after Congress’ inability to reach an agreement on the American Health Care Act, HHS would enforce the current law under the Affordable Care Act (ACA). So the “what now?” is … business as usual.

Despite this directive, we have found there are ACA requirements of which some employers are not fully aware. We have highlighted a number of provisions to help brokers remind employers of their obligations under the current law.

Grandfathered plans

Employers who maintain a grandfathered plan should review whether or not they have maintained their status. Grandfathered plans are excused from some, but not all, of the ACA mandates. If a disqualifying act occurs, even inadvertently, the plan loses its status as of the date of the act.

Questions employers should ask include:

• Have we provided the annual notice to our employees regarding grandfathered status?

• Have we decreased our rate of contributions toward the premium or premium-equivalent?

• Have we made changes to the plan beyond what is allowed?

• Has there been a corporate transaction that may have caused the grandfathered plan to lose its status?

Reimbursement of health premiums

A common employer practice prior to 2013 was to reimburse the premiums for health insurance policies purchased by active employees who, for whatever reason, did not participate in the employer’s plan. In 2013, the IRS indicated that such practice was not in conformance with the market reform provisions of the ACA. Employers who continued this practice would be subject to a daily fine. The one exception under the ACA is if the employer only had one active employee receive such reimbursement in a given year.