Concurrent Session Knowledge How you can Prepare for the Affordable Care Act. Andrew Braswell, Research Analyst, Staffing Industry Analysts

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1 TUES, OCT 7 4:15 PM JAMAICA Concurrent Session Knowledge How you can Prepare for the Affordable Care Act Andrew Braswell, Research Analyst, Staffing Industry Analysts

2 DIGITAL SURVEYS How you can Prepare for the Affordable Care Act Don t forget to rate this session as you exit.

3 How You Can Prepare for the Affordable Care Act Agenda Legislative Background Employer Mandate Basics - Applicable Large Employer (ALE) Determination - Variable hour employees and the Look Back Penalties Coverage Options - Major Medical - Skinny Plans - MVP Plans

4 How You Can Prepare for the Affordable Care Act Agenda, cont d. IRS Reporting Requirements Compliance Cost Projections Survey Results Who is the Common Law Employer? What to do Next Q&A

5 ACA Legislative Background March 2010 ACA signed into law December 2012 Proposed regs on employer mandate issued July yr delay of EM, to 1/1/15 February 2014 Final regs issued - Transition relief delays EM one more year for companies with FTs, lowers bar for compliance for firms with 100+ FTs

6 Employer Shared Responsibility Provision AKA employer mandate, play or pay Applicable Large Employer - 50 or more FT + FTE - Must offer FT employees health coverage meeting certain standards, or face an assessable payment, i.e., penalty Common law employer has obligation of EM

7 Applicable Large Employer Status FT: 30hrs per wk or 130hrs per month FTE: Total PT hours per month / 120 Add FT + FTE for each month Total the monthly values and divide by 12 If monthly average is 50 or above, firm is an ALE for following calendar year ALE determination is on a controlled group basis

8 The Variable Hour Determination At time of hire, is employee reasonably expected to work an average of 30 or more hours per week? Consider whether employees in the same position with the temporary staffing firm typically: - have the right to reject assignments - have periods during which no offer of placement is made - are offered placements for varying periods of time - are offered placements that do not extend beyond 13 weeks

9 Applying the Look Back Method Measurement period of 3 12 months Administrative period of up to 90 days Stability period no shorter than measurement period Treated as new hire following break in service of: - At least 13 weeks or - At least four weeks and longer than preceding period of employment

10 Applying the Look Back Method January 1, 2015 Ongoing New Hire Look Back Full Time Part Time Variable Hour or Seasonal Standard Measurement Period (3 12 months) 90 Days to Enroll No Requirement to Offer Initial Measurement Period (3 12 months) Admin Period (up to 90 days) Admin Period (up to 90 days) Stability Period (min. 6 months) Stability Period (3 12 months)

11 The Penalties in Summary 1) The "No Coverage" Penalty IRS Code 4980H(a) Trigger Annual Assessment Employer fails to offer "minimum essential coverage" to at least 95% [70% for 2015] of its FT employees and their dependents $2,000 x (Total number of company s FT employees minus 30 [80 for 2015]) 2) The "Insufficient Coverage" Penalty IRS Code 4980H(b) Trigger Employer offers coverage that is either not "affordable" or does not provide "minimum value" Annual Assessment $3,000 x (Total number of FT employees that receive subsidized coverage through an exchange)

12 The Penalties Important Details Those within 400% of FPL may qualify for subsidy - $46,680 for an individual - $95,400 for a family of four Assessed on monthly basis, collected annually Not tax deductible Mutually exclusive, with maximum exposure determined under the calculation for the no coverage penalty

13 Workers Exempt from Offer Requirement Part time (<30 hours per week) Short term (<90 days) Seasonal employees - Customary annual employment 6 months or less - Should begin approximately same time each year

14 Offering Major Medical Coverage Coverage must be adequate and affordable - Adequate: plan covers at least 60% of total allowed costs - Affordable: premium for single coverage <9.5% of household income Satisfies both (a) and (b) penalties Likely option of choice for professional staffing firms Must offer coverage to 95% of FT employees and dependents Monthly premium $350 $700+

15 Offering a Skinny Plan AKA MEC, Non MV Limited coverage including preventive care Appear to satisfy MEC - Avoids no coverage (a) penalty Clearly do not provide MV - Remain exposed to insufficient coverage (b) penalty Must be self funded program Monthly cost $60 $100 per employee for ASO Regulators may already be clamping down

16 A New Option: The MVP Plan Meets MV standard of at least 60% cost coverage - Eliminates both (a) and (b) penalties Excludes inpatient hospitalization, surgical Lower participation requirements than major medical Monthly premiums in the range of $200

17 Staffing Supplier Compliance Plans Source: SIA 2014 Staffing Company Survey Preliminary Results

18 IRS Reporting Requirements Beginning with the 2015 year, ALEs must report annually to the IRS on form 1095 C: - Employer name, address and Employer Identification Number (EIN) - The number of FT employees for each month - A certification, by month, as to whether the employer offered MEC to its FT employees and their eligible dependents - For each FT employee, the months for which MEC was offered and the self only policy premium for the lowest cost plan offered that provides MV - The name, address and Social Security number of each FT employee - The months (if any) that each employee was covered under the employer s plan

19 Breaking Down the Cost of Compliance Administrative overhead - Strategic planning - Tracking, reporting, issuing notices - Will be felt most acutely by smaller ALEs Provision of insurance - Higher premiums for ACA compliant plans - Increased take rate due to awareness, individual mandate - Higher employer premium contribution due to affordability rules

20 Staffing Buyers Anticipated Bill Rate Increase 36% 20% 11% 7% 7% 2% 3% 5% 2% 2% 2% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 2% $0.00 $0.20 $0.40 $0.60 $0.80 $1.00 $1.20 $1.40 $1.60 $1.80 $2.00 $2.20 $2.40 $2.60 $2.80 $3.00 $3.20 $3.40 $3.60 $3.80 $4.00 >$4.00 Source: SIA 2014 Contingent Buyers Survey

21 Buyer Views on Cost Question Evolving Buyers expecting to pay no share of ACA costs 1 : % 36% Of the 36% expecting no bill rate increase 1 : - 94% reported that their primary skill purchased was highly compensated professional Median expected bill rate increase: - Buyers: $1.00/hr 1 - Suppliers: $1.50/hr 2 1 Source: SIA 2014 Contingent Buyers Survey 2 Source: SIA 2014 Staffing Company Survey Preliminary Results

22 Who is the Common Law Employer? Multifactor test conceived to distinguish ICs from employees Can yield inconclusive result when applied to thirdparty employment situations Decades of IRS practice and case precedent consistent with interpretation that staffing supplier is common law employer

23 Final Regs Section IX Offers of Coverage an offer of coverage to an employee performing services for an employer that is a client of a [PEO] or other staffing firm (in the typical case in which the [PEO] or staffing firm is not the common law employer of the individual) made by the staffing firm on behalf of the client employer under a plan established or maintained by the staffing firm, is treated as an offer of coverage made on behalf of a client employer only if the fee the client employer would pay to the staffing firm for an employee enrolled in health coverage under the plan is higher than the fee the client employer would pay to the staffing firm for the same employee if the employee did not enroll in health coverage under the plan.

24 Proposed Safeguard for CLE Ambiguity Low probability, high impact event Spell out in agreements that staffing supplier has specific elements of right to control Also specify in agreement that rate reflects cost of providing health coverage to worker Particularly relevant to engagements of 1 year or longer

25 What Should You Do Next? Survey your contingent workforce suppliers - How do they plan to comply with the employer mandate? - What is their anticipated bill rate increase? Examine your contract language - Right to control employee by staffing supplier - Specifies higher fee that reflects provision of coverage Reassess your contingent workforce program - Avoid use of staffing suppliers in effort to evade EM - Higher stakes for IC misclassification

26 Any Questions?

27 DIGITAL SURVEYS How you can Prepare for the Affordable Care Act Don t forget to rate this session as you exit.

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