Smart Technology Lessens Burdens of ACA Compliance
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1 Smart Technology Lessens Burdens of ACA Compliance Employers that haven t updated their information technology systems may find compliance with requirements of the Affordable Care Act especially difficult. by Paul Horalek 32 benefits magazine may 2014
2 E very company has a different structure for its benefits. Some structures are simple; some are complex. Some companies are able to adapt quickly to change while others must manage collectively bargained benefits and historical precedent. Balancing these structures while trying to control costs is a full-time job one made significantly more difficult by the ongoing implementation of Affordable Care Act (ACA) regulations. This article covers the role of technology in dealing with several of ACA s biggest compliance challenges not necessarily its most complicated rules, but regulations that may present significant hurdles for employers. It also examines overarching themes on the ways technology can be an ally in ongoing compliance. While solutions for individual companies often are complex, the principle behind them is not: Smart, flexible technology can help minimize human error, increase efficiency and reduce liability. Variable Hour Tracking One of the biggest burdens for human resource (HR) professionals at large companies has been the rollout of variable hour tracking requirements, the basis for putting employees in full-time or part-time categories for determining benefit eligibility. Generally, variable hour employees are those part-time employees with inconsistent schedules who average paid time of 30 or more hours per week, including holidays, vacation, sick time and other standard categories. While these requirements will not take effect until 2015, employers should have begun counting hours in Employers can use one of two options for determining part-time employee status: 1. Classify those who they are confident will meet the 30-hours-per-week threshold as eligible variable hour employees, understanding that there may be penalties if others who are not classified as eligible do not receive the required benefits. 2. When the situation is less clear for example, part-time employees who work varying schedules using a safe harbor calculation can determine whether an employee is eligible variable hour or ineligible variable hour. This means may 2014 benefits magazine 33
3 takeaways >> ACA will require large employers to track the hours of variable hour employees to determine their benefit eligibility. Doing so manually, especially when employees are in multiple locations, is difficult. Employers need to be able to track the distribution of SBCs and notices of health insurance exchanges. Software can help create benefits packets and ensure materials are delivered appropriately during the process of onboarding new employees. On January 1, 2016, employers will begin having to report whether individuals have been offered plans meeting minimum value and affordability standards. Technology should be flexible so that it can keep up with constantly shifting implementation and reporting dates and requirements. creating a measurement period (between three and 12 months) and taking the average of hours worked during the period. The length of the period must be consistent for all employees in the same category. Tracking should have begun in 2013 so that employers have a 12-month standard measurement period going forward. One of the difficulties this change poses for larger employers is the need for benefits software to track employees across multiple locations in order to correctly assign their status. It can also be a challenge for unionized employers, such as school systems, where employees may have multiple jobs across different departments that must be tracked together. In both situations, a lack of full HR systems integration can quickly become a significant barrier to compliance. Companies often struggle to create solutions for this problem, and often a manual stopgap is put in place. However, with the right approach, compliance can be achieved largely with technology. By ensuring, from an information technology (IT) governance perspective, that HR systems are coordinated and data is integrated, employers can more easily track employees that may split time between multiple locations or departments. Once the framework is in place, tracking systems can be created to flag employees in these categories who are above or below thresholds for eligibility. Managing this information without automated systems will be daunting for both large employers, based on the sheer volume of data to track manually, and smaller employers, which may not have the HR manpower to sort through the numbers. Summaries of Benefits Coverage New requirements make communicating options for benefits coverage to employees more stringent and, in some ways, technologically backward. In some cases, employers are required to send hard copies of basic information for example, a summary of benefits coverage (SBC) to employees. The SBC includes new content, must be trackable and must clearly explain the difference between plan choices. Failure to comply can result in fines for insurers, as well as plan administrators, of up to $1,000 per offense. In addition, failure to comply may potentially trigger an excise tax of $100 per day with respect to each individual to whom such failure relates. As of January 1, 2014, this notice must include a statement concerning whether the plan provides minimum essential coverage and whether the plan s share of total allowed cost of benefits provided meets the 60% minimum. Two key areas where technology can lessen the compliance burden on this front are the tracking of SBC delivery and the identification of new SBCs that need to be sent during new employee onboarding. It is critical for employers to know that each employee is receiving the proper benefits information. Technology can be used to automate the creation of benefits packets, making a significant impact on the time spent building, customizing and proofreading this content particularly when there are a multitude of different plans and employee groups involved. Once the content is finalized, software can help fill the gaps in terms of tracking distribution. When planned correctly, it is easy to set up benefits management programs to automatically include or remind HR team members to include and update specific information as well as keep digital records of dates when materials were sent by HR and received by employees. It is also important to ensure that all new hires are brought quickly into the loop as the new requirements apply well beyond the work of open enrollment. These steps are easy to miss as part of onboarding, so building in software processes to ensure SBCs are completed and delivered every time will help protect employers from fines and penalties. On a similar note, effective October 34 benefits magazine may 2014
4 1, 2013, employers must have a mechanism to identify and distribute a health insurance exchange notice to new hires. Notice must be given to all employees, regardless of benefit eligibility or enrollment status. This includes all employers subject to the Fair Labor Standards Act. Again, ensuring that benefits technology can manage and track distribution of this information is a significant benefit in terms of both time and reporting requirements. Plan Reporting Requirements Large companies (those with more than 50 employees) must start preparing for the January 1, 2015 date when they ll need to begin tracking whether individuals have been offered plans meeting minimum value and affordability standards. This information, part of Internal Revenue Codes 6055 and 6056, also involves a variety of documentation and communication for each employee, which must be tracked and verified. On January 1, 2016, employers will begin having to report this information (6056). Companies with more than 250 employees will need to file this information with the Internal Revenue Service electronically. The required information includes a month-by-month certification that the employer offered full-time employees and their dependents the minimum essential coverage as well as specific data for each employee, such as his or her share of the monthly premium. Similar to the SBC requirements, managing all of the information and ensuring accuracy is a big job, and one that should involve creating software-driven processes to manage the deadlines, distribution and reporting. Companies have been encouraged to use 2014 as a trial period to ensure that the puzzle pieces are in place to meet the official requirements. The ability to automate the tracking processes can turn this regulation into a company strength rather than a liability. Affected employers should already have started ramping up and testing their systems to ensure compliance and, while the If Your Computer System is the Weakest Link in Your Operation, Replace It. Over 250 Fund Administrators and TPAs count on ISSI s easy-to-use computer systems to securely manage their operations with maximum efficiency and reliability, providing stability for the Funds, Trustees, Participants, and Employers. Count On For more information, visit our website: or contact Steve Webb by phone: or by SWebb@ISSIsystems.com may 2014 benefits magazine 35
5 << bio learn more >> Education ACA University Virtual learning environment available to International Foundation members. Visit for more information. From the Bookstore 2014 Healthcare Reform Facts Alson R. Martin, J.D., LL.M. National Underwriter Visit for more details. The New Health Care Reform Law: What Employers Need to Know A Q&A Guide, Fourth Edition Paul M. Hamburger and James R. Napoli. Thompson Information Services Visit for more details. Paul Horalek is the chief information officer at Group Associates LLC in Bingham Farms, Michigan. He has more than 18 years of experience in technology consulting and leads the firm s technology teams to provide custom solutions for both clients and internal operations. He is a graduate of Oakland University and earned an M.B.A. degree in technology management from the University of Phoenix. solutions are not simple, they should make the processes for HR teams much more manageable as the deadline nears. Conclusion In each of these situations, companies can easily become overwhelmed by the sheer scope of the new regulations and the speed at which they are changing the processes of HR teams at employers of every size and shape. As never before, employers have tools available to take a new approach a smarter, more automated and more efficient path to ensure both compliance and sanity for benefits professionals. Tips and reasons for doing so include: Automate, automate, automate: For large organizations, automating as many of these new requirements as possible through technology is critical to ensure compliance. So many processes are involved, and the stakes are so high in terms of compliance, that automation is a virtual necessity to reduce errors and keep the workload manageable. Reduce liability: The clearer the compliance picture for an organization, the more smart technology can be used to take human error out of HR processes and the less likely a company will be at risk of lawsuits and audits of its benefits programs. As with any technology project, having welldefined requirements and scope will allow for the IT department to align resources to successfully solve the challenges presented. Start with smart IT governance: From a best practices perspective, companies should already be working to consolidate their benefits technology within one system, and ACA s complexity makes it even more imperative. While there are still large employers with multiple HR departments and multiple systems, ACA is a reason to move quickly toward working from a single database with a single technology resource. Where replacement of an existing system is not possible, an integration point should be established to create a single database. Ensure technology is flexible: Implementation of ACA s voluminous regulations may always be a moving target. Implementation dates, reporting deadlines and even the requirements themselves are constantly shifting. The more flexible an employer s technology can be, the more effectively it can meet these challenges. 36 benefits magazine may 2014
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