Employer Pay or Play Mandate Delayed One Year – Impact on Employers?


In a blog post yesterday, Mark Mazur, Assistant Secretary for Tax Policy at the U.S. Department of Treasury announced that the Obama administration will, in the next week, be issuing formal guidance delaying health care reform’s employer pay or play mandate and the related employer and insurer reporting obligations (reporting by all employers providing group health coverage and reporting by large employers regarding whether they offer full-time employees minimum essential coverage that is affordable and provides minimum value). The blog post says that this will allow the Obama administration time to simplify the reporting requirements and for employers to comply.

So what does this mean for employers?
We will not know for sure until the formal guidance is issued within the next week, but we expect that this delay will mean that:

Employers can wait to determine if they are subject to the pay or play mandate.
Employers can wait to start tracking employee hours for purposes of determining “full-time employees” under the pay or play mandate.
Premiums will not need to be set at “affordable” levels.
Coverage will not be required to be offered to “dependents.”
Employers will not need to make sure their coverage provides “minimum value.”
The Obama administration is strongly encouraging employers to voluntarily implement many of these changes during 2014.
We expect that employers will still need to, among other things, provide Notice of Public Exchanges by October 1, 2013; make sure their group health coverage complies with the various benefit requirements that have already taken effect (e.g., no cost preventive care, out of network emergency care, no lifetime limits on essential health benefits) and that will take effect in 2014 (e.g., no annual limits on essential health benefits, no pre-existing condition exclusions); report coverage costs on Form W-2; and provide the 4-page Summary of Benefits; and report and pay PCORI and Transitional Reinsurance Fees. We also expect that employers will still be able to take advantage of increased outcomes-based wellness rewards during this delay period.

We also expect that employers will still need to reduce their plan’s waiting periods to 90 days, which could drive up costs for employers with high employee turnover levels who previously implemented six to twelve month waiting periods. If the 90-day waiting period limitation will still apply, these employers may need to take steps before their 2014 plan year begins to reduce their exposure by adopting other legally-permitted eligibility requirements.