Attorney: 'Devil is in the details' of PPACA

Much has been left up in the air around the Patient Protection and Affordable Care Act, with several mandates not yet fully realized because of delays in rules and the possibility of the Supreme Court ruling parts of the law as unconstitutional.

The uncertainty might lead employers to think it’s not vital to follow all the rules, especially if they add administrative burdens, but an expert says this is far from the truth.

“The devil is in the details, there are a lot of details around these requirements,” said Amy Bergner, partner and attorney at Mercer at the Society for Human Resources Legal & Legislative conference Tuesday. “Start now and try to get your arms around some of these concepts and get them in your mind how they relate to each other.”

She went over several possibilities: If the Supreme Court rules the individual mandate is constitutional, there will be no change for employers; if the mandate is unconstitutional, other parts of the law would still be upheld, so there would be less cost increase with employees mandated to get coverage; or the entire law is unconstitutional, but even then, some of the more popular benefits could remain because of employee demand.

“How would it be if you told your employees you weren’t covering dependents until 26 anymore? You would hear something about it,” she said, alluding that employers would on their own, keep the new age limit.

If the individual mandate is upheld, there is a chance that employees will move onto their employer plan, which might possibly drive up costs, a fear that employers had when the law was passed.

There has been some speculation that employers will pass their employees into exchanges, but Bergner said that comes at a great risk.

“Until there is a groundswell of employers dropping coverage, you don’t want to be the employer of non-choice,” she said. “Most of us have bought into the theory that having a healthy workforce means a productive workforce. If you lose control of seeing the results around your workforce health, you lose a lot of control.”

Though employers might not pass on full-time employees to exchanges, Bergner said it might be a good idea for employers who are still paying for retiree health care or for part-time employees.

“There may be parts of your population that you want to find another source of coverage for, the exchanges would be a good place for them to go.”

She also went over the newly released summary of benefit plan requirements and what they mean for employers. Though she noted that the original intent was to give more transparency to employees looking at different plans, the way it’s paned out hasn’t exactly done that.

“The requirement is being imposed on employers, but a lot of companies have already invested in engaging employees and make benefit plans clear if there are options. On top of what you’re doing is another layer,” she said. Now, employers are only required to give out the exact plan summary an employee has, and it has to be within 90 days of hire, meaning that it will not serve the purpose of showing different options. On top of it, employers will have to include every part of a plan, even if it’s from different carriers.

“It kind of defeats the purpose of helping them compare, but it was intended to help employers.” The deadline for providing the summaries to employees is September of this year. “I think there is a lot of angst about this, but at the end of the day, vendors are planning on doing this, particularly if you’re fully-insured.”

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Healthcare reform
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