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Blog By: Beth Ede, SPHR

With the national election behind us and President Obama sworn in for his second term in office, health care pushes on. 


One provision of the health care reform legislation requires that effective January 1, 2014; most employers with 50 or more full-time employees (full-time and full-time equivalent employees) offer full-time employees (and their dependents) “affordable” health care coverage with a “minimum value”, or face possible penalties.  This is called the Employer Shared Responsibility provision; often referred to as “Play or Pay”.


Upon return to work from the New Year’s Holiday, we were greeted with the proposed rule on this provision.  While at best the guidance is complex, we must all be committed to reading and understanding it to maximize our compliance efforts.


The proposed rule (found HERE) contains several caveats that need to be understood and put into practice.  For example, the formula for determining whether an organization has “50 or more full-time employees” isn’t as straight-forward as it sounds.  For this mandate, a full-time employee is defined as one who works on average at least 30 hours per week or 130 hours per month.  Add to that number a special formula for determining full-time equivalent employees, rounding rules, seasonal worker exceptions, etc. and what do you get – confusion and complexity that must be sorted out and applied specific to each of your organizations.


The proposed rule does offer numerous safe harbors that organizations can use to maintain compliance and potentially reduce or eliminate the penalties associated with this mandate.   Gaining understanding of the mandate provisions is your first line of defense. 

At WA, we are committed to providing you the best guidance possible as we work through these uncharted waters.


Posted 11:29 AM  View Comments

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