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Navigating the Pillars of the Affordable Care Act
49

Navigating the Pillars of the ACA - How ADP Can Help

Nov 02, 2014

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Summer Striggs

 
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Page 1: Navigating the Pillars of the ACA - How ADP Can Help

Navigating the Pillars ofthe Affordable Care Act

Page 2: Navigating the Pillars of the ACA - How ADP Can Help

2

50Employers with at least 50 full-time employees will be required to pay a penalty if they fail to offer minimum essential coverage & a full-time employee obtains subsidized coverage from an exchange

60Employers may be subject to a penalty if it decides to play because the coverage offered is either “unaffordable”

or the plan is not designed to pay at least 60% of participants’ covered medical expenses

90 Employers have only 90 days to offer eligible employees health care benefits

What Do These Numbers Represent?

Page 3: Navigating the Pillars of the ACA - How ADP Can Help

3

Three Things You Will Remember

! WHY IT’S IMPORTANT TO YOU

+ HOW ADP CAN HELP

? WHAT IS THE BUSINESS ISSUE?

Page 4: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE? ?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.4

eligibility risk

Schedule and manage hours of service to

minimize

WORKFORCE PLANNING

ACA liability

Page 5: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.5

HOW ADP CAN HELP+

Reports are provided for illustration purposes and are subject to change

Use the hours summary reports on a weekly and annual basis to determine whether schedule adjustments should be made for employees

Workforce Planning

Page 6: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.6

HOW ADP CAN HELP+

Seamless integration of Time & Attendance with Payroll and HR allows access to a list of ACA eligible employees for improved scheduling and ACA benefits cost control

Workforce Planning

Automated scheduling makes it easy to identify when employees are approaching the ACA benefits threshold and adjust the schedule

Page 7: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.7

WHY IT’S IMPORTANT!

Empowers you to be proactive in controlling benefit eligibility

Minimizes your ACA liability

Aids in aligning labor with demand to reduce costs without compromising customer satisfaction

Workforce Planning

Page 8: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

ELIGIBILITY

Accurately determine employee eligibility &

assessment

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.8

method(s)

PART-TIME

FULL-TIME

Page 9: Navigating the Pillars of the ACA - How ADP Can Help

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Ability to categorize workforce and establish measurement/look-back periods to meet your business requirement

Provides automation of measurement periods. This includes Standard, Administrative, & Stability periods for multiple Employee categories

HOW ADP CAN HELP+Eligibility Tools

Page 10: Navigating the Pillars of the ACA - How ADP Can Help

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Ability to pull total hours for each employee to use in the determination of full time equivalency qualification for ACA

Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations

HOW ADP CAN HELP+Eligibility Tools

Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations.

Page 11: Navigating the Pillars of the ACA - How ADP Can Help

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HOW ADP CAN HELP+Eligibility Tools

Eligibility Report provides an easy way to look at employee base as a whole and identify who has reached eligibility requirements

Page 12: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.12

WHY IT’S IMPORTANT!

Enables fair and consistent measurement/look-back periods for all employees

Minimize costs without compromising productivity and service

Helps you comply with government requirements & regulations

Eligibility

PART-TIME

FULL-TIME

Page 13: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

AFFORDABILITY

Select affordability assessment method; Employee premium

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.13

of Box 1 W-2 earnings not to exceed

W-2

%9.5

W-2

Page 14: Navigating the Pillars of the ACA - How ADP Can Help

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HOW ADP CAN HELP+Affordability Tools

Provide tools for the practitioner to conduct analysis of employees purchasing employee only coverage compared to 9 ½% of earnings

Page 15: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.15

HOW ADP CAN HELP+Affordability – Health Insurance

Costs for the W-2

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.

ADP gives the ability to determine which benefit plans should be included in the Group Health Insurance Costs calculation for the W-2

Page 16: Navigating the Pillars of the ACA - How ADP Can Help

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HOW ADP CAN HELP+Affordability Tools

Assist with identifying plans that are minimum essential coverage (60%+ of actuarial value)

Page 17: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.17

WHY IT’S IMPORTANT!

Mitigates risk related to cost of benefits and employee burden levels

Aids in evaluating affordability and minimizes potential penalties to employer

Reduces administration burden in determining wage levels

Affordability

W-2

%9.5

W-2

Page 18: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

ENROLLMENT

Manage end-to-end enrollment of eligibleemployees

“Play or Pay”

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.18

Page 19: Navigating the Pillars of the ACA - How ADP Can Help

Allows employees to opt out of medical plan with required reason to ensure employer has appropriate tracking and auditing tools

19

HOW ADP CAN HELP+Enrollment Tools

Page 20: Navigating the Pillars of the ACA - How ADP Can Help

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HOW ADP CAN HELP+Enrollment Tools

Provides tools to assist with the annual reconciliation of the penalty bill against benefits and W-2 data, enabling client to request W-2 corrections or initiate penalty appeals process

Page 21: Navigating the Pillars of the ACA - How ADP Can Help

Comprehensive report with employees’ plan enrollment details.

HOW ADP CAN HELP+Enrollment Tools

21

Comprehensive report with employee and dependent plan enrollments; including auditing data like age limit and overage dependent details

Page 22: Navigating the Pillars of the ACA - How ADP Can Help

Provides proactive report to show employee enrollment status ensuring Employers take action during their Administrative period.

22

HOW ADP CAN HELP+Enrollment Tools

Page 23: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.23

WHY IT’S IMPORTANT!

Empowers employees with ability to select appropriate plans for lifestyle

Communicates to employer why employee has opted out of benefits

Helps mitigate potential penalties to the employer

Enrollment

Page 24: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

AUDITING & REPORTING

Standard compliance reports for the

Affordable Care Act

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.24

REPORT

Page 25: Navigating the Pillars of the ACA - How ADP Can Help

HOW ADP CAN HELP+Standard Compliance Reports

25

Group Health Insurance Costs reporting is available to generate and review the costs associated with each employee by benefit plan

Page 26: Navigating the Pillars of the ACA - How ADP Can Help

HOW ADP CAN HELP+

Manage end-to-end enrollment of eligible employees with comprehensive enrollment details on employees & dependents

Play or Pay Preparation Report

26

Page 27: Navigating the Pillars of the ACA - How ADP Can Help

HOW ADP CAN HELP+

ADP provides Practitioners with self administered plans the means to calculate the research fee

Patient –Centered Outcomes Research Fee Report

27

Patient-Centered Outcomes Research Fee report provides the detailed information on fees owed by each benefit plan provider towards the Patient-Centered Outcomes Research

Page 28: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.28

WHY IT’S IMPORTANT!Auditing & Reporting

Aids ACA compliance efforts to government agencies

Improves accuracy and reduces risk of penalties

Reduces administrative burden of ACA auditing and reporting

REPORT

Page 29: Navigating the Pillars of the ACA - How ADP Can Help

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Of the Affordable Care Act

ADDITIONAL PROVISIONS

Page 30: Navigating the Pillars of the ACA - How ADP Can Help

Source: Mercer Select Health Care Reform Briefing, October 27, 2011

WHAT IS THE BUSINESS ISSUE?

DEPENDENT COVERAGE

Employers must expand coverage for qualifying dependent children

up to age 26

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.30

Page 31: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.31

Ability to configure ADP platform to apply age rules where applicable

Provide open and life event enrollment tools to allow dependent children up to age 26 access to health and welfare plans

Provide benefit plan setup template to track dependent age requirements

HOW ADP CAN HELP+Dependent Coverage

Page 32: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.32

Reduces costs associated with ineligible plan participants

Reduces premium overpayments

Helps ensure compliance with coverage regulations

WHY IT’S IMPORTANT!Dependent Coverage

Page 33: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

Insurers and self-insured group health plans must provide SBCs for annual enrollments beginning on or after

9/23/12+

BENEFITS

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.33

SUMMARY OF BENEFITS AND COVERAGE (SBC)

Page 34: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.34

ADP supports delivery of SBC electronically as well as obtaining acknowledgement from employees; client can also print hard copy

HOW ADP CAN HELP+Summary of Benefits and

Coverage (SBC)

Page 35: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.35

WHY IT’S IMPORTANT!

Aids compliance with SBC requirements

Reduces administrative burden of communicating SBCs to employees

Empowers employees with access to coverage-related information

+BENEFITS

Summary of Benefits and Coverage (SBC)

Page 36: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

FSA ANNUAL LIMIT

maximumAbility to determine the

amount an employee can contribute to FSA

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.36

Page 37: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.37

HOW ADP CAN HELP+

Provide one- stop shop for all ADP Healthcare spending accounts for 2013 open enrollment (FSA, HSA, HRA), including single debit card and mobile access

FSA Annual Limit

Page 38: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.38

WHY IT’S IMPORTANT!

Aids compliance with FSA requirements

Reduces administrative burden of communicating FSA limits to employees

Boosts employee engagement by improving communication

MAXIMUM

FSA Annual Limit

Page 39: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

Ability to be notified of new statutory

regulations

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.39

MEDICARE TAX ON WAGES AND UNEARNED INCOME

Page 40: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.40

HOW ADP CAN HELP+Medicare Tax on Wages and

Unearned Income

ADP allows practitioners to generate a report in order to conduct analysis of payroll & deductions for high-income employees who may meet criteria for the new taxes

Calculates the new Medicare tax for appropriate employees

Page 41: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.41

WHY IT’S IMPORTANT!

Increases employee satisfaction with highly compensated/executive associates on planning their taxes

Improves accuracy and reduces risk of penalties

Medicare Tax on Wages and Unearned Income

Page 42: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

Ability to

load notice describing availability of marketplace/exchange coverage

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.42

EMPLOYEE NOTICE OF MARKETPLACE/EXCHANGE

Page 43: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.43

ADP supports delivery of Notice of Marketplace/Exchange electronically as well as obtaining acknowledgement from employee; client can also print hard copy

HOW ADP CAN HELP+Employee Notice of Marketplace/

Exchange

Page 44: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.44

WHY IT’S IMPORTANT!

Aids compliance with marketplace/exchange notice requirements

Reduces administrative burden of communicating marketplace/exchange option to employees

Employee Notice of Marketplace/ Exchange

Page 45: Navigating the Pillars of the ACA - How ADP Can Help

WHAT IS THE BUSINESS ISSUE?

WAITING PERIODS

Ability to define when an employee is eligible to enroll in employer group health plans

Date of Hire

First of the Month

following Hire DateX number of Days following Date of Hire

?

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.45

Page 46: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.46

Provide new hire reports (up to 90 days) to validate employment status & change triggers to ensure appropriate benefits enrollment

HOW ADP CAN HELP+Waiting Periods

Page 47: Navigating the Pillars of the ACA - How ADP Can Help

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.47

WHY IT’S IMPORTANT!

Helps mitigate excessive costs based on employment status

Aids compliance with FLSA rules

Date of Hire

First of the Month following Hire Date

X number of Days following Date of Hire

Waiting Periods

Page 48: Navigating the Pillars of the ACA - How ADP Can Help

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ADPTime and Labor Management

ADPReporting and Reconciliation

ADPPayroll

ADPBenefits

• Report on Hours of Service including Projected Scheduled Hours

• View & Adjust Work Schedules

• Ability to Set Threshold Notification for Total Hours of Service (January 2014)

• Full – Time Status Reporting

• Auto-enrollment Required in 2015

• Enrollment of Eligible Employees

• Coverage Termination

• W-2 Affordability Calculation

• Data to/from Exchanges

• Reporting to Federal Government

• Reconcile Penalties Levied for Exchange Participation

• Deductions and Other Earnings

• W-2 Earnings

• System of Record for Hours of Service

• Look Back Approach

Workforce Planning

Eligibility &

Enrollment

Reporting/Penalties

Affordability

EMPLOYERS Need an Integrated Approach to Manage the ACA

Page 49: Navigating the Pillars of the ACA - How ADP Can Help

Why ADP . . .

Our goal is to minimize your administrative burden across the entire spectrum of payroll, tax, HR and benefits, so that you can focus on running your business.

#ADPHCM "We're proud of our payroll heritage" but #ADP is much more than payroll today -- global HCM leader in the cloud.NAOMI BLOOM, HCM INDUSTRY ANALYST IN FULL BLOOM

With RSM McGladrey and ADP managing our most sensitive business information, I come away each day with a sense of confidence and internal control becauseI am managing the business, not the tasks.MIKE NICHOLAS, CHIEF FINANCIAL OFFICERRSM MCGLADREY

“Committed to assisting businesses with increased compliance requirements resulting from rapidly evolving legislation.

© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.

Marketplace Buzz

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