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Healthcare Reform Recap: What Was and Was Not Delayed?

August 02 - Posted at 2:01 PM Tagged: , , , , , , , , ,

On July 2, 2013, the U.S. Treasury Department delayed enforcement of the employer “play or pay” mandate penalties and reporting requirements by one year to 2015. Removing the penalties for noncompliance and the requirement to report compliance or noncompliance essentially allows large employers one more year to prepare for implementation of the play or pay provisions.


There has been some confusion, however, on the healthcare reform changes taking effect in 2014 regarding what was and was not postponed. Still taking effect in 2014 are the State Exchanges (and the October 1, 2013 employer’s notice of Exchange requirement), the individual mandate to obtain minimum essential coverage, federal premium assistance, the 90-day limit on waiting periods, the termination of all pre-existing condition limitations for all participants, the removal of annual limits on essential health benefits and the optional increase in wellness program incentives from 20% to 30% (50% if tobacco related).


Please contact our office for more information on Health Care Reform and how it will impact your business.

According to a recent employer survey by the nonprofit National Business Group on Health and Fidelity Investments, corporate employers plan on spending an average of $521 per employee on wellness-based incentives in 2013.  This marks a 13% increase from the average of $460 per employee in 2011 and almost doubles the per employee average from 2009.


The survey also found that the overall use of these incentives among corporate employers continues to increase. 86% of employers surveyed indicated that they offered wellness-based incentives.


The most populate wellness-based incentives continue to be:


  • A decrease in premiums


  • Cash or gift cards


  • Employer sponsored contribution to an H.S.A. or similar health care savings vehicle



A large majority of employers (54%) have also expanded their wellness-based incentives to include dependents as well.  As part of the wellness incentives, employer are requiring employees to complete a health activity- like an employer sponsored biometric screening or health risk assessment- in order to determine their eligibility for the company’s health plans in 2013.  Some employers are even taking steps as far informing employees that their failure to complete a health risk assessment may result in the employee being moved automatically into a less attractive medical plan offered by the company or even completely being removing them from the health coverage.


Forty-one percent of employers include, or plan to include, an outcomes based metrics as part of their incentive program. This will give both the employer and employees a measurable goal that can be used to reward behavior or results in certain health categories, such as lowering cholesterol or blood pressure or their waist line.

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