We’ve updated the Health Policy section of our website with information recently released about the Patient Protection and Affordable Care Act.
You can find a link to the Department of Labor‘s guidance on the requirement to provide a 4-page summary of benefits. The link includes details about the requirement and a link to sample templates. You’ll find it near the bottom of the PPACA page under the heading “Additional Tools for Employers”, “Info from the U.S. Department of Labor”.
EEOC Clarifies Stance on Using Medical History in Wellness Programs
The Equal Employment Opportunity Commission (EEOC) recently released a guidance letter that clarifies the use of genetic information in wellness programs.
The EEOC says that employers and other entities covered by the Genetic Information Nondiscrimination Act (GINA):
“may use the genetic information voluntarily provided by an individual to guide that individual into an appropriate disease management program.”
Related to incentives:
“If that program offers financial incentives for participation and/or for achieving certain health outcomes, the program must also be open to employees with current health conditions and/or to individuals whose lifestyle choices put them at increased risk of developing a condition.”
This means employers may collect genetic information, such as family medical history, and use it to help employees improve their health, but it must be done on a voluntary basis. Employers must obtain written authorization from a plan participant before requesting the individual’s genetic information.
We’ve also added this to our website’s PPACA page under “Additional Tools for Employers” for future reference. As guidance is released on this and other requirements, look for it in the Health Policy section.
IRS Requests Comments on “Pay or Play” Implementation
The IRS is considering a safe harbor for employers that would allow companies to use employees’ W-2 wages instead of household income to determine affordability of coverage.
Employer penalties are triggered under the Patient Protection and Affordable Care Act (PPACA) if an employee accesses exchange credits because their employer sponsored coverage exceeds 9.5 percent of his or her household income. Household income can include a spouse’s, dependent’s income and other variables unknown to the employer.
Under the potential safe harbor, employers could avoid penalty by ensuring employees’ contributions for self-only health coverage do not exceed 9.5 percent of any employee’s W-2 income, even if employees become eligible for exchange subsidies or cost sharing reductions. However, whether an employer could escape the penalty would be determined on a case-by-case basis at the end of the year.