Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity
-
Upload
healthdecisions -
Category
Business
-
view
188 -
download
0
description
Transcript of Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity
![Page 1: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/1.jpg)
Presenter:
Si Nahra, Ph.D., PresidentMay 29, 2014
ACA Communications Requirements:An Employee Relations Opportunity
![Page 2: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/2.jpg)
Copyright Health Decisions, Inc. 05/2014
2
About Health Decisions, Inc.
Pioneering Specialists inPioneering Specialists in
Group Health CareGroup Health Care
Post-Payment AdministrationPost-Payment Administration
For Over 25 YearsFor Over 25 Years
RespectRespect for Existing Procedures for Existing Procedures
EmphasisEmphasis on Customization on Customization
FocusFocus on Solutions on Solutions
Customer Philosophy
![Page 3: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/3.jpg)
2014 ACA Series
Copyright Health Decisions, Inc. 05/2014
3
Non-grandfathered, calendar year plans.
Comply not just because you have to.Comply in a way that helps your plan.
FOCUS
![Page 4: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/4.jpg)
Quick ReviewWhat you should have done.
• Reporting to employees– W-2 plan values– Summary of Benefits and Coverage (SBC)– Exchange Notices
• Benefits– Selected Essential Health Benefits– No cost sharing for federal preventive care benefits– No pre-existing conditions– No lifetime maximums– Dependents covered until 26– Clinical trial coverage
• Safe Harbors– Minimum Value Safe Harbor – Affordability Safe Harbor
• New Out-of-Pocket rules implemented
Copyright Health Decisions, Inc. 5/2014
4
ACA Compliance Checklist
Sessions available now.
Call 734-451-2230Ask for Leslie.
![Page 5: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/5.jpg)
Employee Communications
• Required: Scheduled or Event Driven– ACA– DOL– IRS
• Opportunities – ACA Q&A to and from employees– Spouse/Dependent confirmation– Public Exchange Navigation– COBRA Options– Private Exchange Options
Copyright Health Decisions, Inc. 05/2014
5
![Page 6: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/6.jpg)
Scheduled CommunicationsEvent DOL
http://www.dol.gov/ebsa/pdf/rdguide.pdf
ACA IRS
OctOpen Enrollment
SPD, SMM, WHCRA, Wellness
Summary of Benefits and CoverageNov
Dec
Jan Tax Filings W-2 benefit value6055/6056 Notices
W-2 filing6055/6056 filingFeb
Mar
Apr
May
Jun
Jul
Aug
Sep
OctOpen Enrollment
SPD, SMM, WHCRA, Wellness
Summary of Benefits and CoverageNov
Dec
Copyright Health Decisions, Inc. 05/2014
6
Communication “Silent Period”
![Page 7: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/7.jpg)
Event CommunicationsEvent DOL ACA IRS
New Hires: Eligible Enrollment Rights Notice Marketplace NoticeAffordability Confirmation
W-4
New Eligible Enrollment Rights Notice Marketplace NoticeAffordability Confirmation
New Enrollee SPD, etc. Summary of Benefits and Coverage
New Dependent MCSO Notice SSN Collection
New Hire: Ineligible Marketplace Notice W-4
Employment Termination Certificate of Credible CoverageCOBRA Election Notice
New COBRA Notices
Change in Employment Status
“Trigger Events”: Notice of Change in Eligibility
Change in Coverage Status
Claim Payment Processing
EOBNotice of Benefit Determination
Copyright Health Decisions, Inc. 05/2014
7
![Page 8: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/8.jpg)
Communications Opportunities:Going Beyond Minimum Requirements
Event Communication Opportunity
Post Open EnrollmentPost Tax Filing
Validation survey to confirm eligibility and enrollment with required response to engage employee
New Hire/ New Eligible Personalized offers of election assistance
Trigger Events Follow-up survey to confirm understanding and decision
New Hires Not Eligible Market Options and Navigator Assistance
Termination COBRA/ACA coordination and Navigator Assistance
Claims Request sharing of EOBs to compare payments
Copyright Health Decisions, Inc. 05/2014
8
![Page 9: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/9.jpg)
Communications OpportunitiesFilling In the “Silent Period”
Event DOL ACA IRSOct
Open Enrollment
SPD, SMM, WHCRA, Wellness
Summary of Benefits and Coverage
Nov
Dec
Jan Tax Filings W-2 health plan value6055/6056 Notices
W-2 filing6055/6056 filing
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
OctOpen Enrollment
SPD, SMM, WHCRA, Wellness
Summary of Benefits and Coverage
Nov
Dec
Copyright Health Decisions, Inc. 05/2014
9
• ACA Family Elections and Attitudes• Satisfaction with Current Coverage• Reactions to Proposed Changes• Attitudes towards Private Exchange• Provider Ratings• Other Topics of Interest to Management
![Page 10: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/10.jpg)
Communications Opportunities:Why Bother? Employee Perspective
• ACA confusion and misinformation creates employee concerns you help alleviate.
• ACA notices need explanations you provide.
• ACA election assistance and Navigators reduce concerns, costs and COBRA elections.
• Opinion surveys show you care and foster positive relations.
• Use of outside firm shows respect for privacy.
Copyright Health Decisions, Inc. 05/2014
10
![Page 11: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/11.jpg)
Communications Opportunities:Why Bother? Employer Perspective
Copyright Health Decisions, Inc. 05/2014
11
Recruit/Retain a High-Quality Workforce.
Gain a competitive advantage over other employers drawing from same labor pool.
How:•Offer support to ineligible workers.•Partner with eligible workers.•Realize Savings
• Eliminate ineligible dependents.• Reduce employee calls, concerns and complaints.• Re-direct COBRA costs and other elections as appropriate.• Engage consumer in monitoring costs and plan performance
![Page 12: Health Decisions Webinar: ACA Communication Requirements - An Employee Relations Opportunity](https://reader034.fdocuments.in/reader034/viewer/2022051817/547df1a4b4af9ff45f8b4809/html5/thumbnails/12.jpg)
Copyright Health Decisions, Inc. 05/2014
12
For More Information
Contact
734-451-2230
Connect with me on LinkedIn
Add me to your circles on Google+
Like us on FaceBook
Follow us on Twitter