1 / 33

Affordable Care Act

Implementation Issues for Kentucky School Districts. Affordable Care Act. Presenters. Susan Barkley Susan.Barkley@education.ky.gov 502-564-3930 extension 4437 Jan Johnston Jan.Johnston@pendleton.kyschools.us 859-654-6911 Melissa Sullivan Melissa.Sullivan@education.ky.gov

george
Download Presentation

Affordable Care Act

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Implementation Issues for Kentucky School Districts Affordable Care Act

  2. Presenters • Susan Barkley Susan.Barkley@education.ky.gov 502-564-3930 extension 4437 • Jan Johnston Jan.Johnston@pendleton.kyschools.us 859-654-6911 • Melissa Sullivan Melissa.Sullivan@education.ky.gov 502-564-3846 extension 4415

  3. Resources • KDE website: Health and Life Insurance Benefits and Flexible Spending Accounts page • http://education.ky.gov/districts/FinRept/Pages/Health-and-Life-Insurance-Benefits-and-Flexible-Spending-Accounts.aspx • Implementation Guide • Timekeeping documentation • KEHP FAQs and Responsibility Chart

  4. Disclaimer • The Guide is only one of many resources • IRS continues to issue regulations on ACA • Information in the Guide could become inaccurate • Not comprehensive of all aspects of ACA • Consult legal counsel

  5. Whose Responsibility? • Districts: • Eligibility and offers of coverage (Play or Pay) • Nondiscrimination • Marketplace Notice • Employer Reporting • KEHP: • Affordable coverage • Adequate coverage • Plan details and options

  6. Failure to comply = PENALTY

  7. Action Steps Repeat Annually

  8. Who are Employees? An employee relationship exists when the employer has the right to control and direct the individual who performs the services and the details and means by which the result is accomplished.

  9. Who are employees?

  10. “Large” Employer • Full-time and FTEs = 50 or more • Most KY school districts are large • ACA applies to all large employers

  11. “Hours of Service” • Hours actually worked (or equivalency) • Hours paid or entitled to be paid • Vacation • Holiday • Sick leave • Disability • Jury duty • Military duty

  12. Who Do We Need to Worry About?

  13. Equivalency Hours

  14. Employment Breaks • Breaks at least 4 consecutive weeks in length • Cannot count zero hours worked • Exclude from average hours of service Examples: summer break, FMLA leave

  15. Eligibility Break Point • Step 1 – calculate number of days excluding breaks of > 4 weeks • Step 2 – multiply 5.997 by the number of days from Step 1 and then divide by 8 5.997 * 207 / 8 = 154 days

  16. Do I need to track actual time? • To limit the number of employees tracking actual time worked: • Limit number of days/year • Limit number of days/week • Use equivalency of 8 hrs/day

  17. Board Action • Measurement, administrative, and stability periods • Limitation of days worked • Track actual hours or use equivalency • Terminate subs that refuse assignments

  18. Full-time Employees for ACA Employees who average 30 hours of service per week or 130 hours of service per month

  19. Who is Full-time? Average hours of service over measurement period • Max 12 months • Recommended: October 3, 2013 – October 2, 2014 • Don’t forget to exclude breaks >4 weeks

  20. Recommended Measurement Periods Continually measuring

  21. What About Mid-Year Hires? • InitialMeasurement Period • Begins the first day of the month after hired • Max 12 months • Transitions to standard measurement period

  22. Initial Measurement Period Note that the standard measurement period begins during the initial measurement period; both periods occur simultaneously

  23. Offering Coverage • ACA requires coverage for full-time employees and dependent children – not spouses • Coverage must begin Jan 1, 2015 • Offer must be made, employee can decline • Maintain documentation • Annual requirement

  24. Offering Coverage • If employee is expected to work full-time must offer coverage at the time of hire • If it is unknown if the employee will have an average of 30 service hrs/week or 130 service hrs/month, use the measurement period

  25. Offering Coverage • Full-time during Measurement Period = Coverage during Stability Period regardless of hours of service during Stability • NOT full-time during Measurement Period = NO coverage during Stability Period regardless of hours of service during Stability

  26. COBRA

  27. Funding • State funds non-federal employee premiums • If health insurance appropriation is inadequate, funds come from SEEK • Avoid a blanket policy to offer coverage to all employees

  28. Penalty • If no Substantial Compliance • 95% or no more than 5 full-time employees • Penalty is • Number of full-time employees minus 30 • Multiplied by $167 per month

  29. Nondiscrimination • Cannot provide more for highly compensated employees • Example: paying the superintendent’s employee premiums • Penalty is • Number of employees minus the superintendent • Multiplied by $100 per day until in compliance • Solution: tax the additional benefit

  30. Employer Reporting • Will be required • IRS guidance not finalized • More information forthcoming

  31. Your Good Questions

More Related