Patient Protection and Affordable Act Archives

How to Determine Full-Time Employment Status of Employees for the ACA Employer Shared Responsibility Mandate

As part of the insurance market reforms enacted under the ACA, large employers are required to maintain a certain level of health insurance for their common law employees (and only their common law employees) or pay a penalty — the so-called pay or play or employer shared responsibility rules. The rules for determining which workers should, or even can, be offered coverage are quite daunting. This article provides a road map for determining which workers must have an offer of health insurance coverage from the employer to avoid triggering penalties under the employer shared responsibility requirements.

Read the full article.

Proposed Regulations Addressing Multi-State Plans

by Amy M. Gordon, Susan M. Nash and Jacob Mattinson

As part of the regulations under the Patient Protection and Affordable Act (PPACA), the U.S. Office of Personnel Management (OPM) proposed a requirement that OPM contract with private health insurance companies to ensure that at least two multi-state plans are offered in each state’s Affordable Insurance Exchange. Under the law, a multi-state plan issuer may phase in the states in which it offers coverage over four years, but must offer a multi-state plan in exchanges in all States and the District of Columbia by the fourth year. The proposed regulations generally address OPM’s approach to the offering of multi-state plans and the attributes of the multi-state plans to be offered. Comments are being solicited, and are due within 30 days after the rules are published in the Federal Register, which is expected to take place this week.