Becker's ASC Review

Register Today for the 20th Annual Ambulatory Surgery Centers Conference in Chicago, October 24-26--Call 1-800-417-2035 65 Employer Mandate, Individual Mandate & Health Insurance Exchanges: 7 Things for ASC Owners to Know By Laura Miller T he rules, regulations and cost of employee benefits will fluctuate over the coming years based on healthcare reform's individual mandate, employer mandate and health insurance exchanges. "Delaying the employer mandate sounds like we are off the hook for another year, and really that isn't the case," says Mr. Jacobs. "There are still a dozen or more things employers need to be aware of that will impact them." "There are a number of things coming down the pike with human resources that surgery center leaders need to know about," says Tom Jacobs, CEO of MedHQ. "Benefits are usually a big cost for providers and most ASCs do offer some type of health insurance for employees." The government expects to publish proposed rules and more detailed information on the Patient Protection and Affordable Care Act's employer coverage mandate later this year after meeting with large employers and other stakeholders. According to the Congressional Budget Office, the delay will cost the government $12 billion. Mr. Jacobs discusses seven PPACA issues that will impact ASC employee benefits in the future. 1. Employer mandate delayed. The Obama Administration has delayed the employer mandate — a provision that requires businesses and companies with 50 employees or more to offer employee health benefits or pay a penalty — by one year. Originally set to begin Jan. 1, 2014, the mandate will now take effect in 2015. 2. Individual mandate was upheld. Since the Supreme Court upheld the individual mandate last summer, it's likely this provision will still go into effect. The individual mandate requires all people to seek insurance either through their employers or on the health insurance exchange. "If an individual employee of the ASC goes to the exchange and tries to enroll in benefits, that will cue up a red flag that the Tom Jacobs employer doesn't have a plan that meets the requirements," says Mr. Jacobs. "That puts the employer in an awkward position because if they are offering a plan, that visit to the exchange could touch off several administrative processes that aren't going to be fun." Clearly educate employees about your insurance plan and make it clear that your plan meets coverage requirements of the Affordable Care Act. With the proper health plan provisions, employers can mitigate the risk of becoming burdened with this issue. Health insurance exchanges are expected to begin enrollment Oct. 1, 2013 and go into effect Jan. 1, 2014.

• Cover