King v. Burwell: What the Decision Means for You

At Benefitfocus, we are constantly evolving our platform to anticipate the needs of employers, insurance carriers, brokers and consumers on our platform. We also monitor developments in the regulatory and legal environments to rapidly respond to industry changes and keep customers ahead of the compliance curve. Today’s Supreme Court decision in the case of King v. Burwell is no exception.

At issue in King v. Burwell was the question of whether public health insurance exchanges run by — AKA the Federally Facilitated Marketplace (FFM) — have jurisdiction to provide subsidies for health insurance, as allowed by the Affordable Care Act. Today’s decision for the government (Burwell) means that there is no change to the current administration of the Affordable Care Act’s exchange and that most companies will remain largely unaffected.

However, we all know that change is constant and you will want to keep some significant events in mind as you continue your plan design for the upcoming open enrollment and beyond.

  • The Cadillac Tax. This surcharge goes into effect January 1, 2018, and its impact is driving many companies to act now to reduce plan premium costs that could expose you to additional taxes.
  • 1094-C and 1095-C Reporting Requirements. Under Affordable Care Act (ACA) regulations, companies with more than 50 full-time employees must submit both forms to the IRS by March 31 of the year following the reporting year; all groups submitting more than 250 must do so electronically. Form 1095-C must be sent to employees by January 31 of the year following the reporting year. These requirements begin in 2016 with the reporting of 2015 data.
  • Risk corridor and reinsurance programs. These are intended to help stabilize the individual market and will expire at the end of 2016. The expiration could result in increased premiums in the individual market in 2017 and beyond. That, in turn, may drive individuals receiving coverage on public exchanges to look to their employers for coverage.
  • Communication and Engagement. Now, more than ever, your employees will benefit from a flexible, intuitive platform that informs employees of their plan options and insures that they are making the right benefit choices.

The ACA continues to add complexity to benefits administration. Learn how our cloud-based solutions enable your organization to effectively manage ACA compliance while keeping you and your workforce up-to-date on evolving requirements.