health decisions webinar: aca communication requirements - an employee relations opportunity
DESCRIPTION
The Affordable Care Act requires a range of communications with employees and their families (consumers). This webinar presents ways to use these new communication requirements as part of a strategy to engage consumers. ACA elevates the role of individual consumers in health care decision-making to new heights. Viewing employees and their families as decision-makers means employers will want to communicate with them and listen to them. Employers that embrace this new reality can increase their ability to attract and retain a high-quality workforce (the only reason employers offer health benefits). To view the webinar, please go to: https://www4.gotomeeting.com/register/823073671 For more information, please visit: http://www.healthdecisions.comTRANSCRIPT
Presenter:
Si Nahra, Ph.D., PresidentMay 29, 2014
ACA Communications Requirements:An Employee Relations Opportunity
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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
2014 ACA Series
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Non-grandfathered, calendar year plans.
Comply not just because you have to.Comply in a way that helps your plan.
FOCUS
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
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ACA Compliance Checklist
Sessions available now.
Call 734-451-2230Ask for Leslie.
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
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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
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Communication “Silent Period”
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
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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
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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
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• 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
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.
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Communications Opportunities:Why Bother? Employer Perspective
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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
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For More Information
Contact
734-451-2230
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