• Health Care Reform: Employer Mandate and Insurer Reporting Requirements Delayed until 2015
  • July 5, 2013 | Authors: Jeanne E. Floyd; Jonathan A. Kenter; Evelyn Small Traub
  • Law Firms: Troutman Sanders LLP - Richmond Office ; Troutman Sanders LLP - New York Office ; Troutman Sanders LLP - Richmond Office
  • This is the twenty-fifth in a series of advisories on Health Care Reform and other recent developments in health care.

    The Obama administration informally has announced a delay in the employer mandate to provide health insurance and the insurer reporting requirements under the Patient Protection and Affordable Care Act (“ACA”). The employer mandate and the insurer reporting requirements - which were scheduled to become effective on January 1, 2014 - will now be delayed until 2015. Formal guidance describing the delay is expected to be published by July 9, 2013.

    Under the ACA, companies with at least 50 “full-time equivalent” workers must provide affordable, minimum value health care coverage to their full-time employees or incur a series of escalating tax penalties if just one worker enrolls in government-subsidized insurance. In order to determine which employers owe penalties for failure to provide affordable, minimum value health care coverage, the ACA requires insurers and employers providing health care coverage to report specific information about any coverage provided on or after January 1, 2014. The delay in information reporting until 2015 will make it impractical to determine which employers owe penalties for failure to provide affordable, minimum value health care coverage. As a result, any employer shared responsibility payments will not apply until 2015.

    Individuals, however, are still subject to the individual mandate and the resulting tax penalties for failure to obtain health insurance. Individuals also will have access to the premium tax credits available under the ACA.

    The delay in the employer mandate and insurer reporting requirements does not impact the establishment of the government-sponsored insurance “exchanges,” which are scheduled to begin open enrollment in October 2013.