[MyOEBB] OEBB -- Affordable Care Act (ACA) Guidance

Mon Oct 5 15:23:05 PDT 2015

Dear Superintendents, Business Managers and Benefit Representatives:

In March 2015, Towers Watson presented a webinar on the affordability provisions under the Affordable Care Act (ACA).  OEBB received numerous requests for clarification and application of the guidelines to very specific entity circumstances. OEBB provides general guidance on a variety of topics relevant to the administration of an employer-sponsored health plan, including ACA rules.

Interpreting specific provisions of the ACA for unique entity circumstances is beyond the scope of the services available through OEBB and OEBB's consulting relationship with Towers Watson. However, OEBB and Towers Watson are committed to providing the most comprehensive guidance as possible without crossing the line of providing legal advice.

Following are links to six bulletins relating to the affordability provisions under the ACA.  These bulletins were developed to allow you to focus on the specifics of how your entity contributes toward the costs of benefits for benefit-eligible employees, including whether employees are eligible for a cash incentive when opting out of an OEBB medical plan.

Please note that if you have more specific questions about how the ACA affordability provisions apply to your entity, or to an employee group, you should seek legal advice from your entity's legal advisor(s).  Also, even though final regulations have been issued, the IRS has yet to provide written guidance on the treatment of flex credits and opt-out credits as they relate to the employer safe harbor affordability calculations.

Bulletin 8-A
Applicable to employee groups that receive a benefit contribution which may only be used to purchase medical, dental and vision benefit plans AND employees in the group have the option to receive a cash incentive (taxable income) from the entity when choosing not to enroll in an OEBB medical plan. This includes flat dollar contributions (insurance cap) and contributions representing a percentage of the premium.
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8A-Cash--October-2-2015.pdf

Bulletin 8-B
Applicable to employee groups that receive a benefit contribution which may only be used for one or more of the following options: to purchase medical, dental and vision benefit plans, have a portion of the contribution go into a healthcare FSA (HCFSA) OR to receive a cash incentive (taxable income) from the entity when choosing not to enroll in an OEBB medical plan.
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8B-FSA--October-2-2015.pdf

Bulletin 8-C
Applicable to employee groups that receive a benefit contribution from an entity which may be used to purchase medical, dental, vision, life, disability, AD&D, long term care or any other benefit available through the employer AND employees in the group have the option to receive a cash incentive (taxable income) from the entity when choosing not to enroll in an OEBB medical plan. This includes flat dollar contributions (insurance cap) and contributions representing a percentage of the premium.
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8C-LifeDis--October-2-2015.pdf

Bulletin 8-D
Applicable to employee groups that receive a benefit contribution which may only be used for one or more of the following options: to purchase medical, dental, and/or vision benefit plans; have a portion of the contribution go into a healthcare flexible spending account (HCFSA); AND employees in the group have the option to receive a cash incentive (taxable income) or a contribution to a Health Reimbursement Arrangement (HRA/VEBA) from the Entity when choosing not to enroll in an OEBB medical plan.
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8D-HRA--October-2-2015.pdf

Bulletin 8-E
Applicable to employee groups that receive a benefit contribution which can be used for one of the following options: to purchase medical, dental and/or vision benefit plans; have excess funds contributed to a Health Savings Account (HSA); OR to receive a cash incentive (taxable income) from the entity when choosing not to enroll in an OEBB medical plan.
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8E-HSA--October-2-2015.pdf

Bulletin 8-F
Applicable to employee groups that receive a benefit contribution which can only be used to purchase medical, dental and/or vision benefit plans. This includes flat dollar contributions (insurance cap) and contributions representing a percentage of the premium AND employees in this group are NOT eligible to receive cash for choosing not to enroll in an OEBB medical plan (i.e., employees only have the option to "waive" OEBB medical coverage).
http://www.oregon.gov/oha/OEBB/HealthcareReform/ACA-Bulletin-8F-NoOptOut--October-2-2015.pdf

To review prior bulletins or access historical webinars on various ACA-related subjects, here is a link to the main "Healthcare Reform/ACA" page of the OEBB website:
http://www.oregon.gov/oha/OEBB/Pages/ACA-Healthcare-Reform.aspx

We hope this information is helpful as your entity moves forward to gain or retain compliance with the ACA.

Sincerely,

Denise L. Hall
Denise L. Hall, Deputy Administrator
Oregon Educators Benefit Board
http://egov.oregon.gov/OHA/OEBB<http://egov.oregon.gov/DAS/OEBB>

OEBB encourages all members to stay healthy and be happy!!!!     Pass it on.....
http://www.oregon.gov/oha/OEBB/Pages/Wellness-Resources.aspx

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