The Affordable Care Act – Where Things Stand to Date

It seems like there is weekly news to report on the Affordable Care Act — generally about a provision being delayed, infrastructure that’s not quite ready or some other administrative or technical gum in the works.

If you’re wondering how to keep track of what’s delayed, what’s not and what the current slate of ACA deadlines are, wonder no more. Here’s a rundown of where things stand to date:

The employer mandate

Requiring employers with more than 50 employees to offer health benefits, it has been delayed for one year to January 2015. However, ACA’s individual mandate remains in effect for January 1, 2014.

Here’s what you need to know about what to tell employees and our advice on how to communicate your plan’s value. Caps on out-of-pocket costs —  hold health plan participants to spending no more than $6,350 (for individuals) and $12,700 (for family coverage) per year — also has been delayed until 2015, but only for plans with an employer using two separate vendors for its medical and pharmacy benefits.

For employers using a single vendor, the cap provision remains in effect for Jan. 1, 2014.

Technical delays

Oregon, one of just 14 states that chose to finance and operate its own health insurance exchange under ACA, hit some stumbling blocks in its effort to open the marketplace by Oct. 1 (less than a month from now).

Applicants to the Oregon exchange won’t be able to purchase health coverage completely independently on Oct. 1 — rather, for at least two weeks, they’ll need the assistance of a third-party broker or similar organization. Similar functionality delays are occurring in states building DIY exchanges, including Connecticut and Nevada. Oregon aims to have the exchange be fully functional within the first two weeks of October.

The government-run super computer — a $267 million system known as the “Hub,” which pulls together data from seven federal agencies from the IRS to the Peace Corps and aims to keep track of which Americans have health insurance and/or are eligible to buy it with a federal subsidy through the exchange system — will be unable to verify whether people who buy insurance via exchanges are eligible to receive the subsidy by Oct. 1, when the marketplaces start enrolling new members. No word from the administration about when the Hub might be operating at full functionality.

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Computer problems slow implementation

Another government computer glitch will relieve smokers from premium penalties due to their tobacco status. Although ACA allows insurers to make smokers pay higher premiums (up to a 50 percent penalty), the glitch has delayed the penalty for at least a year.

The problem is that ACA also prohibits carriers from charging older plan members more than three times the premiums of the young and hardy. So, the government’s computers are unable to apply both the premium cap and the smoker penalty at once. The same penalty must apply equally to young and old, or not at all. Yet, despite the delays, all exchanges still are required to open their doors to new applicants on Oct. 1.

Also, your communications to-do list remains, and may be more important now than ever!

This article was originally published on the Benz Communications blog.

Kelly Butler is the Editorial Director at Benz Communications, a San Francisco-based benefits communications strategy firm. Prior to joining the Benz team, Kelly was Editor-in-Chief of Employee Benefit News, where she directed the magazine’s daily operations and oversaw (and contributed) to many of EBN’s online and social media initiatives.

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