PPACA Updates
These health reform updates can help you understand how the Patient Protection and Affordable Care Act (PPACA) impacts your plan. We encourage you to work with your attorney and other business partners to comply with these changes.
Legislative Briefs on High-Impact PPACA Provisions
Grandfathered Status: Keep it or Lose it, and What it Means for Your Plan
Internal Appeals and External Grievance Review Requirements for Non-Grandfathered Plans
Four-page Summary of Benefits (SBC)
Preventive Care Mandates for Non-Grandfathered Plans
- Read the letter The Alliance sent in response to DOL and HHS request for comments.
Employer Responsibility Provisions
Article: Automatic Enrollment Update
Article: New Guidance on W-2 Reporting Requirements
Rules Released on Health Plan Fees to Fund Comparative Effectiveness Research
You'll find many of the PPACA Administrative Requirements in this document. It is meant as a starting point for discussion between TPAs and employers to determine where action has been or needs to be taken. This Excel spreadsheet (.xls) can be used to keep track of what has been done. (updated January 21, 2011)
Legislative Briefs on Other PPACA Provisions
State Innovation and Implications for Employers
PPACA Cost Containment Concepts: Quality, Transparency, Wellness, Prevention and Provider Payment Reforms
Exchange and Subsidies under Federal Reform
Additional Resources
PPACA Section-by-Section Analysis from the National Association of Insurance Commissioners
Affordable Care Act Tax Provisions from the IRS.
Guidance Issued Specifically for Self-Funded, Non-federal Government Plans from The Center for Consumer Information & Insurance Oversight.
The U.S. Department of Labor website - visit the main page for PPACA
FAQ from the DOL:
- Part I – Q & A about grandfathered status, internal appeals and external review, dependent coverage, o-of-network emergency services, and highly compensated employees.
- Part II – Q & A about grandfathered status, dental and vision benefits, and preventive health benefits.
- Part IV – Q & A about grandfathered status and lifetime limits applicable to essential health benefits.
- Part V – Q & A about preventive health benefits and value-based insurance designs, auto-enrollment, notice requirements for plan changes, adult dependent coverage, pre-existing exclusions, grandfathered plans, the Mental Health Parity and Addiction Act (MHPAEA), and wellness program initiatives.
- Part VI – Q & A about grandfathered status
- Part VII – Q & A about about four-page summary of benefits and MHPAEA.
- Part VIII– Q & A about Summary of Benefits and Coverage (SBC)
Information from EBSA.
Info from the EEOC
The Equal Employment Opportunity Commission (EEOC) recently released a guidance letter that clarifies the use of genetic information in wellness programs.
Alliance Online Excise Tax Calculator (updated March 30, 2010)
The Alliance has developed this calculator to help organizations understand the possible implications of the excise tax.
Health Reform Subsidy Calculator (Kaiser Family Foundation)
This tool illustrates premiums and government assistance for individuals and families under PPACA in 2014.
Health Care Mandate Cost Calculator (National Retail Federation)
This tool helps organizations determine what penalties they might face under the recently enacted federal health care reform law if they do not provide health benefits to all full-time workers.
We provide links to outside organizations as a convenience. It does not constitute an endorsement.