Health Care Reform Resource Page

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To avoid penalties and put in place effective health benefit strategies under the Affordable Care Act (ACA), employers must comply with the law's numerous and complex requirements.

Latest Articles


2016 Transitional Reinsurance Fee Submission Due Nov. 15
The deadlines for the 2016 transitional reinsurance fee are approaching. To determine the 2016 reinsurance fee, insurers or self-insured group health plan sponsors must submit plan enrollment counts to the federal Centers for Medicare & Medicaid Services by Nov. 15. Also, the second contribution for the 2015 reinsurance fee must be made by that date.

Self-Insured Plans May Struggle to Get SSNs from Employees
The IRS has proposed a "three tries" approach that self-insured employers can follow to show they acted responsibly to get the Social Security numbers of health plan participants, including spouses and dependents, as required by the Affordable Care Act.

Are You Down With OOPs?: Opt-Out Payments Under the ACA
IRS proposed regulations address opt-out payments—made to employees who decline enrollment in an employer's group health plan—on affordability under the Affordable Care Act (ACA). The proposal clarifies that "unconditional" opt-out payments increase the employee's cost of coverage and, accordingly, impact whether the coverage is affordable under the ACA.

ACA Midyear Checkup: Count Your Contingent Workers
Now is a good time to catalog and assess your existing and planned staffing arrangements to determine who are and who may be deemed to be your employees

Employers Project Health Premium Hike of 6% in 2017
The good news: health premiums are not growing at a faster clip year after year, as they were a decade ago. The bad news: the increase in health plan costs still outpaces general inflation

2017 ACA Information Reporting: Prepare Now for Earlier Deadlines
By the end of January 2017, large employers must provide 1095-Cs reflecting 2016 health care coverage to their employees. That won't leave much time, and HR should prepare now to move quickly.

IRS Eases Penalties for Late ACA Reports
Employers still have an opportunity to submit Affordable Care Act (ACA) information returns without facing penalties, even though the filing deadline has passed.​

Respond Quickly to New Marketplace Notice
Employers' quick response to new notices from the government's health insurance marketplaces, informing that then employees have received federal subsidies to purchase policies on a public exchange—may limit employer-mandate liability under the Affordable Care Act. 

EEOC Offers Model Notice for Employer Wellness Plans
The Equal Employment Opportunity Commission (EEOC) issued a sample notice that will help employers comply with wellness program rules.​​

Health Plans Must Pay PCORI Fees by Aug. 1
Each year, sponsors of self-insured group health plans must pay a fee to fund the federal Patient-Centered Outcomes Research Institute (PCORI). Plan sponsors should prepare to report and pay this fee by the Aug. 1, 2016, deadline.

After ACA Repeal, Most Employers Would Keep Some Provisions
The future of the Affordable Care Act (ACA) will be hotly debated this election season. If it were to be repealed, over two-thirds of e​mployers would favor keeping in place at least some of the mandated changes that they’ve made to their health plans.

EEOC Issues Final Rules on Wellness Programs
The Equal Employment Opportunity Commission (EEOC) has issued final rules that describe how wellness programs can comply with the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act, and that clarify limits on financial incentives for participating in voluntary wellness programs.

Health Plans Can’t Discriminate Under New Rule
A final rule under the Affordable Care Act bars health care discrimination, including on the basis of sex and gender identification.

Health Costs and Consumerism at Midsize Firms
When given the choice, over one-third of employees at midsize firms select a high-deductible health plan, with Millennials the most likely to do so. Here’s a look at average plan costs in the midsize space.

IRS Sets 2017 HSA Contribution Limits
2017 health savings account (HSA) contribution limits for individual (self-only) coverage will increase by $50; most other HSA-related limits, including for HSAs linked to family coverage, remain unchanged from 2016.

Agencies Issue Final SBC Template and Glossary
Federal agencies have issued the final summary of benefits and coverage (SBC) template and uniform glossary for use during the fall 2017 open enrollment season.

More Compliance Reminders


All Health Care Reform Compliance Q&As

For additional information on implementing the Patient Protection and Affordable Care Act, please contact the SHRM Knowledge Center.


Cost & Coverage

Topic Index


Online Calculators:

Pay or play interactive tool. Via Unum.

Pay or play decision tree. Via Unum.

Estimated-penalty calculator. Via Littler.

Full-time employee worksheet. Via BenefitMall.

Subsidy calculator. Via Kaiser Family Foundation.

Actuarial value calculator / Minimum value calculator. Via Centers for Medicare and Medicaid Services.

Penalty Checklists:

Employer Shared Responsibility Penalties: A Checklist for Employers. Via Snell & Winter LLP.

Excluding Certain Classes of Employees from your Health Plan May Increase Risk of Penalty. Via Warner Norcross & Judd

Compliance Guides:

Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016. Via Buck Consultants.

Complying with and Leveraging the Affordable Care Act. A SHRM toolkit (members only).

Out-of-Pocket Limits for 2014 and 2015; Preventive Services Requirements. Via Segal Consulting.

Compliance Checklist for Plan Sponsors. Via Snell & Wilmer LLP.

The 95% Coverage Rule—The Critical Details. Via Moulder Law.

Applying PPACA Market Reforms to HRAs, FSAs and Other Health Accounts. Via Towers Watson.

DOL Plan Audits: Are You Prepared? Via McKenna Long & Aldridge LLP.

DOL's Self-Compliance Tool. Via the Department of Labor.

ACA Notice Requirements. Via Segal Consulting.

State-Specific Employer Guidance. Via

Triggering Loss of 'Grandfathered' Status. Via Sibson Consulting.

DOL Health Care Reform Webpage. Via U.S Department of Labor. Website. Via U.S. Department of Health & Human Services.

Small Business Health Care Tax Credit. Via IRS.

SHRM Member-Only Excel Spreadsheets:

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