2015: Top 5 Health Care Reform Trends

By Stephen Miller, CEBS Dec 23, 2015

These five health care reform articles from 2015 were some of the most-read content all year on SHRM Online. They describe developments and trends that will have a continuing impact in 2016:

ACA Information Reporting: Insights for the Journey

The Affordable Care Act (ACA) requires large employers to track their employees’ full-time status and report offers of coverage and enrollment information to the IRS beginning in 2016. Now is the time to evaluate the technology and the resources available to accurately prepare hundreds or even thousands of reporting forms. Also, it may be beneficial for a representative from the tax department to be engaged with HR professionals in reviewing these forms prior to both their distribution to employees and their transmittal to the IRS.

Family Plans Must ‘Embed’ Out-of-Pocket Limits in 2016

Effective for plan years beginning in 2016, nongrandfathered health plans—even if self-funded—must apply an embedded self-only out-of-pocket (OOP) maximum to each individual enrolled in family coverage if the plan’s family OOP maximum exceeds the ACA’s OOP limit for self-only coverage ($6,850 for 2016). This significant change affects the design of many high-deductible health plans.

Changes to the Summary of Benefits and Coverage

Federal agencies issued a final rule in June 2015 regarding the Summary of Benefits and Coverage (SBC) and the uniform glossary that must be provided to employees. But revisions to the SBC template and the uniform glossary, along with new coverage examples, are not expected to be finalized until January 2016. These revisions will apply to SBCs for coverage beginning on or after Jan. 1, 2017.

Growth Predicted for Private Health Care Exchanges

Private exchanges are essentially online marketplaces that provide employees with a new and different insurance shopping experience for ACA-compliant group insurance plans. These technology-based platforms not only offer employees more insurance options but they control employer costs, as employers provide a specific contribution to employees to purchase insurance on the marketplace.

Retiree Health Care Alternatives Gaining Steam

Amid growing concerns over the high cost of retiree health benefits and the impact of health care reform, many large U.S. employers are considering plan alternatives for retirees. One strategy involves employers purchasing group annuities for retirees. The annuities transfer the financial responsibility and liability for employer-provided subsidies to a highly rated insurer, which guarantees lifetime funding of health care benefits for retirees.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow me on Twitter.


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