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Top 10 Questions Employees Have about the ACA

As the Affordable Care Act hits high gear and the individual mandate has been in effect for nearly one year, employees in most organizations have a heightened awareness of the new law.

But just because they are more aware of it, doesn’t mean they understand it, particularly considering the immense amount of misinformation that’s circulating online and in the news.

And as the employer mandate takes effect for companies with 100 or more employees starting in 2015, they will likely have more questions about the law.

According to the International Foundation of Employee Benefit Plans’ “2014 Employer-Sponsored Health Care: ACA’s Impact Survey”, the top 10 questions employees have are as follows (we’ve also provided answers as per HR Morning, a website focusing on human resources issues):


How do exchanges work? Am I eligible? Are they free? Could I qualify for a subsidy? How does exchange coverage compare to my current coverage?

Answer: The exchanges act as an insurance agent of sorts, allowing employees to shop for plans that meet their needs. And yes, everyone can use them, but they are not free. However, whether or not employees get a subsidy depends upon a number of things – like whether or not you offer them coverage, the level of that coverage and their income.


How does the law affect me? Do I need to do anything?

Answer: Individuals are now required to carry insurance or pay a penalty. And if you’re offering them coverage that meets the law’s minimum requirements, they don’t have to do anything.


What will it cost me? Why are my costs going up?

Answer: The costs to your employees will be whatever portion of the premiums and cost-sharing they are responsible for under your employee benefits plan. Your benefit plan summary has all of these answers. Costs are increasing mostly because the cost of care continues rising.


Is the company planning to drop coverage?

Answer: You have to answer this based on what your plans are.


How will our benefits change? Is this benefits change because of the ACA?

Answer: Most likely, your plan has already changed to comply with the ACA. However, if you are planning changes for 2015, be prepared to explain what they are and the reasons behind them.


Can my child stay on the plan longer?

Answer: Under the ACA, a plan’s coverage for dependent children must be extended until they turn 26.


Do I have to get coverage if I don’t have it now? I need to sign up for benefits now because I will be penalized by the ACA; when will there be open enrollment?

Answer: If the employee does not receive health coverage from you, they will be required to obtain coverage on an exchange or in the private market, or pay a penalty. The exchanges opened in November 2014 for the 2015 benefit year. If they get coverage through you, share details of your plan’s next open enrollment period with them.


Will I have an average of 30 hours per week and qualify for benefits in 2015?

Answer: Tell them your plans and if they will qualify for your company plan.


Are we dropping spousal/dependent coverage?

Answer: Under the ACA, dependent children must be allowed to remain on a parent’s plan until age 26. But, employer plans are not required to cover spouses. Some employers will still offer spousal coverage.


How does the law affect the future of the company?

Answer: Only you know the answer to this question. However, if you’re planning to stay the course, you should communicate that with your employees.


The answers provided here are standard ones, and they may vary depending on your organization’s circumstances. To minimize the impact of such questions on your daily workload, be sure to inform employees that you (and not the news, Internet or a neighbor) are in the best position to help answer their questions, and then be prepared to answer these types of questions.

If you have a first-time benefits-eligible population (due to the ACA play-or pay provision), you may want to consider holding an Employee Benefits Basics session as they may be completely unfamiliar with benefits.

But now that you know what’s on the average employee’s mind, you can set about tailoring your employee outreach to cover these topics.

The most popular channels for communicating with employees about the ACA include annual enrollment materials, e-mails, company websites, special meetings and special written communication pieces.

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