BREAKING NEWS: Health Care Reform Delay Applies Only to Employer Reporting and Penalties

Jul 03, 2013

Yesterday, the Obama administration announced (official guidance will be released within the next week) that it will not enforce the mandatory employer and insurer reporting rules required under health care reform until 2015. Such requirements will be voluntary in 2014, and employers will be encouraged to voluntarily report to test the reporting systems during the 2014 transition period. The delay is designed to provide a transition year that will be utilized to simplify required reporting and adapt the new exchange coverage system and reporting systems to be more workable for employers and all reporting entities.

Due to the delay of mandatory reporting until 2015, the employer penalties under the “Play or pay” rule applicable to large employers (employers employing 50 or more full-time or full-time equivalent employees) will not be enforced until 2015.


For example, still in effect for 2014:

  • Exchanges will be established and subsidies will be available for coverage through the exchange.
  • The individual penalty will still apply to any individual that does not have health coverage.
  • Waiting periods prior to eligibility for health coverage may not exceed the date 90 days from an employee’s date of hire.
  • Pre-existing condition exclusions will NOT be allowed.
  • Cost-sharing is capped and no annual or lifetime limits on benefits will be allowed.
  • Coverage of adult children to age 26 is required (even if the adult child has other coverage available).

We will know more details regarding the delay and how it applies after official guidance is released, and we will be issuing a more detailed e-alert at that time. In the meantime, this news does not mean you should completely suspend your planning for health care reform compliance. Please contact Dannae Delano with any questions you have about the announced delay or regarding what you need to do for 2014 compliance after the official guidance has been issued on the delay.

This E-Alert is intended as an informal summary of certain recent legislation, cases, rulings and other developments.  This E-Alert does not constitute legal advice or a legal opinion and is not an adequate substitute for advice of counsel.  This E-Alert is not intended to nor does it create an attorney-client relationship.  The choice of a lawyer is an important decision and should not be based solely upon advertisements. If this E-Alert is deemed to be an advertisement please disregard this solicitation if you have already engaged a lawyer in connection with the legal matter referred to in this solicitation.  You may wish to consult your lawyer or another lawyer instead of us.  The exact nature of your legal situation will depend on many facts not k nown to us at this time.  You should understand that the advice and information in this solicitation is general and that your own situation may vary.  This statement is required by rule of the Supreme Court of Missouri.

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