The FEHBlog nearly fell off his chair this evening when he read the news first reported by Bloomberg that the Obama Administration is delaying enforcement of the employer shared responsibility provisions of the ACA for one year until 2015. Those provisions require employers with more than 50 full time employees to provider health benefits to those full time employees (defined as working at least 30 hours per week). Non-compliance means a $2000 penalty per full time employee over 30. There is also a $3000 penalty per full time employee who picks up subsidized coverage in the exchange because the employer sponsored coverage is not minimum value (60% actuarial value) or unaffordable, meaning the employee contribution exceeds 9,5% of W-2 income..
The IRS claimed that it opted for the delay in order to provide a more thoughtful implementation of this unnecessarily complicated law. The IRS announcement explained that the agency is working on the implementing the massive reporting obligations under IRC §§ 6055 and 6066 that the ACA imposes on insurers. It wants to test these massive reporting systems before the law takes full effect. The Hill’s Healthwatch provides up to date reaction to this decision.
The IRS is not delaying the individual shared responsibility provisions which impose a penalty of the higher of $95 or 1% of adjusted gross income in 2014 on individuals who fail to maintain minimum essential coverage. The Kaiser Family Foundation has a chart that explains this penalty which jumps in 2015 and again in 2016. FEHBP coverage is such minimum essential coverage.
The IRS is encouraging employers to comply with the ACA obligations for 2014. Much of the adverse reaction stems from the ACA’s unusual definition of full time employee — only 30 hours per week. The FEHBP currently provides coverage to a portion of this cadre. OPM explains on its website that
As a Federal employee, you are eligible to elect FEHB coverage, unless your position is excluded by law or regulation. Your agency applies these rules and determines your eligibility. However, there are numerous special provisions for people in part-time or intermittent employment, temporary appointments, and specifically named positions.
It will be interesting to see if OPM issues regulations expanding coverage in accordance with the ACA for 2014.