Attention agricultural employers: Mandatory health care coverage under the Affordable Care Act (ACA) won't start until January 2014, but government requirements already are in play to get you and your employees ready for this monumental and potentially mind-boggling event. The National Council of Agricultural Employers calls ACA the biggest deal in health care since Medicare and Medicaid were created in the 1960s, but this bill is designed to impact everyone -- whether you hire one employee or more than 50, or are simply a self-employed operator who buys insurance on your own.
Important features to follow in 2013 will be:
-- Employee notification rules. It's up to employers to educate employees about mandatory coverage and where/how to buy it in state exchanges;
-- Your 2013 employee headcount, including seasonal workers, since this will influence what coverage you will need to provide employees starting in 2014. If you have more than 50 full-time workers, you are required to insure workers and their dependents up to age 26. Just be warned the formula for seasonal and part-time workers is complicated;
-- What kind of insurance coverage satisfies the government's "adequacy" and affordability rules if you do offer insurance;
-- Whether you can purchase insurance coverage less expensively from one of the new insurance pools available in each state.
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Last week, the Department of Labor issued long-delayed rules instructing employers how to notify all existing and new employees in writing about access to their state's insurance marketplace to purchase individual insurance. The marketplaces won't open for business until Oct. 1, 2013, but 50 statewide marketplaces will be announcing which insurers will be offering individual policies, premium costs and the types of plans within the next few weeks. For example, on May 23 the California marketplace will announce the options available for an estimated 5 million people expected to buy insurance on its state exchange.
Employers were supposed to notify existing employees information about the exchanges by March 1, 2013, and new employees at the time of hiring, but that requirement was postponed until Oct.1, 2013 since this Department of Labor guidance was delayed.
Click here for the Department of Labor's Technical Release: http://www.dol.gov/…
Click here for the model Exchange notice for employers who do not offer a health plan: http://www.dol.gov/…
Click here for the model Exchange notice for employers who offer a health plan to some or all employees: http://www.dol.gov/…
Exchanges will be the centerpiece of the new law and will be open to: (1) employees who are not covered by employer-provided insurance; (2) those workers whose employer plans do not meet affordability (premiums less than 9.5% of household income) or other minimum government requirements for coverage; and (3) individuals (like many self-employed farmers) who buy insurance as individuals or in small groups.
It's not all bad news for agriculture. Small employers who employ less than 100 employees may be able to access insurance coverage in these exchanges at their state's discretion; but everyone who employs 50 or fewer full-time employees is eligible to use the marketplaces, points out NCAE's Matt Coffindaffer. That's intended to give small employers and self-employed individuals the same insurance buying muscle Fortune 500 companies enjoy.
Finding more affordable coverage could be a plus for some farm families and their workers. Of firms with three to nine employees, 50% do not offer some kind of health insurance, surveys by the Kaiser Foundation show, largely due to cost. Those small firms with insurance have shaved costs by charging workers higher deductibles and requiring employees to pay a larger share of the family premiums -- sometimes with deductibles as high as $4,500. At many farms, those "employees" are adult children, in-laws and siblings.
Sound complex? It is. My advice is to start talking to your insurance providers or accountants now. This is no place for a do-it-yourselfer. Says Frank Gasperini, NCAE's executive director, "We are nearing the point where the insurance/legal professionals will be the 'go-to' folks because in just a few more months businesses will have to start the actual enrollment process and that will require 'on the ground' technical help."
I'll be posting more details in the next few days, but if anyone would like to share how they are handling health insurance in their farm business -- for both their own family partners and their employees -- I'm willing to listen!
Marcia Taylor can be reached at email@example.com
Marcia Zarley Taylor on Twitter@MarciaZTaylor
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