1. Do I have to provide health insurance for my employees?
   
   There is no mandate in the law requiring employers to offer insurance coverage to their employees. Large employers (200+ employees) that offer health insurance must automatically enroll their employees into a health plan (though employees may opt out of enrollment).

   Beginning in 2014:
   Employers with at least 50 employees who do not offer “minimum essential coverage” (as defined by the law) and who have at least one full-time employee who receives a federal tax credit to purchase insurance on his or her own must pay the federal government a $2,000 penalty for each full-time employee, except the first 30 employees, which are exempt from this penalty.
   
   Employers with at least 50 employees who do offer minimum essential coverage and who have at least one full-time employee who receives a federal tax credit to purchase insurance on his or her own must pay the federal government the lesser of: $3,000 per employee receiving a credit OR $2,000 for each full-time employee, excluding the first 30 employees. For more information on employers’ “shared responsibility” requirements, see IRS Notice 2011-36 and Notice 2011-73.

   
   
2. What is the Small Business Health Care Tax Credit? Who is eligible to receive the credit?
   
   Read a detailed description of the Small Business Health Care Tax Credit here.
   
   
3. Can employers still apply for the Early Retiree Reinsurance Program?
   
   The Centers for Medicare and Medicaid Services (CMS) has announced that it will no longer be accepting applications after 5 p.m. ET on May 5, 2011, from employers for participation in the Early Retiree Reinsurance Program (ERRP). Applications were first accepted on June 29, 2010, and are being processed on a "first-come, first-served" basis. UPMC Health Plan has existing materials to supplement your application as required by regulations, though completing an application is ultimately the employer's responsibility. For official information on the program or to download an application, visit the ERRP website.
   
   Update: On December 9, 2011, CMS announced that ERRP reimbursement requests will only be accepted for claims incurred on or before December 31, 2011. Eligible claims that are received after program funding has been exhausted will be held in the order of receipt, pending availability of any funds. More information about this announcement and the end of the ERRP program is available here.
   
   
4. What is grandfathering?
   
   Grandfathering is the Affordable Care Act term for allowing the continuation of certain health insurance coverage that was in effect before March 23, 2010. Plans and coverage that have grandfathered status are exempt from making some changes that would otherwise be required, including no-cost coverage of preventive health services, special rules for handling members’ benefit appeals, federally mandated “essential health benefits” in 2014, and various other provisions, both now and in the future. Grandfathered plans can only make very limited changes to their plan’s design or members’ cost-sharing.
   
   
5. How is grandfathered status communicated to members/employees?
   
   Those members who are enrolled in a grandfathered plan will receive a notice of their plan’s status as part of their member materials for renewals on or after October 1, 2010. Members of all other plans will not receive any notice of their status.
   
   
6. How do the grandfathering rules apply to groups with a collective bargaining agreement (CBA)?
   
   Groups with a CBA that was in effect on March 23, 2010, are deemed to be grandfathered plans until the expiration of their existing CBA. At that time, the group will be evaluated for continued grandfathered status based on compliance with the standard grandfathering rules. For groups with multiple CBAs, the initial grandfathering period will end when the last of their agreements (among those in effect on March 23, 2010) terminates.
   
   
7. If I have grandfathered coverage and I hire new employees, will I have to also offer a non-grandfathered plan?
   
   No. Both new employees and family members of existing employees can be added or removed from your grandfathered coverage.
   
   
8. I offer my employees a choice among multiple grandfathered plans. How do grandfathering rules apply if I want to eliminate one plan and move employees enrolled in that plan to another?
   
   The Department of Labor discusses this issue in a Frequently Asked Questions document. Click here to read that document.
   
   
9. What are the new W-2 reporting requirements?
   
   Beginning with the 2012 calendar year (W-2 forms issued in January 2013), most employers will be required to report the cost of employer-sponsored group health plan coverage on employees' W-2 forms. This reporting requirement does not change the non-taxable status of your employer-sponsored coverage. The IRS has also provided a temporary exemption for some employers, including those who filed fewer than 250 W-2 forms for 2011. Please click here for more information on this new requirement and answers to some common questions.
   
   In January 2012, the IRS published additional guidance on the W-2 reporting requirements for employers. Click here to read the official guidance (IRS Notice 2012-9).
   
   
10. Do the new W-2 reporting requirements mean health insurance benefits are taxable?
    
    No. The reported figure is informational only and does not change the status of coverage that is otherwise tax exempt.
    
    
11. What is the "Cadillac Tax"?
    
    Starting January 1, 2018, plan administrators or insurers must pay a 40% excise tax for employer-sponsored coverage valued above $10,200/$27,500 (single/family). Because this provision is delayed for several years, regulations providing further details have not yet been finalized.
    
    
12. Which employers are eligible to receive grants for establishing workplace wellness programs?
    
    Read a detailed description of workplace wellness program grants here.
    
    
13. Do the new rules for appeals and external review apply to self-funded plans?
    
    Yes. The rules apply to all non-grandfathered plans regardless of funding status.
    
    
14. Are plans (including self-funded plans) required to contract with Independent Review Organizations?
    
    Self-insured non-federal government health plans (i.e., state and local government self-funded plans) and insurers in states whose external review processes fail to meet federal standards must use either the federal external review process (administered by HHS) or the private accredited Independent Review Organization (IRO) process for self-insured plans.
    
    Self-insured plans subject to ERISA and/or the Internal Revenue Code who do not use an approved state external review process must contract with three (3) IROs by July 1, 2012. These plans may take advantage of a safe harbor by contracting with two (2) IROs by January 1, 2012. Claims must be rotated between the contracted IROs. In some instances, a third-party administrator may contract with these IROs on a plan's behalf.
    
    As of August 1, 2011, HHS determined that Pennsylvania’s external review process does not meet certain federal requirements. Until Pennsylvania challenges this determination or amends its external review process, health plans in Pennsylvania must use one of the HHS-approved alternative processes.
    
    
15. What are "free choice vouchers" and are employers required to provide them in 2014?
    
    The Affordable Care Act originally required employers who offer employer-sponsored coverage to provide, beginning in 2014, "free choice vouchers" to employees for whom the employer-sponsored coverage is unaffordable. Congress repealed this provision in April 2011 and these coverage vouchers will therefore no longer be required.
    
    

Read more information about Health Care Reform.