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The Role of HR in ACA Compliance

The Affordable Care Act has proved to be a monumental HR compliance challenge. Even though many predicted it would be declared unconstitutional, the Supreme Court confirmed its constitutionality, and the legislation remains in full effect.

Whether your role is in HR, benefits, payroll, or the legal department, you have a crucial role to play in ensuring your company’s ACA compliance posture. Here are some tips to help you get started.

Educating Employees About Health Insurance

HR professionals are skilled at managing people and projects and balancing the demands of multiple roles. Those skills are useful when dealing with the many details involved in ACA compliance and tracking employee data, including providing employees with a Summary of Benefits Coverage (SBC) and ensuring they are not enrolled in a health insurance marketplace plan.

Additionally, HR professionals are frequently adept at staying on top of the ACA’s constantly evolving rules and regulations and informing other departments of any changes. Due to the high cost of non-compliance, this is extremely crucial.

The HR department must also be able to make the business decisions necessary to support the organization’s ability to meet its ACA Compliance group obligations, such as recruiting and hiring practices that optimize a company’s chances of complying with ACA requirements. They must also ensure that the ACA is front and center during onboarding processes when it is most likely to be discussed with new hires.

In addition, the HR department must ensure that they can accurately record and submit the required IRS ACA forms. Those include IRS Forms 1095-C and 1095-B. The HR team must train all their departmental staff to enter data into the ACAS database to prevent errors

Providing Health Insurance

HR professionals work with the rest of the company to determine the compensation philosophy and oversee benefits such as medical, dental, vision, life insurance, and 401(k) programs. They also help create work-life balance initiatives and paid time off programs to keep employees happy, healthy, and productive.

According to the ACA, sometimes known as Obamacare, companies with 50 or more full-time equivalent employees must provide health insurance to those workers or face a fine. To comply with the legislation, businesses must provide an online marketplace for consumers to compare health insurance options, submit standard Summary of Benefits and Coverage (SBC) documents to every employee within 14 days of hiring, and guarantee that the plans they sell are ACA compliant.

Some types of health coverage do not have to follow the ACA’s guidelines, such as short-term medical insurance, accident supplements, fixed dollar indemnity plans, dental and vision insurance policies, and critical illness coverage. In addition, some religious-based health care sharing ministries do not have to be ACA compliant.

Staying current with rules and regulations is a constant duty for HR professionals. By combining data from your HR, benefits, and payroll systems, a solution may assist in identifying vulnerabilities and determining benefits eligibility by ACA standards. The team monitors new laws to keep current and ensure you continue to comply with the ACA.

Keeping Track of Employees’ Health Information

HR teams must be familiar with the laws that affect their company and its employees. They are responsible for designing workplace policies and ensuring the company complies with all applicable laws. This includes laws on harassment, discrimination, and benefits. Legal disputes cost U.S. companies over 505 million dollars in 2018.

It’s also important for the department to keep track of internal and external factors that may impact the workforce. For example, some employees have medical conditions that can impact their performance at work. Those conditions need to be considered when an employee is given reprimands or warnings for being late or performing poorly in other ways.

Tracking employee health information is a fairly new trend. Some companies gather this data by hosting on-site wellness programs, weight loss competitions, smoking cessation classes, and questionnaires. Others do it through blood tests or medical exams. The law isn’t clear on whether this type of information can be collected.

Some companies outsource their HR functions to a professional employer (PEO). A PEO employs the company’s workforce, takes legal responsibility, and oversees all hiring, firing, and compensation processes. However, a business needs an in-house HR team to manage its workers effectively. This is often more efficient than outsourcing to a PEO.

Managing Benefits

In addition to health insurance, HR departments oversee all non-wage compensation that supplements workers’ salaries. This includes retirement funds, private medical insurance, and profit-sharing programs. HR professionals also develop and administer employee wellness programs. These might include fitness challenges, healthy eating guidelines, and stress reduction practices. These programs help employees maintain a better work-life balance and may even reduce the number of sick days they take, which helps the company’s bottom line.

Lastly, HR professionals often feel comfortable approaching employees to discuss and settle workplace disputes or issues. This requires strong interpersonal skills so that HR professionals can tactfully address concerns. Additionally, they may occasionally give public presentations or announcements in front of large groups, departments, or the whole company.

It’s also important for HR departments to keep track of external factors that affect the company and its employees. These might include changes in technology, global developments, and trends in social media networking. They must also keep up with new specializations, like Diversity, Equity, and Inclusion (DEI), that have emerged in recent years.

HR professionals with a good grasp of these various functions and responsibilities can help their companies navigate the tricky waters of ACA compliance. They’ll know how to educate employees on the rules and regulations, create effective time-tracking processes, and provide engaging training programs for all staff members.

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