ACA compliance: February settled ‘the family’s business’

When President Obama signed the Affordable Care Act into law on March 23, 2010, efforts to undermine the law began in earnest. While the media closely followed political and legal efforts to end its existence early, they largely ignored those who sought to make a quick buck off finding a way around the ACA’s various mandates.

In the past five years, I’ve gotten a lot of pitches about products to help employers avoid compliance. “Split the company into multiple parts to get below 50 ... ” “Reimburse your employees who buy their own coverage … ” “Offer a limited medical product that covers 100% preventive benefits …” “See, we don’t have to cover in-patient or outpatient services to get to minimum value ...”

These folks ranged from respectable businesses to snake oil salesmen, all trying to convince us that what they were selling was perfectly legal and legitimate.

I once joked to Chris Harrison, our company’s president and my boss, that the first mistake every one of these companies made was to get on the front page of The Wall Street Journal. While not completely true, what’s interesting is that the signs of a reckoning were there if you watched what was said — and what wasn’t said.

Score settled

This February reminded me of the last 10 minutes of The Godfather and The Godfather Part II. In the last four weeks, Treasury, Labor and Health and Human Services settled their business in a concerted effort through notices, instructions for 1094-C and 1095-C reporting forms, payment and benefit parameters and regulations; to make clear what would be permitted or prohibited when it came to compliance with the law.

Employer reimbursement of individual premiums? Shot in the eye while lying on the masseuse’s table.

Below minimum value plans?Shot in the back while running up the courthouse stairs.

Limited medical plans without hospital or physician services?Trapped in revolving doorway with nowhere to go once the gun was drawn.

Now there’s word that folks are trying to apply health care sharing ministry approaches to group health plans, and start selling products meant to supplement individual policy premiums, built on the premise that the IRS overstepped its authority when it applied parameters for “integration.” These continued attempts leave agents and plan sponsors tempting fate and finding a 4980D horse head in their bed one morning.

The moral of the story is there are no real short cuts around the law. As quickly as these “creative” products are developed, the departments are prepared to respond in kind.

As March begins, I have a funny feeling that someone will be celebrating the law’s fifth anniversary in a dark room and comfortable chair, a glass of scotch in one hand, having sent the message: Don’t mess with the family business again.

Smith is vice president, health & welfare benefits, at Ebenconcepts in Fayetteville, N.C. Reach him at dcsmith@ebenconcepts.com.