Providing health care coverage to employees is expensive and more complicated than ever after the Affordable Care Act (ACA). Employers struggle to understand their ACA obligations and potential risk of non-compliance. With court challenges and extended deadlines, many employers have failed to develop a comprehensive ACA compliance plan. While no federal law, including the ACA, requires employers to provide health insurance, certain large businesses that fail to do so for full-time employees may face penalties. But there may be options beyond this “pay or play” scenario.
Saul Ewing’s ACA Consulting Team can design a compliance game plan that makes sense for your business or organization in the wake of health care reform. The team’s attorneys track the thousands of pages of ACA guidance issued by federal agencies and interpret this information to develop sophisticated ACA compliance strategies. In addition, they draw on their depth and breadth of experience with other employee benefit laws that interact with the ACA, such as COBRA and HIPAA, to help clients develop a plan that takes into account myriad business challenges.
Having experienced employee benefits counsel also can help clients understand the legal risks associated with health care coverage decisions that follow from health care reform. These risks include the imposition of “pay or play” penalties, whistleblower actions and excise taxes. Should litigation arise, discussions between your benefits team and our attorneys about workforce management and other strategic business decisions related to ACA compliance can remain confidential due to the attorney/client privilege.
The ACA Consulting Team provides counsel to closely-held businesses as well as multi-national corporations. Representative engagements include:
- Assisting the U.S. subsidiary of a multinational corporation in developing an ACA-compliant strategy for labor negotiations;
- Supporting a private college and a public university in navigating the special ACA compliance challenges faced by institutions of higher education; and
- Counseling the owner of numerous small restaurants on options to consider under the “pay or play” rules.
The team’s legal services span a range of needs related to health care reform. This includes helping businesses interpret “pay or play” rules. Team members also review and draft an array of documents affected by ACA regulations, including enrollment materials, group health plan documents and summary plan descriptions; and they can help employers negotiate agreements with their health care coverage service providers, including administrative only service providers for self-insured plans. In addition, attorneys in the practice have experience providing guidance on controlled group analyses critical to the determination of “large employer” status.