Key Provisions in Healthcare Reform Legislation

Oasis has a team of experts dedicated to enhancing our PEO clients’ understanding of how the changes will impact their business. We’ve been at the forefront of the legislative process since the beginning, and we keep in constant communication with healthcare experts, regulators and independent advisors to make sure we have a thorough understanding of all facets of Healthcare Reform.

This page provides you with a brief overview of how Healthcare Reform can potentially impact your business. Keep in mind, this information is only intended to be used as a summary of some of the key provisions of the law; for additional information on how to address Healthcare Reform in your company, please call us at 866-709-9401 or click here to Request a Free Consultation.


Small Business Tax Credit

Targeted Business Size: Less than 25 full-time employees with an average wage below $50,000.
Key Provision: Maximum amount of the credit is worth up to 35% of a small business’ premium costs. On January 1, 2014, the rate increases to 50%.
How we can help: Oasis conducts a review of all new clients to advise them if they may be eligible for this credit. Supporting payroll documentation is provided as required to assist in capturing all available tax credits.

Mandated Benefits

Targeted Business Size: All
Key Provision: Pre-existing conditions restriction eliminated for children under the age of 19. Lifetime maximums must be eliminated.
How we can help: All Oasis plans comply with this requirement.


W-2 Reporting

Targeted Business Size: All
Key Provision: Employers must report the aggregate value of employer-provided coverage that is taken into account for purposes of the excise tax on high-value health coverage.
How we can help: The Oasis payroll system will be amended to comply with this requirement.

2012 and Beyond

New Plan Disclosure Obligations

Targeted Business Size: All
Key Provision: Plan sponsors must supply participants at enrollment or re-enrollment, a new form of plan summary that must include information on benefits exclusions and cost-sharing requirements. Businesses are subject to a $1,000 penalty for each failure.
Implementation: 2012
Key Provision: Employers must provide written notice regarding the existence of the Insurance Exchange and that the employee might qualify for subsidies.
Implementation: 2013
Key Provision: Plan sponsors will be required to provide an annual statement to the government and covered individuals reflecting the months during the calendar year for which the individual had “minimum essential coverage.” Businesses are subject to a $50 fine for each missed statement to an employee up to a maximum of $100,000.
Implementation: 2014
How we can help: Oasis will supply all required disclosures for clients participating in an Oasis-sponsored medical plan.

Health FSA limits

Targeted Business Size: All
Key Provision: Employee contributions to FSA are limited to $2,500/year.
Implementation: 2013
How we can help: The Oasis plan will be amended to comply with this requirement effective January 1, 2013.

Free Rider Surcharge

Targeted Business Size: Businesses that average 50 or more full-time employees
Key Provisions:

  • Plan design is expected to pay at least 60% of allowed charges.
  • Employee contribution must not exceed 9.5% of employee’s Household income.
  • Voucher Requirement if employee contribution is more than 8% and the employee’s household income is less than or equal to 400% of the Federal Poverty Level.

Penalty for noncompliance: If an employer offers some coverage but it’s not “qualifying” and “affordable”, then the employer pays a maximum annual penalty of $3,000 per full-time employee who receives a subsidy through an Insurance Exchange . If an employer does not offer coverage at all, the maximum annual penalty is $2,000 times total number of full-time employees.
Implementation: 2014
How we can help: The Oasis-sponsored medical plan designs will be amended to comply with this regulation.

Automatic Enrollment

Targeted Business Size: Businesses with 200 or more employees
Key Provision: Employers must automatically enroll new, full-time employees in health plan. Employees may opt out.
Implementation: 2014, after issuance of regulation
How we can help: The Oasis payroll system will automatically enroll eligible employees in the lowest cost plan.

Mandated Benefits

Targeted Business Size: All
Key Provision: Plans may not impose a waiting period of more than 90 days.
Penalty for noncompliance: Employers with 50 or more employees will be fined for waiting periods between 60-90 days ($600 per full-time employee in waiting period).
Implementation: 2014
How we can help: The Oasis payroll system will enroll eligible employees as directed by the employer.