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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.

2010

Small Business Tax Credit

Targeted Business Size: Less than 25 full-time employees with an average wage below $50,000.
Key Provision: The maximum credit is 35% of total premiums paid for small business employers (2010-2013). There will be a maximum tax credit of 50% of premiums paid by eligible small employers that are a part of the SHOP Exchange. The credit is available for employers for a maximum of two consecutive years (2014).
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: 50 or more full-time employees
Key Provision: Pre-existing conditions restriction eliminated for children under the age of 19 and lifetime maximums must be eliminated (2010). Pre-existing conditions restriction eliminated for everyone (2014).
How we can help: All Oasis plans comply with this requirement.

2012 and Beyond

W-2 Reporting

Targeted Business Size: Employers who issued at least 250 W-2s in the prior year
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: Oasis includes the aggregate value of the employer-provided coverage on employees’ W-2s (2013 for the 2012 tax year).

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: Oasis has set the correct limit for FSA contributions and distributes that information to new and current employees during annual enrollment.

Employer Mandate/Shared Responsibility

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

  • Plan design is expected to pay at least 60% of allowed charges (2015).
  • Employee share of single premium contribution must not exceed 9.5% of employee’s W-2 income (2015).

Transitional Relief:

  • Employers with 50 to 99 full-time or full-time equivalent employees: The requirement won’t be enforced until plan years with effective dates on or after January 1, 2016, if certain conditions are met.
  • Employers with 100 or more full-time or full-time equivalent employees: These employers will need to offer minimal essential coverage (MEC) to at least 70 percent of full-time employees in 2015 and at least 95 percent in 2016 and beyond for the penalty not to be triggered.

Penalty for noncompliance:  Employers that do not offer MEC to all full-time employees and eligible dependents face a tax penalty of $2,000 for each of their full-time employees, until they offer such coverage. This applies if one FT employee purchases a qualified health plan in an Exchange and receives a federal subsidy. This penalty is subject to an exemption for the first 30 full-time employees. Employers who offer coverage that is “unaffordable” or not of “minimum value,” will pay a penalty of $3,000 for each full-time employee who turns down employer coverage, purchases a qualified health plan in an Exchange and receives a federal subsidy.
Implementation: 2015
How we can help: Oasis plans cover at least 60% of the allowed charges. Oasis will consult with clients and provide tools for clients to determine affordability based on employee contribution.

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: TBD
How we can help: The Oasis payroll system will automatically enroll eligible employees in the lowest cost plan unless another election is made.

Waiting Period

Targeted Business Size: All
Key Provision: Plans may not impose a waiting period of more than 90 days (60 days in some states).
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 client. The Oasis plans will require a waiting period of no longer than the first of the month following 60 days (30 days in some states).

IRS Section 6055/6056 Annual Reporting

Targeted Business Size: Varies
Key Provision: (6055) – All employers that offer minimal essential coverage (MEC) must provide annual reporting. Additionally, a statement to each responsible individual, including information from the annual report, is required (2016 for 2015 tax year). (6056) – Large employers must provide annual reporting of health coverage. Additionally, a statement to each FT employee, including information from the annual report, is require (2016 for 2015 tax year).
Penalty for noncompliance: TBD
How we can help: Oasis will assist in this reporting for all clients participating in an Oasis-sponsored medical plan.

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The major benefit of partnering with Oasis is the availability of great benefit plans and their purchasing power that give our employees a lot more options then we would, if we were to do the benefits on our own.

Matt L. | Country Club Industry

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I think it’s actually very difficult to find anyone who understands the Healthcare Reform. And the confidence that we have that someone at Oasis and a team at Oasis are actually working on our behalf lets us focus on what we do best.

Matt L. | Country Club Industry

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The electronic onboarding is painless and walks you through the e-verification process easily.

Chris R. | Retail Industry

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The client portal is pretty intuitive and easy to use. I’ve had no issues entering payroll or making changes to employees’ information. The available reports are relevant and easy to tailor.

Chris R. | Retail Industry

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I have been able to focus more of my time on the business because Oasis has taken the burden of our payroll, complying with all the new laws, the new standards with the health insurance. Oasis deals with all of that. They take care of everything.

Doug F. | Hospitality Industry

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All of my questions have been dealt with in a very timely manner. I like having dedicated contacts. It allows me to form a working relationship with a couple of people, rather than calling a 1-800 number and being put in a queue for the next available representative.

Chris R. | Retail Industry

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When it comes to health benefits, all phone reps are licensed benefit specialists- they answer the phone quickly and have strong knowledge when it comes to employees setting up or making changes to their health benefits.

Suzie S. | Retail Industry

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I have only positives in regards to the 401(k) – they work quickly, are quite responsive and are always willing to conduct meetings as needed to keep employees informed & updated. Personally, I have benefited from the support in administering changes to my own 401(k).

Suzie S. | Retail Industry

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I have called on Oasis HR specialists a couple of times for advice on how to handle certain situations. They have done a good job of giving me practical answers. I have confidence in the advice I have received. The customer service level is excellent.

Chris R. | Retail Industry

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I am a fan of their website- the payroll process is simple and easy to customize, the reports are easy to find and download.

Suzie S. | Retail Industry

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Oasis is able to keep things real competitive when it comes to insurance and workers’ comp. Rates have been real reasonable over the years.

Owen L. | Printing Industry

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Another thing that makes Oasis stand out to me is that their invoice is straightforward and easy to understand. I feel like I have a better idea of where my payroll dollars are going.

Chris R. | Retail Industry

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In today’s world, especially, she stands out as a shining example of how to treat people and certainly clients. Service is every bit as important as product and she certainly offers gold star performance.

Mary B. | Environmental Manufacturing Industry

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Oasis staff, especially in the HR section has been real helpful and friendly. They take the time one-on-one, always have good answers and always help you and guide you in the right direction when it comes to complicated problems that might arise with some employees.

Owen L. | Printing Industry

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The relationship with our HR specialist is very beneficial. She is always there to return a phone call, to bounce an idea off of and to give us advice on how to best handle a situation.

Matt L. | Country Club Industry

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We have taken advantage of the partnership with Oasis and their purchasing power to offer our employees great plans at very competitive rates.

Matt L. | Country Club Industry

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When I do need immediate support, my rep is very responsive, well-versed in HR matters and very professional, kind and easy to work with. She is always willing to come out to meet with me if needed and [she is] easy to get a hold of on her office & cell phone.

Suzie S. | Retail Industry

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[I find that] HR handles the legal issues, the benefits are priced better through Oasis, and payroll handles all of the taxes. With all of these areas being handled by Oasis, it frees up my time to focus on my business and puts my mind at ease knowing that experts are handling everything.

Brad L. | Retail Industry

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The services that are offered by Oasis are why I continue my relationship. Having someone else take care of the HR, workers’ compensation, health insurance and payroll takes the liability off of my shoulders.

Marjorie K. | Pharmaceutical Industry

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A relationship with Oasis includes the ease of having one contact for multiple things that go on into day-to-day operations.

Yvette S. | Medical Industry

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