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Searching for Articles by Mary Ellen Schill
Mary Ellen Schill
Attorney
Wausau Office
.
Found 28 Results.

No Backup Plan Needed, Exchanges Will be Ready by October 1 Says HHS Secretary

Posted on April 15, 2013, Authored by Mary Ellen Schill, Filed under Employment

Last week I had the pleasure of talking Affordable Choice Act with human resource and benefits professionals in Madison and Wausau. From some of the questions I was fielding it was clear that there were some out there who doubted whether the federally facilitated exchanges will be operational by October 1, as required by the ACA. Wisconsin is one of 33 states where the federal government is operating all or part of the exchange (now referred to as the Marketplace). During our discussions I speculated that the decision to postpone implementation of the Marketplace would probably be made sooner rather than later, as I didn't think a decision later in the year (even if it delayed the Marketplace) would be helpful to anyone. I'm sure it was just a coincidence, but last Friday Kathleen Sibelius, HHS secretary, told the House Ways and Means Committee that the federal exchanges will be ready and open for business by October 1. She also stated that there was no need for HHS to have a backup plan, because the October 1 deadline will be met. From my experience the Marketplace is getting more and more interest from employers with less than 100 employees. Since the passage of the ACA most of the discussion of the Marketplace has revolved around individual use. Recent guidance on the Small Business Health Options Program (SHOP) (see my earlier blog post) has made businesses and their advisors more aware of the ability of employers to take their full-time employees and SHOP the Marketplace.

Waiting For The Affordable Care Act Marketplace To Open

Posted on July 25, 2013, Authored by Mary Ellen Schill, Filed under Employment

Late last month I returned to the scene of an earlier crime (October 2012) and once again met with employer-members of the Eau Claire Area Chamber of Commerce to talk about the Affordable Care Act and the October 1 opening of the Marketplace (formerly known as the Exchange). I think it is safe to say that both me and my audience had grown a little older and a little wiser since my last presentation. The issuance of a few hundred pages of regulations definitely has an effect on a health care reform advisor. This presentation pre-dated the announcement of the delay of the employer pay or play mandate, so as with everything lately related to health care reform, the shelf life of this presentation is a little bit shorter than the new Twinkies. The grand opening of the Marketplace however hasn't been delayed, so still some takeaways to be had.

Sorting Out the Federal Health Insurance Marketplace - Forum Provides Answers (and More Questions!)

Posted on June 17, 2013, Authored by Mary Ellen Schill, Filed under Employment

On Thursday evening June 13, I had the pleasure of participating in a public forum sponsored by the Wisconsin Institute for Public Policy and Service entitled, "Preparing for the Federal Health Insurance Marketplace: A View from Wisconsin." As one of three panelists, I was asked to talk about how employers large and small are preparing for the Marketplace (also known as the Exchanges). I found the composition of the audience to be varied, young and old, business owners, employees, and retirees. It seems that everyone has a lot of questions about the Marketplace, and those of us on the panel did what we could to answer those questions. As attorneys oftentimes we feel as though "we'll have to wait and see" isn't necessarily a helpful response to a client's question, but in the case of the Marketplace there really are still a lot of unknowns.

One-Year Delay for Pay or Play Does Not Affect October 1 Opening of the Marketplace (Maybe)!

Posted on July 22, 2013, Authored by Mary Ellen Schill, Filed under Employment

The Obama Administration's announcement of the one year delay for the employer shared responsibility requirements (the "pay or play" mandate) did not directly impact the October 1 opening of the health insurance exchanges (now known as the Marketplace). Last month I had the opportunity to sit on a panel at a public forum here in Wausau which discussed the Marketplace. The Wausau Daily Herald published an article about the forum, and an op-ed. Employers with less than 100 full-time equivalents in Wisconsin, while not subject to the pay or play mandate in 2014, might still decide to take their employees to the Marketplace in 2014, not to avoid a penalty, but rather to identify the extent to which employees are interested in what the Marketplace has to offer.

Treasury Department Postpones ACA Employer Mandate To 2015

Posted on July 2, 2013, Authored by Mary Ellen Schill, Filed under Employment

The Treasury Department announced late Tuesday afternoon that it was delaying until 2015 the employer "shared responsibility" mandate, the Affordable Care Act mandate for large employers, until 2015. This means that employers with more than 50 full time equivalents will NOT be subject to penalties in 2014 for failing to offer coverage, or failing to offer affordable coverage, to full time employees. So far, it is still anticipated that the Exchanges (now known as the Marketplace) will be up and running in 2014. Also, individuals will still be eligible for premium tax credits for purchasing coverage through the Marketplace. So, employers will now have additional time to determine whether they are subject to the shared responsibility mandate, and if so, how to comply. I think most of us thought any delay with respect to 2014 would be in implementation of the Marketplace, but instead it is a delay in the employer mandate that came to fruition. The Treasury expects to issue some more detail about this delay within the next week.

How the DOMA Decision Affects Employee Benefit Plan Sponsors

Posted on June 26, 2013, Authored by Mary Ellen Schill, Filed under Employment

This morning, in a 5-4 decision, the United States Supreme Court ruled in United States v. Windsor that the federal Defense of Marriage Act (DOMA) is unconstitutional. On equal protection grounds, the Court held that if a state has recognized same sex marriages, then the federal government must honor those marriages with respect to federal benefits such as social security. The impact on benefit plan sponsors might not be immediately apparent, because many may be of the belief that for federal tax and benefit purposes, the federal statute defines who a spouse is. However, both the federal tax code and Social Security laws have long provided that for purposes of those federal benefits, whether an individual is a "spouse" depends on state law. This is why DOMA was so significant upon enactment, it in effect said that notwithstanding how a state decides to define marriage, the federal government was not going to recognize any state's marriage law to the extent it legalized same sex marriage for purposes of any federal benefits. Today's decision does not require states to recognize same sex marriages. But what it does say is that if a state does decide to recognize them, then the federal government must consider those marriages to be valid for purposes of all federal laws and benefits for which the definition of spouse is a creature of state law. Social Security benefits are a prime example. Federal tax laws are another. Even ERISA is implicated. Qualified retirement plans are required under ERISA to provide spousal protections which would now be available to same sex spouses in states where same sex marriage is recognized. For example, if a 401(k) plan participant is legally married to a same sex spouse under the state law where the employee resides, then the spouse has the right to be the beneficiary of the employee's account unless the spouse consents to another beneficiary designation. Health coverage provided to a same sex spouse would also be nontaxable (again, only if the couple resides in a state which recognizes their marriage). Wisconsin does not recognize same sex marriage. Today's decision does not require it to do so. But Wisconsin employers still must consider whether they have employees who are legally married to same sex spouses where the marriage must now be recognized for purposes of employee benefit plans.

An Accommodation to Religious Accommodation

Posted on February 1, 2013, Authored by Mary Ellen Schill, Filed under Employment

Today the various federal agencies responsible for providing guidance on the Affordable Care Act issued proposed rules which just might satisfy the objections of religious employers to ACA's contraception mandate. It seems like every day another lawsuit is filed objecting to ACA's requirement that contraceptives be included in the list of preventative health services which must be covered first dollar (no co-pay or deductible). That requirement is effective now, but religious organizations were given a one year reprieve due to complaints that the mandate interfered with the free exercise of religion. The proposed rule issued today is supposed to ensure that eligible "religious organizations" (think churches) and "nonprofit religious organizations" (a nonprofit which holds itself out as a "religious" entity) would not be forced to "contract, arrange, pay or refer for any contraceptive coverage to which they object on religious grounds." So how will that be done, while still providing access to contraceptive coverage first dollar to women who work for these institutions? Well, by forcing insurers of group health plans to provide separate, individual market contraceptive coverage at no cost for plan participants. In effect, the contraceptive coverage will be broken off from the group insurance policy and provided under a separate, stand along individual policy which is "free" and doesn't involve the religious employer's involvement. For self-funded group health plans, the TPA is supposed to work with a health insurer to obtain this insured contraceptive coverage. Will this work? I guess if this rather technical work around satisfies the objecting religious organizations that they won't be providing or paying for contraceptive coverage (since it will be free and under an individual policy), then maybe it will. But if the real basis for the objection is that the employees have access to contraceptive coverage (no matter who pays for it), then presumably some organizations will see this "accommodation" as anything but.

Small Businesses can SHOP for Health Coverage Starting in 2014

Posted on March 11, 2013, Authored by Mary Ellen Schill, Filed under Employment

When I take my Affordable Care Act show on the road, usually my audience consists of human resources and benefits professionals who are looking for information they can take back to their workplace and the business owners. Last week I had the opportunity to meet with business owners directly when I gave a presentation on ACA to members of the Main Street Wausau business community. Almost all of the businesses represented have less than 50 full-time equivalent employees (FTEs), so they weren't there to listen to me ramble on about the pay or play mandate in 2014. What they did want to hear about (or maybe what I decided to talk about!) was what the marketplace for health coverage would look like in 2014 for a small business. Thankfully, I was able to talk about opportunities in 2014, rather than just obligations. The opportunities come from ACA's creation of the Small Business Health Options Program (or SHOP). For Wisconsin employers, SHOP will be part of the federally facilitated insurance exchange which will be up and running in 2014. Small employers (less than 100 FTEs) looking for health coverage for their employees can go to SHOP and do just that, shop. Employers can shop for a tier of coverage (from basic tier bronze to highest tier platinum) from which their full-time employees will be able to pick qualified health plans. Employees can then shop among the various qualified health plans offered within the tier selected by the employer. Unlike the current marketplace, the SHOP part of the exchange will allow small employers to bring to the health insurance market their full-time employees, but with more choices for those employees (a selection of many qualified health plans within the coverage tier), and without the sting of premiums being determined by the health status of only the employer's small group. Instead, premiums will be determined on a modified community-wide basis. Small employers are not required to contribute towards coverage through the SHOP, but they can do so if they desire. One nice feature of the SHOP (starting in 2015) is that the SHOP will aggregate all of the premiums required for the coverages selected by the employees, and then send one statement to the employer. The SHOP will also determine whether the employees are entitled to premium subsidies and offset those subsidies before sending the statement to the employer. So, even if your employees select coverage under different qualified group health plans and/or have premium credits coming from ACA, the SHOP will handle the financial accounting and send just one statement to the employer. As is often the case, the first year of the SHOP implementation (2014) means a slightly slimmed down version of the full program. For example, employers do not have to make available all qualified health plans within a coverage tier to their employees, instead they can select just one qualified health plan for 2014. Also, the premium aggregation feature (the SHOP aggregates all premiums due and sends the employer one statement) will not be offered until 2015. I can see the SHOP providing more opportunities to smaller employers including non-profits to actually offer group health plan coverage, without the small size of the employers workforce having such a big impact on the premiums.

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