Apothegm Software
New ACA Employer Mandate Regulation’s Challenges Met by Powerful Pay or Play Modeling Tool

New ACA Employer Mandate Regulation’s Challenges Met by Powerful Pay or Play Modeling Tool

Danville, CA, February 24, 2014 – It’s a new year and we’ve seen the 2014 implementations for ACA including the start to the state and federal health exchanges. We’ve now also experienced an additional delay and regulatory modification to the ACA Shared Responsibility, or Employer Mandate. Also referred to as ‘Pay or Play’, the regulatory updates are summarized as follows:

• Employers with less than 50 FTEs are still not required to participate in the shared responsibility.

• Employers with 50 to 99 FTEs are now further delayed from incurring penalties until January 1, 2016.

• Employers with 100 or more FTEs, while still required to comply with ‘Pay or Play’ regulations by January 1, 2015 now have a reprieve when complying with the participation requirements of the law:

  • In 2015, a qualified plan need only be offered to 70% of full-time employees. The full requirement for 95% offering is not effective until January 1, 2016. It is believed that this will help lessen the burden of offering coverage based on the 30 hour a week rule and allow employers an additional year to determine how to handle what had previously been considered part-time and ineligible employees.

• Affordability will be determined by comparing an employee’s wages and their contribution for employee only coverage in 2015. In 2016, this comparison will expand to include dependent coverage.

Danville, California based health plan system developer Apothegm Software (www.apothegmsoftware.com ) announced today that their PoP Navigator™ application that empowers large employers to understand and manage many of the potential impacts of ACA has already been updated to evaluate ACA under these new regulatory guidelines. Bolstering their position as the most flexible and comprehensive ACA Employer Mandate, also known as ‘Pay or Play’, tool on the market, Apothegm also notified current customers that they can now see their previously created scenarios and receive an updated assessment. PoP Navigator™ stores customer’s work and allows them to apply new and updated logic as it is made available at the push of a button. Apothegm has assessed the new regulations and implemented a solution for users of PoP Navigator™ in just 14 days.

PoP Navigator™ offers a wide range of functionality beginning with a financial assessment of each employee and health coverage offered by an employer. PoP Navigator™ forecasts health plan affordability, sufficiency, employee migration, and potential penalty risks using a robust actuarial evaluation tool. It also includes analysis of exchange subsidy and expanded Medicaid qualification for employees, considerations for grandfathered plans, and calculation of any expected excise, or ‘Cadillac’, tax.

PoP Navigator™’s actuarial engine includes features such as rate and contribution forecasting, alternate benefit design modeling, and estimated actuarial plan value. Users can easily target any ‘Metal level’ plan value and view its impacts to premium, employer cost, penalties, and incremental corporate income taxes. Packaged with a library of reports, PoP Navigator™ provides detailed analysis and executive summary information for each year from the present plan year through 2018 needed to navigate ACA and make critical business decisions. Reports include legislative background as well as a tutorial of the decisions and processes PoP Navigator™ uses to arrive at its results.

Further information regarding PoP Navigator™ , its features, sample reports, and purchasing a subscription may be obtained by visiting Apothegm’s website or at www.shouldipayorplay.com.

Ryan de la Gente
(925) 627-6000


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