If you've ever fought an unemployment claim, you know what not to do. You don't show up for the hearing with vague recollections and engage in he-said, she-said.
to win with Obamacare, do like Dr. Dre negotiating with Apple - beat them with content!
Instead, you do like Dr. Dre negotiating with Apple. You show up armed with content - emails, pay records, assignment refusal messages.
Winning in the Obamacare era will be no different. As we saw last week, preparing now will open up a once-in-a-decade opportunity to help you and your clients win. The opportunity is especially good because so many of your staffing competitors are ignoring the ACA or are at a complete loss as to how to react to it.
This week we look at how you or your clients might incur the draconian fines that Obamacare purports to assess and how to fight them. For those of you used to fighting unemployment, worker comp or EEOC claims, you'll feel quite at home.
It's again all about avoiding infractions in the first place and controlling the agenda when claims do arise. Those claims may come about either through a complaint that you are illegally withholding health insurance or it may happen via a government audit.
Either way, you'll want to be prepared. If you can quickly respond to inquiries and rapidly push back at an attack with hard data, you can mitigate your risk considerably.
Last week, we looked at alerts and reports for managing look-back, measurement, and administrative periods, and how they will be your primary tools in controlling the agenda when fighting claims.
Remember that government agents are people too, and just like business people they look for low hanging fruit. They operate with limited resources and know that no employer out there could possibly adhere to the entirety of employment law. So they look for the best targets.
Let's dig into these reporting tools and see how they work.
Lookback reports take into effect the 13-week break in service rule as well as the length of
inactivity versus previous assignment rule. You can analyze this data based on average
weekly hours during the period as well as total hours during the period.
These reports should include the option to group by customer to determine any customers with exceptionally high numbers of eligible employees. This analysis is particularly helpful in determining pass-through costs per customer.
By providing customers with the ability to put in any date range, these reports can be used to determine which Standard Measurement Period (SMP) and Initial Measurement Period (IMP) length will be most beneficial from a financial perspective.
Insurance Census Reports
These reports make it easy to interface with insurance carriers and provide necessary
information to receive a policy quote. You should allow these reports to interface with lookback reports to allow users to filter by active or inactive employees, as well as those who are currently on assignment.
Insurance providers are under a lot of stress to mitigate their risks, so you'll want to easily customize the format of reports they ask for and do it quickly.
Make it easy for them. Give them data exports with employee mailing addresses to
assist with pre-filling initial enrollment forms and creating mailing labels.
Financial Exposure “Pay or Play” Reports
Keep a grip on your financial exposure at every turn. You can use the lookback period rules to enter a monthly insurance premium. With this you can calculate the cost to pay the per employee penalty or offer insurance based on any lookback period you've selected.
Remember that managing this will be complicated for nearly everyone first dealing with compliance. Your exposure reports should not only use the $2,000 penalty and factor in the tax repercussions, but keep things simple (for example, by tracking company totals as well).
Compliance Determination Report
Of course, you'll want to verify if you or your clients are subject to the ACA in the first place. Keep accurate track of the total number of full time employees along with Full Time Equivalents (FTEs) to determine your status.
We looked here at how reports can serve as your primary tools for avoiding and defending against Obamacare claims. In your next post, we'll look at specific tools staffing companies can use to efficiently pass Obamacare costs to end-clients. We'll develop a notion pioneered by TempWorks Software of passing on the cost as 'ACA Excise Tax'.