If you the consumer feel confused and overwhelmed by provisions of the Patient Protection and Affordable Care Act, imagine what business owners are going through.
They have to understand their rights and responsibilities, and what will happen if in exercising the former they shirk the latter.
We’ll start with the seemingly easy stuff: Determining a full-time employee in order to determine who is eligible for coverage.
How would you define “full-time employee”? If you do it in less than 25 words and make it understandable to a fifth grader, you’ll never work for the government.
The IRS uses terms such as “safe harbor,” “ongoing employee,” “standard measurement period,” and “stability period.” I don’t know what any of it means, either.
On to a semi-related topic, apparently PPACA calls for a “transitional reinsurance program” in each state to “help stabilize premiums for coverage in the individual market” from 2014 to 2016.
This is to offset the effect of high-cost individuals who now will be more likely to have insurance. This affects self-funded plans and all health insurers and third-party administrators have to pony up. There will be a formula based on a national contribution rate multiplied the number of people covered under a plan.
So this sounds as though in addition to covering its own people, a self-funded plan also chips in to cover potential high-cost individuals shopping the exchange. One estimate put the cost at $60 per covered person in the first year.
What happens if a self-funded plan decides to scrap its coverage? Don’t know.
Seriously, why are we going through these machinations on the way from our current health insurance system to a single-payer format? Granted, that’s not a perfect system, either. But why are we making health insurance, which should be provided at a basic level to each citizen, more complicated than putting a man on the moon?
Then again, it’s taken us 100 years to get to this mess and we needed only a decade to reach the Sea of Tranquility.