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May	
  22,	
  2013	
  
Addie	
  Prewi)	
  
Legal Update
2	
  
Do I Pay or Play?	

•  To play, offer minimum essential coverage to
substantially all full-time employees.	

•  Must pay if:	

1.  Don’t offer coverage – pay $2,000 annually per
full-time employee over 30 full-time employees.	

2.  Offer unaffordable coverage or coverage that
lacks minimum value – pay $3,000 annually per
full-time subsidized employee	

Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
3	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
When must I decide to pay or play?	

•  Penalties effective on January 1, 2014 unless
qualify for certain transitional relief for fiscal
years plans.
•  However, employers must know by October
1, 2013, whether they will pay or play in
order to issue required notices to all
employees regarding coverage options and
exchanges.
•  See https://www.dol.gov/ebsa/healthreform/index.html for
technical release and model notices.
•  Employee that works more than 30 hours
per week or 130 hours per month is a full-
time employee	

•  Part-time/full-time equivalent employees
irrelevant for calculating penalty; ONLY used
to determine if an applicable large employer	

4	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
Who is full-time for penalty?
•  Actual hours worked	

•  Safe-harbor measurement period	

o  Measurement or look-back period – measure
(on average) whether employees are full-time
or not
o  Administrative period – identify and enroll full-
time employees
o  Stability period – penalty may be due for
employees found to be full-time during
measurement period
5	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
What period used for full-time?
Measurement
Period	

Administrative
Period	

Stability
Period	

On-going
employees	

3 to 12 months	

 Up to 90 days	

 At least 6 months
but not shorter than
measurement period	

New employees
hired as full-time	

N/A	

 Up to 90 days to
enroll	

N/A	

	

New variable hour
and seasonal
employees	

3 to 12 months	

 Up to 90 days but
measurement and
admin period cannot
exceed 13 months	

3 to 12 months but
not longer than
measurement period	

6	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
What period used for full-time?
7	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
Transition relief in 2014	

•  For 2014, employers can use a transitional measurement period
that is shorter than the stability period for determining full-time
employees if the following requirements are met:
1.  The measurement period is at least 6, but less than 12 months,
2.  The measurement period begins on or before July 1, 2013, and
3.  The measurement period ends no sooner than 90 days before
the beginning of the employer’s 2014 plan year.
•  For fiscal year-plans, the transitional relief effectively delays the
first date on which the employer can be subject to a penalty to the
first day of the fiscal year plan in 2014.
Plan Year	

Transitional
measurement
period	

Administrativ
e period	

Stability
period	

Calendar year	

 April 15, 2013 –
Oct. 14, 2013	

Oct. 15, 2013 –
Dec. 31, 2013	

Jan. 1, 2014 – Dec.
31, 2014	

Calendar year	

 May 15, 2013 – Oct.
14, 2013	

Nov. 15, 2013 –
Dec. 31, 2014	

Jan. 1, 2014 – Dec.
31, 2014	

FY beginning April
1, 2014	

July 1, 2013 – Dec.
31, 2013	

Jan. 1, 2014 – March
31, 2014	

April 1, 2014 –
March 31, 2015	

FY beginning
July 1, 2014	

June 15, 2013 –
April 14, 2014	

April 15, 2014 –
June 30, 2014	

July 1, 2014 – July 1,
2015	

FY beginning Nov.
1, 2014	

Sept. 1, 2014 – Oct.
31, 2014	

Sept. 1, 2014 – Oct.
31, 2014	

Nov. 1, 2014 – Nov.
1, 2015	

8	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
Examples of 2014 transitional relief
9	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
Next steps for employers	

•  Work with the payroll department to ensure an appropriate
system is in place to track the numbers of hours for
determining and substantiating employee’s status as full-time
or less than full-time.
•  Consider the timelines to adopt for the first measurement
period, subsequent measurement periods for ongoing
employees, and initial measurement periods for variable or
seasonal employees.
10	
   Office:	
  225.381.0281	
  
Email:	
  addie.prewi:@taylorpoter.com	
  
Circular 230 disclosure and disclaimer	

Any tax advice contained in this communication is not intended
and cannot be used by any taxpayer to avoid penalties under the
Internal Revenue Code or Treasury Regulations.
This is provided for educational and informational purpose only
and should not be considered legal or accounting advice. You
should consult with legal counsel and accountants for their
interpretation of the applicable law, rules, regulations, guidance
and consideration of other relevant facts before acting on any
information contained herein.
Thank you
Addie	
  Prewi)	
  
Attorney, Taylor Porter
Tax  Health Care Practice Team
addie.prewitt@taylorporter.com
225.381.0281

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PPACA: Legal

  • 1. May  22,  2013   Addie  Prewi)   Legal Update
  • 2. 2   Do I Pay or Play? •  To play, offer minimum essential coverage to substantially all full-time employees. •  Must pay if: 1.  Don’t offer coverage – pay $2,000 annually per full-time employee over 30 full-time employees. 2.  Offer unaffordable coverage or coverage that lacks minimum value – pay $3,000 annually per full-time subsidized employee Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com  
  • 3. 3   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   When must I decide to pay or play? •  Penalties effective on January 1, 2014 unless qualify for certain transitional relief for fiscal years plans. •  However, employers must know by October 1, 2013, whether they will pay or play in order to issue required notices to all employees regarding coverage options and exchanges. •  See https://www.dol.gov/ebsa/healthreform/index.html for technical release and model notices.
  • 4. •  Employee that works more than 30 hours per week or 130 hours per month is a full- time employee •  Part-time/full-time equivalent employees irrelevant for calculating penalty; ONLY used to determine if an applicable large employer 4   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   Who is full-time for penalty?
  • 5. •  Actual hours worked •  Safe-harbor measurement period o  Measurement or look-back period – measure (on average) whether employees are full-time or not o  Administrative period – identify and enroll full- time employees o  Stability period – penalty may be due for employees found to be full-time during measurement period 5   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   What period used for full-time?
  • 6. Measurement Period Administrative Period Stability Period On-going employees 3 to 12 months Up to 90 days At least 6 months but not shorter than measurement period New employees hired as full-time N/A Up to 90 days to enroll N/A New variable hour and seasonal employees 3 to 12 months Up to 90 days but measurement and admin period cannot exceed 13 months 3 to 12 months but not longer than measurement period 6   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   What period used for full-time?
  • 7. 7   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   Transition relief in 2014 •  For 2014, employers can use a transitional measurement period that is shorter than the stability period for determining full-time employees if the following requirements are met: 1.  The measurement period is at least 6, but less than 12 months, 2.  The measurement period begins on or before July 1, 2013, and 3.  The measurement period ends no sooner than 90 days before the beginning of the employer’s 2014 plan year. •  For fiscal year-plans, the transitional relief effectively delays the first date on which the employer can be subject to a penalty to the first day of the fiscal year plan in 2014.
  • 8. Plan Year Transitional measurement period Administrativ e period Stability period Calendar year April 15, 2013 – Oct. 14, 2013 Oct. 15, 2013 – Dec. 31, 2013 Jan. 1, 2014 – Dec. 31, 2014 Calendar year May 15, 2013 – Oct. 14, 2013 Nov. 15, 2013 – Dec. 31, 2014 Jan. 1, 2014 – Dec. 31, 2014 FY beginning April 1, 2014 July 1, 2013 – Dec. 31, 2013 Jan. 1, 2014 – March 31, 2014 April 1, 2014 – March 31, 2015 FY beginning July 1, 2014 June 15, 2013 – April 14, 2014 April 15, 2014 – June 30, 2014 July 1, 2014 – July 1, 2015 FY beginning Nov. 1, 2014 Sept. 1, 2014 – Oct. 31, 2014 Sept. 1, 2014 – Oct. 31, 2014 Nov. 1, 2014 – Nov. 1, 2015 8   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   Examples of 2014 transitional relief
  • 9. 9   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   Next steps for employers •  Work with the payroll department to ensure an appropriate system is in place to track the numbers of hours for determining and substantiating employee’s status as full-time or less than full-time. •  Consider the timelines to adopt for the first measurement period, subsequent measurement periods for ongoing employees, and initial measurement periods for variable or seasonal employees.
  • 10. 10   Office:  225.381.0281   Email:  addie.prewi:@taylorpoter.com   Circular 230 disclosure and disclaimer Any tax advice contained in this communication is not intended and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code or Treasury Regulations. This is provided for educational and informational purpose only and should not be considered legal or accounting advice. You should consult with legal counsel and accountants for their interpretation of the applicable law, rules, regulations, guidance and consideration of other relevant facts before acting on any information contained herein.
  • 11. Thank you Addie  Prewi)   Attorney, Taylor Porter Tax Health Care Practice Team addie.prewitt@taylorporter.com 225.381.0281