By Kari Stevens, Cigna®

Cigna is an ICMA Strategic Partner

It’s hard to believe it’s been six years since the Affordable Care Act (ACA) legislation was passed. Many provisions of the law have been implemented, several have been modified or delayed, and there’s still more to come.

Here are the health care reform topics that employers might be thinking about as they plan for 2017 and beyond:

Q: Which topics are Cigna’s teams focused on right now?

A: Two hot topics are the final wellness regulations and the 40 percent excise tax, also known as the Cadillac tax.

Q: Starting with wellness, what do employers need to know?

A: ACA wellness rules have been in place for several years, but new regulations under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) affecting wellness programs were published this year in May. The final ADA and GINA rules provide some important guidelines for employers, but there continue to be areas where they don’t align with the ACA.

The rules address program design, participation, incentives, reasonable alternatives and accommodations for employees unable to achieve the criteria for an incentive, reward timing and limits, and how medical and genetic information must be protected.

Compliance with one set of rules does not ensure compliance with all. Employers should work with legal counsel to ensure compliance overall.

Q: What are the basics of the 40 percent excise tax?

A: Beginning in 2020, employers will pay a 40 percent excise tax on employer-sponsored medical plans if the cost of coverage exceeds certain thresholds. This is known as the Cadillac tax because it was originally expected to affect only a small number of very rich plans. Over time, it has become clear that the tax may impact many more plans.

Q: How should employers prepare for the 40 percent excise tax?

A: The effective date was delayed from 2018 to 2020, which gives employers extra time to develop a strategy to reduce the cost of their health plans to eliminate or reduce the impact of this tax. Employers with unions should be particularly mindful of this delay for their negotiations.

Q: Should the 40 percent excise tax be repealed?

A: The 40 percent excise tax is highly controversial. Many groups have opposed it based on concerns about the financial burden to employers, open issues about how to calculate and administer the tax, and the potential for adverse outcomes for employees.

Cigna is a founding member of the Alliance to Fight the 40 (www.fightthe40.com), which is a group of employers, insurers, brokers, and other stakeholders working to repeal or significantly modify the tax.

We welcome others to join us in this effort and in the meantime, encourage employers to prepare and assess their benefit plan strategies.

Q: As employers plan for 2017 and beyond, what are the most important considerations?

A: Start with a strategic benefits plan that addresses both short- and long-term needs. From there, take a proactive approach toward ACA compliance, along with other federal and state regulations.

And remember, under ACA, employers have several ongoing responsibilities. From the employer mandate to annual reporting requirements to providing a summary of benefits and coverage (SBC), it’s important to remain compliant while staying on top of new developments.

Q: What is the current political environment’s potential impact on health care reform?

A: There continues to be a highly charged environment around health care reform and the ACA across all branches of government. We continue to see court challenges on different aspects of the law; proposed legislation to repeal, modify, or clarify aspects of the law in Congress; and a lot of activity coming from such various federal regulating bodies as the IRS, DOL, and HHS.

We also know that ACA, and health care generally, is a significant issue among the majority of voters.

So, while the impact of the current political environment on health care reform is not entirely certain, one thing that is certain is that ACA has transformed the way health care is purchased, consumed, and delivered in our country.

No matter what the outcome of the 2016 elections, it is safe to say this issue will continue to evolve and be a hot topic for many years to come.

Q: How can employers stay up-to-date on health care reform?

A: There are many great resources, but we are especially proud of Cigna’s website at www.InformedonReform.com. It includes news alerts, fact sheets, podcasts, answers to frequently asked questions, and much more.