Employer Services Advisory: State and Local Mandates After ACA - San Francisco
November 25, 2013 - McKenna Long & Aldridge LLP
With all of the focus on the federal Affordable Care Act (gACAh), many
employers are wondering if they still need to comply with state and local health
plan mandates. There is nothing in ACA that repealed state or local
mandates. The fate of those mandates is up to the applicable state or local
government. Below is an update on the San Francisco mandates.
San Franciscofs Health Care Security Ordinance
(gSFHCSOh) continues to require medium and large-sized employers to
spend a minimum amount of money on health care for their employees who work in
San Francisco. If you have San Francisco employees, the SFHCSO provides that you
may elect to satisfy this obligation by purchasing health insurance coverage,
making payments to San Francisco for the benefit of your covered employees,
reimbursing your employees for their health care expenditures, or providing a
medical spending account for your employees that meets certain
requirements. Recent guidance under ACA, however, suggests that some of
these methods for satisfying the SFHCSO, such as reimbursement or direct payment
of employee individual health insurance coverage and stand-alone health
reimbursement accounts (gHRAsh), will violate ACA in 2014 and later
years. (See ACA guidance here
and here). San
Francisco has issued an FAQ acknowledging that the use of stand-alone HRAs may
violate ACA and promising future guidance on the interplay between ACA and
SFHCSO. (See FAQ here). If you are
currently using a reimbursement arrangement or directly paying for individual
policies, you should consult with legal counsel to make sure your arrangement
does not violate ACA.
In addition, you should note the following changes
to the minimum amount you must spend to satisfy the SFHCSO during 2014:
- Employers with more than 100 employees must spend at least $2.44 per hour
on health care for their employees (an increase from $2.33 per hour in
2013).
- Employers with 20 to 99 employees must spend $1.63 per hour on health care
for their employees (an increase from $1.55 per hour in 2013).
- Small employers with less than 20 employees and non-profit organizations
with less than 50 employees remain exempt from this requirement.
In determining your employer size and expenditure rates, you must count all
employees, regardless of where they live, where they work, or how they are
classified (i.e., part-time, seasonal, permanent, etc.). Employees covered
by the SFHCSO generally include any employee (independent contractors are
not covered) who is entitled to payment from you of a minimum wage under
ordinances of San Francisco, has been employed by you for 90 calendar days
after first beginning work (including periods of leave), and performs at least 8
hours of work per week for you within the geographic boundaries of San
Francisco.
If you are subject to the SFHSCO, you must report your
health care expenditures to San Francisco on an annual basis on the SFHCSO
Mandatory Annual Reporting Form. This form continues to be due by April
30th following the end of each calendar year.
With a team of attorneys who are highly experienced in the employee
benefits field, MLA can provide answers to questions and assistance in
complying with these federal, state and local law requirements.