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September 15, 2014

Top 10 employee questions about ACA

Questions abound about the Affordable Care Act (ACA) and inquiring minds want to know. The International Foundation of Employee Benefit Plans recently surveyed 600 employers to find out which questions employees ask most often.

Here’s a useful summary you can share with your group’s HR staff who field inquiries from their employees. It identifies the top 10 questions from employees—and basic answers that can help benefit professionals be prepared:

  1. How does a Health Insurance Exchange work? Most states, including Florida, use the federal Marketplace (, and other states have their own. It lets employees shop for plans that have the features and benefits they like best, and all employees can use it. Some employees may qualify for a subsidy, depending on a variety of factors.
  2. How does the ACA affect individual employees? It requires individuals to have health insurance or pay a penalty. If the employer offers insurance that satisfies the ACA’s requirements, employees don’t have to take any further action to be compliant.
  3. What are the cost implications for employees? It depends on the premiums and cost-sharing details of the plans available and their location.
  4. Is the employer going to drop existing coverage? That’s a decision each employer makes. If they do, employees will be able to purchase it on the exchange and may qualify for a subsidy.
  5. Will the ACA result in different benefits? To comply with the law’s requirements, most plans did make changes in benefits in 2014—or will be modifying plans in 2015. This is different for every employer, and HR professionals will need to be prepared with the reasons.
  6. How long can children stay on employees’ plans? The ACA requires that coverage must be available for dependent children until age 26. This requirement went into effect in 2010 and has not changed.
  7. When is the next open enrollment period for the federal Marketplace? It starts Nov. 15, 2014 and ends Feb.15, 2015.
  8. What about the required 30 hours per week needed to qualify for coverage next year? An employee’s hours determined by management and the HR department. If an employee doesn’t qualify for employer-offered health insurance, he or she can still obtain it through the exchange starting in November and may qualify for a federal subsidy to help pay the premiums.
  9. Are spousal and dependent coverage still available under the employer plan? Spousal coverage is not required, but companies have the option to offer it. Employers are required to offer coverage for dependent children until the age of 26. 
  10. What will be the impact of ACA on the company? Employees should consult with management for a consistent answer to this question. If you know for sure that no immediate drastic changes are being considered, it’s a good idea to share that with employees.

Employers that will no longer be providing workplace coverage can help their employees by recommending an agent to provide assistance or by referring the employee to for help finding an individual plan.

Source: HRMorning

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