Phoenix Attorneys Advise on Healthcare Management for Businesses

Guidance on compliance for companies affected by the ACA

The Patient Protection and Affordable Care Act (ACA) was enacted in 2010 with three primary goals: to make affordable health insurance available to more people, to expand the Medicaid program and to support innovations designed to lower healthcare costs. Unfortunately, the ACA’s burdensome compliance requirements have raised the cost of doing business and can expose companies to liability if they are found out of compliance. At the Law Offices of Donald W. Hudspeth P.C. in Phoenix, Arizona, we understand the anxiety of business leaders who want to act within the law but are in uncharted territory when it comes to ACA requirements. We offer comprehensive advice on policies and practices to ensure that your employees are served, and your business is minimally impacted.

Helping your company manage compliance with regulations

The ACA covers applicable large employers (ALEs), namely those that had 50 or more full-time and full-time equivalent (FTE) employees on average during the previous year. Whether a business fits the legal definition of an ALE is not always clear-cut. You might not be aware that some workers qualify as FTEs. You might also operate with several federal employer identification numbers (FEINs) and not realize that the law requires you to take the total number of employees under all your FEINs.

If you are covered by the ACA, there are four requirements for compliance:

• Determining employee eligibility — ACA requires that ALEs provide health insurance for at least 95 percent of their full-time employees, as well as for their dependents. A full-time employee is any worker who works 30 hours or more per week on average, or 130 or more hours per month.
• Confirming affordability — An employer-sponsored health plan must provide a certain level of benefits and cannot cost workers more than a certain percentage of their household income. Employers do not necessarily know the total household income of their workers, so this calculation can be complicated.
• Reporting data — Employers must file Form 1095-C with the IRS and issue copies to all affected workers. Form 1095-C includes information about the coverage offered, the lowest premium available to each employee and the period of coverage. Employers also must file Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, with the IRS. There may be additional state reporting requirements.
• Responding to penalty notices — If the IRS suspects an ALE is out of compliance, it issues a penalty notice, and the company usually has 30 to 45 days to respond.

Companies may be subject to other requirements, such as HIPAA’s regulations covering medical privacy. This is a complex area of the law, especially for owners of businesses that have recently expanded and are newly facing ACA requirements. Our healthcare business lawyers provide the guidance you need to master compliance.

Legal compliance and risk mitigation

Falling out of compliance with ACA and other regulations can cause unnecessary and unwelcome complications for your business and drain the resources you need to fund operations and meet your business goals. You can rely on our in-depth understanding of local, state and federal regulations related to healthcare. We can identify areas of risk where noncompliance is likely to occur and help steer you clear of potential liability. 

Knowledgeable guidance on healthcare policy development

Savvy employers realize that solid healthcare policies help them retain talented workers. Our attorneys have been instrumental in crafting comprehensive healthcare policies tailored to the needs of our business clients.

Contact a pragmatic Phoenix law firm for answers on healthcare compliance

The Law Offices of Donald W. Hudspeth P.C.in Phoenix, Arizona offers practical advice on complying with the Affordable Care Act and other healthcare regulations. We eliminate the confusion that often comes from complex legislation and help employers adopt consistent protocols that mitigate risk. Call our firm today at 866-696-2033 or contact us online.