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The Trump Administration is doing the unexpected and considering a special ACA enrollment period in light of the COVID-19 Pandemic.
The special enrollment period will provide uninsured Americans the opportunity to enroll in coverage through the federal health exchange for a predetermined amount of time.
Prior to the declaration of a national emergency in response to COVID-19, there were roughly 30 million uninsured but with the Pandemic disrupting daily business operations, individuals are losing their coverage. Subsequently, the number of uninsured will continue to rise, unless special enrollment periods are executed.
According to an article by HuffPost, American’s Health Insurance Plans and the Blue Cross Blue Shield Association urged lawmakers to include insurance plan subsidies in the coronavirus stimulus packages. “Given the risk posed by COVID-19, it is more important than ever for people to have health coverage,” they added.
The Trump Administration will need to act quickly in order to make health coverage available during this critical time and perhaps reconsider its position on the constitutionality of the ACA.
California’s health insurance marketplace,Covered California introduced a special enrollment period as a result of the statewide Individual Mandate penalty that went into effect earlier this year. The exchange recently extended the special enrollment through June 30 in response to the COVID-19.
Covered California executive director, Peter Lee stated “There’s no economic or public health rationale to not open the doors wide in the face of the pandemic,” according to an article by the New York Times.
California joins Colorado, Connecticut, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont, Washington and the District of Columbia in allowing the uninsured and recently laid-off workers the opportunity to obtain health coverage.
These states operate under their own statewide health exchange and now the federal government will need to play catchup and allow the remaining states the opportunity to offer coverage to their uninsured.
Employers should note that with extended open enrollment periods coming into play, the likelihood of your employees receiving a Premium Tax Credit (PTC) is greater than ever. As a reminder, a PTC is a trigger to the IRS for initiating ACA non-compliance penalties, such as Letter 226J.
If your organization is not complying with the ACA’s Employer Mandate, you may be subject to significant IRS penalties under IRC section 4980H. The IRS is currently issuing penalties under section 4980H for the 2017 tax year through Letter 226J.
As a reminder to employers in conjunction with the Employer Shared Responsibility Payment (ESRP), the ACA’s Employer Mandate, Applicable Large Employers (ALEs) organizations with 50 or more full-time employees and full-time equivalent employees) are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is Affordable for the employee or be subject to Internal Revenue Code (IRC) Section 4980H penalties.
We’re committed to helping companies reduce risk, avoid penalties, and achieve 100% ACA compliance. For questions about the ACA contact us here.