The impact of the Patient Protection and Affordable Care Act (PPACA) on Employee Retirement Income Security Act (ERISA), and The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

            Your business is affected by PPACA, ERISA, and HIPAA compliance in ways you are probably not aware of or fully comprehend. It is important to understand that you, and your business, are likely in violation of these regulations.

In one-way or another you might be subject to costly penalties!

Patient Protection and Affordable Care Act (PPACA)

The Patient Protection and Affordable Care Act commonly referred to as Obamacare was established in March of 2010. The PPACA was designed to make healthcare more affordable, by compelling people to purchase health insurance or pay penalties. In other words, all U.S citizens are forced to purchase some form of health insurance or pay a penalty of either 2.5% of their annual family income or a max of $2,085 dollars, whichever is higher.

For employers, under the PPACA businesses with 50-100 employees are subject to penalization effective January 1, 2016. Businesses may be penalized for a multitude of reasons and face much higher penalties.

Learn More About the Penalties

Employee Retirement Income Security Act (ERISA)

The Department of Labor (DOL) created the Employee Retirement Income Security Act in 1974 to address the public’s concern regarding the fraudulent use of private pension plans.  Over the last 40 years ERISA’s responsibilities have broadened, focusing on the protection of retirement and healthcare essentials for employees and their families. The overlapping interests of ERISA and the Affordable Care Act have triggered the issuance of more audits from the DOL than ever before.

According to the DOL, 3 out of ever 4 plans are non-compliant under ERISA law, and 70% of these non-compliant plans are subject to monetary fines issued to the employer.

DOL Fines & Penalties 1999-2014

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was established to protect working Americans with medical ailments by safeguarding the privacy of their medical histories. HIPAA ensures that people with per-existing medical conditions cannot be denied insurance if they switch to a new job based on their medical history. Since PPACA also abolishes any discrimination towards a person with a per-existing medical condition the number of HIPAA audits has simultaneously been increasing.

Obamacare has flipped the healthcare industry upside down. Your opinion on whether or not the Affordable Care Act is good or not is your own. Regardless, everyone is going to be effected by these newly enforced regulations. The importance of being aware of these changes is immense, and the Department of Labor has made it clear that they will send audit letters to as many businesses as possible. If you have questions about PPACA, ERISA, or HIPAA contact Skyline Risk Management, Inc. at (718) 267-6600 to discuss your concerns.