The Affordable Care Act 2023 (ACA) made a number of significant reforms to group health plan coverage when it was enacted in 2010. Since then, changes have been made to various ACA requirements that employers should be aware of. These changes include annual cost-of-living increases to certain ACA dollar limits, extensions to ACA reporting deadlines and updates to preventive care coverage guidelines.
Changes to some ACA requirements will take effect in 2023 for employers sponsoring group health plans. To prepare for 2023,employers should review these requirements and develop a compliance strategy. Employers should ensure that their healthplan documents, including the summary of benefits and coverage (SBC), are updated to reflect any new plan limits and thatup-to-date information is communicated to employees at open enrollment time.
This ACA Overview provides an ACA compliance checklist for 2023. Please contact Benefit Analysts, Inc. for assistance or if youhave questions about changes that were required in previous years.
On Oct. 13, 2022, the U.S. Social Security Administration announced that Social Security beneficiaries can expect an 8.7% increase in benefits next year. This increase surpasses the 5.9% cost-of-living adjustment (COLA) in 2022, which, at the time, was the highest in four decades. On average, Social Security benefits will increase by more than $140 per month for beneficiaries beginning in January. This change is based on the Consumer Price Index for Urban Wage Earners and Clerical Workers.
On Oct. 11, 2022, the IRS released a final rule that changes the eligibility rules for the premium tax credit (PTC). The PTC is available to eligible individuals who purchase health insurance coverage through the Exchange. Individuals are not eligible for the PTC if they have access to employer-sponsored health coverage that is affordable and provides minimum value. 
In general, under the pay or play provisions an applicable large employer (ALE) evaluating affordability and minimum value options may either offer affordable minimum essential coverage that provides minimum value to its full-time employees (and their dependents) or potentially owe a penalty payment to the IRS. For this purpose, a dependent is an employee’s child (including a child who has been legally adopted or placed for adoption) and who has not reached the age of 26. Spouses are not considered dependents and neither are stepchildren or foster children.
