Selected ACA and Higher Education Issues Council on Government Relations Steven M. Bloom October 22, 2015.

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Presentation transcript:

Selected ACA and Higher Education Issues Council on Government Relations Steven M. Bloom October 22, 2015

Overview Student Health Insurance Plans (SHIPs) ACA, Employer Mandate, and Student Employment ACA and Graduate Student SHIP Coverage 2

Student Health Insurance Plans (SHIPs) – Overview Schools are not required to provide SHIPs under the ACA because students are not employees. Under HHS regs, SHIPs defined as a type of Individual health insurance coverage, subject to ACA’s individual insurance reforms. Not sold on individual market. Other than self-funded schools, plans provided by a school through a health insurance company. Only available to enrolled students and their dependents, with schools permitted to define eligible student/dependents. 3

SHIPs Overview - Continued SHIPs will be considered minimum essential coverage (MEC) for individual mandate if they meet regulatory requirements: No pre-existing conditions discrimination or dropping coverage if a student (or dependent) gets sick. No life-time and annual limits on essential health benefits. SHIPs exempt from guaranteed renewability and availability requirements. Must provide specified essential health benefits, preventative care, broad prescription drug coverage, and in general, contraceptive coverage. 4

ACA, Employer Mandate, and Student Employment Employer Mandate Larger employees (100 +) – 70% employees by Jan. 1, 2015, 95% by Jan. 1, 2016 Smaller employees (50-99) - Jan. 1, 2016 Definition of Full Time Employee – 30 or more hours Adjuncts Treasury Formula = 1 x 1.25 e.g. 9 credits Student Workers Work Study and FLSA Activity Based Approach Undergrads and Graduate Students Hours tracking and potential alternative proposals 5

ACA and Graduate Student SHIP Subsidies Graduate Student SHIP subsidies Often provided as part of graduate package or related to activity e.g. teaching, research, graduate assistant IRS Notice 2013 – To prevent end run around employer mandate – Became aware could interfere with Grad Student SHIP subsidies. Discussions with regulators Issues: Fringe benefit or scholarship/grant Form of taxable income? 6