Health care reform

Employer shared responsibility

Affordable Care Act (ACA) provisions require that Kansas businesses offer affordable, minimum value coverage to their full-time employees and their dependents. This is often referred to as employer shared responsibility or "Play or Pay.” Businesses with fewer than 50 employees are not affected by the employer mandate provisions.

Businesses with more than 50 full time employees

Must offer coverage to 95 percent of full time employees as of the first day of the plan year starting after Jan. 1, 2016.

Provision details and questions and answers

Comprehensive details about employer shared responsibility is available at the IRS website. You can also review our Employer Mandate brochure to see how the employer mandate may affect you.

Minimum Essential Coverage (MEC) and Applicable Large Employer (ALE) reporting requirements

You can find detailed information on the MEC and ALE reporting requirements at the IRS website.

Summary of Benefits and Coverage (SBC) and the Uniform Glossary

The SBC summarizes the key features of a health plan, such as the covered benefits, cost-sharing provisions and coverage limitations. SBCs include a standardized plan comparison tool called "coverage examples," similar to the familiar Nutrition Facts labels required for packaged goods.

The Uniform Glossary is a set of terms written in plain language that helps consumers understand some of the most common but confusing jargon used in health insurance.

For more information, review our SBC Brochure.

Notice of coverage

Kansas businesses have the responsibility to inform all current employees about the availability of the Health Insurance Marketplace.

Employers that offer medical coverage to some or all of their employees should provide the “Employee Notice of Coverage Options,” using this model notice (also en español).

The notice must be provided in writing and may be delivered electronically if ERISA standards for electronic delivery are met.

Comparative effectiveness research fee

Fully insured and self insured plans will be assessed $2 per participant to fund comparative effectiveness research. This research was established to assess the most effective treatments for certain conditions and to share that information with health care providers.

See how new fees and taxes affect premiums

Employee wellness discounts

Many Kansas employers provide incentives for their workers to remain healthy and/or prevent harmful health issues. Such incentives and rewards can’t exceed 30 percent of the total cost of an employee’s health benefits coverage.