ACA Cadillac Tax Delay Didn’t Stop Employer Strategies

Anticipating the Cadillac tax, now set to go into effect in 2020, and higher costs for health care, plan sponsors are continuing to make changes to health benefits offerings.

Despite already modifying their benefit plans last year, employers expect their health care costs to rise again in 2016, which will require additional changes, according to the Employee Benefits Trend Study released by Wells Fargo Insurance, part of Wells Fargo & Co.

Fifty eight percent of employers surveyed expect their medical plan costs to exceed the thresholds for the Affordable Care Act (ACA) excise tax, or “Cadillac” tax, which was originally to take effect in 2018, but has been delayed until 2020. Additionally, 70% of employers expect their budgets for benefit plans to increase, as human capital and health and productivity remain key issues for businesses to manage.

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Half of the employers in the study said they will continue to make changes to their plans either this year or in 2017 by adding a high deductible plan option (52%), increasing the employee contribution percentage (56%), or increasing co-insurance features (55%). Employers are also making strategic changes to plans that address not only the physical well-being of their employees, but also chronic condition management and mental, financial, and social well-being.

For example, as more employers offer high deductible health plans, the C-suite is also aware of the financial exposure that employees face with these types of plans. As a result, they are looking to mitigate those costs by offering voluntary benefits solutions (e.g. critical illness and accident insurance). In addition, employers of all sizes are seeking ways to encourage a healthier and more productive workforce. Fifty one percent of companies expect to increase wellness offerings, and 37% will add wellness incentives or penalties to their programs in 2016.

NEXT: Measuring ROI and attracting talent

The study found employers are focused on return on investment (ROI)—91% of C-suite respondents said improving the health of employees is important as it correlates with lower medical costs, reduced absenteeism, and increased productivity.

Aside from becoming compliant with the ACA and lowering costs, the study also found that C-suite executives are making changes to their plans because of an increased focused on attracting and retaining talent, with 62% saying it is a top concern, up from 45% last year.

“As they balance business goals with controlling cost, employers are also exploring additional changes to their plans to avoid the Cadillac Tax,” says Dan Gowen, national practice leader with Wells Fargo Insurance’s Employee Benefits National Practice. “The rapidly changing market and delay in the tax implementation provides another opportunity for employers to be creative as they continue to refine their benefit plans.”

The Employee Benefits Trend Study surveyed more than 650 middle-market companies and large corporations. Wells Fargo Insurance’s 2016 Employee Benefits Market Outlook provides additional insights about trends in the market.

Case About Reducing Hours Due to ACA Moves Forward

A court found there was plausible evidence that Dave & Buster’s intended to interfere with employees’ rights to benefits.

The U.S. District Court for the Southern District of New York has denied a motion to dismiss a lawsuit filed by an employee of Dave & Buster’s Inc. in New York City.

The lawsuit claims the company violated the Employee Retirement Income Security Act (ERISA) Section 510 interference of benefits provisions when it reduced full-time employees’ hours following passage of the Patient Protection and Affordable Care Act (ACA).

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According to the court’s opinion, Dave & Buster’s argues that an employee has no entitlement, and thus no legally sufficient claim, to benefits not yet accrued, and that a “plaintiff must show more than ‘lost opportunity to accrue additional benefits’ to sustain a Section 510 claim.” However, U.S. District Judge Alvin K. Hellerstein noted that Maria De Lourdes Parra Marin alleges the company’s discrimination affected her current benefits, in addition to interfering with her ability to attain future benefit rights.

Hellerstein found that Marin sufficiently pled that the employer acted with an “unlawful purpose” when taking an adverse action against her. He noted that the critical element is intent of the employer—proving that the employer specifically intended to interfere with benefits. He found that Marin sufficiently and plausibly alleged this element of intent.

NEXT: Proof of intent to interfere with benefits

Hellerstein noted that in her complaint, Marin describes two employee meetings in June 2013 in which the Dave & Buster’s general manager and assistant general manager explained that the ACA would cost the company "two million dollars" and it was reducing the number of full-time employees to approximately 40 to avoid that cost. The complaint describes a nation-wide effort to lower the number of full-time and part-time employees, and that similar meetings were held at other locations.

According to the compliant, one employee from another location posted on D&B's Facebook page on June 9, 2013, that "[t]hey called store meetings and told everyone they were losing hours (pay) and health insurance due to Obamacare."

The complaint also alleges that a senior vice president of human resources responded to a query from the Dallas Morning News about the company’s reduced workforce by saying that "D&B is in the process of adapting to upcoming changes associated with health care reform."

In addition, a filing with the Securities and Exchange Commission (SEC) from September 29, 2014, stated that: "Providing health insurance benefits to employees that are more extensive than the health insurance benefits we currently provide and to a potentially larger proportion of our employees, or the payment of penalties if the specified level of coverage is not provided at an affordable cost to employees, will increase our expenses."

Hellerstein denied Dave & Buster’s motion to dismiss the suit, saying “accepting as I must that these factual allegations will be proved, the complaint states a plausible and legally sufficient claim for relief.”

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