Skip to main content

 

 

YOURPEOPLE, INC.

Rules for Non-Discrimination Under the ACA

To comply with the Affordable Care Act's rules for non-discrimination, companies are subject to the following rules.

  • Companies cannot look at compensation to determine health care eligibility.
  • Companies cannot vary employee contributions based on years of service.
  • Companies cannot have different waiting periods.
  • All benefits provided to highly-compensated participants must be the same for all other participants.
  • Companies cannot approve claims for a highly-compensated employee and deny the same claim for a normal employee.

The following plans are also subject to these rules:

  • Major Medical
  • Mini-med plans
  • HRAs
  • Dental and Vision that are not standalone

The following plans are not subject to these rules:

  • Stand alone Dental and Vision
  • Long Term Care
  • Accident Plans
  • Disability Income Plans
  • HIPAA Excepted Benefits
  • Retiree only plans with no active employees
  • Short term medical plans
  • Medicare supplements
  • Employee Assistance Plans
  • Specific Disease Plans
  • Hospital Indemnity Plans

To comply with the Affordable Care Act's rules for non-discrimination, companies are subject to the following rules.

  • Companies cannot look at compensation to determine health care eligibility.
  • Companies cannot vary employee contributions based on years of service.
  • Companies cannot have different waiting periods.
  • All benefits provided to highly-compensated participants must be the same for all other participants.
  • Companies cannot approve claims for a highly-compensated employee and deny the same claim for a normal employee.

The following plans are also subject to these rules:

  • Major Medical
  • Mini-med plans
  • HRAs
  • Dental and Vision that are not standalone

The following plans are not subject to these rules:

  • Stand alone Dental and Vision
  • Long Term Care
  • Accident Plans
  • Disability Income Plans
  • HIPAA Excepted Benefits
  • Retiree only plans with no active employees
  • Short term medical plans
  • Medicare supplements
  • Employee Assistance Plans
  • Specific Disease Plans
  • Hospital Indemnity Plans
  • Zenefits does not  perform non-discrimination  testing.
  • This provision is enforced via "non-discrimination  testing"

  • Non-discrimination  testing is performed for two different categories of employees: Key Employees and Highly Compensated Employees (HCEs)
    • Non-discrimination  testing for Key Employees is performed using the Top-Heavy test.
    • Non-discrimination  testing for HCEs  is performed using the ADP and  ACP  Tests .
    • Employers with safe-harbor  plans are typically exempt from the ADP test

  • Was this article helpful?