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.
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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 .
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Employers with safe-harbor plans are typically exempt from the ADP test