MINNEAPOLIS--()--HealthCare Impact Associates LLC has announced the beta release of its Affordable Care Act (ACA) health benefits management information system, Health E(fx)™.
“The decision to ‘Pay or Play’ is not an easy or trivial one”
Health E(fx)™ (pronounced “Health Effects”) was developed to meet the acute and immediate need for accurate management of data, analytics, compliance, reporting, and audit capabilities employers require to fully assess, decide, and manage their options and compliance under the regulatory health reforms of the ACA.
“ACA regulations create a significant information gap in corporate systems that employers must bridge in order to address their obligations under the new regulations,” says company president, Andy Brown. “Many of these decisions must be made by January 1, 2014, when key elements of the new law go into effect.”
Critical to employer-sponsored health benefit plans is the regulatory guidance on “Pay or Play”—the benefits industry description for the decision employers must make whether to provide affordable employer-sponsored benefits, or opt out of providing benefits, requiring employees to seek benefits under the ACA’s individual mandate requirements from the upcoming public health insurance exchanges.
“The decision to ‘Pay or Play’ is not an easy or trivial one,” continues Brown. “This is a decision that must be monitored and validated on an ongoing basis after January 1, 2014 as well.” Employee eligibility definitions under the ACA will affect many employee populations and demographics differently, and employers must consider a number of scenarios such as:
- What will the effective “measurement look-back,” “stability,” and “wait periods” be?
- How does this impact employee eligibility? How will employee hours worked over time affect eligibility?
- Does the employer meet safe harbor requirements under the ACA?
- What is the effect of alternate health benefit plan design strategies on overall costs?
- How do health benefits fit into overall compensation strategies, and how will decisions on “Pay or Play” impact attraction and retention of employees?
- What will the impact be to taxable benefits and compensation for employees, and what are downstream effects of decisions on tax and penalty issues?
Currently, critical data that is required to conduct full analyses of “Pay or Play” often resides in disparate, disconnected systems within the enterprise. Further, these systems do not have the analytical or functional capability to assist employers with managing their health benefits and compliance requirements under the new laws.
If an employer elects to continue to offer health benefits, there will be a myriad of ongoing management issues that require accurate data, management, analyses, and reporting to meet and comply with the ACA on an ongoing basis.
About Health E(fx)™
Health E(fx)™ is a comprehensive
management information system that provides complete data integrity,
analytics, compliance, and audit capabilities for health benefits
management under Affordable Care Act (ACA) regulations. Health E(fx)™
facilitates complex data integration and provides tools that alert and
ensure data integrity and quality. Cost, demographic, and decision
modeling and impact analysis functionality provide a framework for
ongoing cost management; plan design, affordability, and eligibility
compliance and alerting; and much more. Health E(fx)™ establishes a
collaborative foundation for effective communication and decisions from
the Benefits Administrator, to the executive team, to the broker and
others to ensure regulations are met, penalties are avoided, and
compliance and reporting is accurate without the need for ERP, HRIS,
Payroll, or other corporate system upgrades. For more information,
please visit www.healthefx.us.

