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Healthcare Reform

Exchange Notice - Samples of OEBB Mailing August 26, 2013

On August 26, 2013, OEBB mailed the following notice to each eligible employee, early retiree and COBRA continuee who had an active employment segment in the MyOEBB system on August 15, 2013. These samples are provided for INFORMATIONAL PURPOSES ONLY as an example of the letters OEBB mailed and should not be used as templates by educational entities. Educational entities can find their templates on this page under "Exchange Notice - Templates for Educational Entity Benefits Administrators".

SAMPLE - Active Employees

SAMPLE - Early Retirees still administered by their Educational Entity

SAMPLE - Self-Pay Early Retirees administered by OEBB

SAMPLE - COBRA Continuees

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Exchange Notice - Templates for Educational Entity Benefits Administrators

If you are a benefits administrator at an OEBB-participating educational entity, you may use the following templates to comply with the federal exchange notice requirements. Detailed instructions are available below the template links.
 
Use this template to notify employees who are not eligible for benefits.
 
"Benefits Eligible Aug. 15 - Sept. 30" TEMPLATE
Use this template to notify employees who became benefits-eligible prior to October 1, 2013 who were not in the MyOEBB system on August 15, 2013.
 
Use this template to notify employees hired October 1, 2013 or later who are not eligible for benefits.
 
Use this template to notify benefits-eligible employees hired October 1, 2013 or later.

 

 

INSTRUCTIONS FOR USING THESE TEMPLATES:
1)    Determine which of your employees have already received the required notification from OEBB.
On August 26, 2013, OEBB mailed a notice to all members on your August invoice as well as any new members added to the MyOEBB system between the time the August invoice was generated and the time the mailing data was pulled from the system on August 15. If your entity added any employees to the system during this time, you will find a report in your document management area of the MyOEBB system titled “Exchange Mailing not on August Invoice”. These members were also notified by OEBB along with those listed on your August invoice. If you do not have a report with this title in your document management area, then the August invoice is the complete listing of your members who received the OEBB notification.
 
2)    No later than September 30, 2013, use the “Benefits Eligible Aug. 15 – Sept. 30” template to notify any employees who were not notified by OEBB as described above, but who gained or will gain eligibility for benefits prior to October 1, 2013.
 
3)    No later than September 30, 2013, use the “Not Eligible For Benefits” template to notify all individuals who are active employees of your educational entity as of September 30, 2013, but who are not eligible for benefits.
Anyone technically listed as an employee in your records on the date you mail the notification up through September 30, 2013, should be notified, even if they have not been actually reporting hours as “worked” for any period of time. This can include substitutes, student workers, temporary employees, and/or employees on an approved leave of absence. As long as there is an active “employment relationship” in place at this time and/or on or before September 30, you should send them the notice.
 
4)    Beginning October 1, 2013, notify each new employee within their first 14 days of employment.
Two additional templates are now available above which can be used to notify employees hired on or after October 1, 2013.
This notification may be mailed to the employee’s home, or it may be hand-delivered directly to the employee. It may also be included in a new-hire information packet, but that packet must be hand-delivered directly to the employee or delivered via first-class USPS mail.
Note that sending the notice via email will NOT comply with the federal requirement. In addition, other alternate delivery methods, such as making the notification available online, making multiple copies of the notification generally available in a common area, or providing a link to the notification rather than providing the full notice, will NOT comply with the federal requirement.
Employers must ensure that each new employee receives the proper notification within their first 14 days of employment either by mailing the notice first-class USPS mail or hand-delivering it directly to the employee.

 

  

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Exchange Notice - Q&A

Q: Can the notice be delivered via email?

A: No, email will not satisfy the federal requirements. It must be mailed first class or hand-delivered.

 

Q: Do substitute teachers and student workers need to receive the notice?

A: Yes, it doesn't matter what position they hold or how many hours they work. As long as an employment relationship exists on September 30, 2013, that employee needs to receive the notice. This includes substitute teachers, student workers, temporary workers, and employees on approved leave of absence.

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Spotlight on Healthcare Reform - Bulletins by Towers Watson

As federal guidance becomes available and new phases of the Affordable Care Act (ACA) are implemented, these bulletins will guide you through the changes and help you prepare for the future.

 

Bulletin #1 - July 23, 2013 (this bulletin was reviewed in April 2014 and no revision was needed)

This first ACA Bulletin for OEBB-participating entities identifies the Affordable Care Act (ACA) provisions OEBB has already met on behalf of all educational entities participating in the OEBB benefits program, the requirements of the health insurance exchange notice, and the recent decision by the Obama administration that will delay the Play or Pay mandate and certain reposting requirements.

 

Bulletin #2 - September 25, 2013 (revised April 2014) 

This second ACA Bulletin for OEBB-participating entities discusses the ACA's Employer Shared Responsibility Provisions, including when and how they may apply to the entities. 

 

Bulletin #3 - December 27, 2013 (revised April 2014)

This third ACA Bulletin for OEBB-participating entities reviews the various measurement periods that can be used to determine full-time employee status under the ACA's Employer Shared Responsibility Provisions.

  

Bulletin #4 - February 4, 2014 (revised April 2014) 

This fourth ACA Bulletin for OEBB-participating entities reviews the affordability provision that is used to determine the ACA's Employer Shared Responsibility penalties.

  

Bulletin #5 - March 7, 2014 (revised April 2014)
This fifth ACA Bulletin for OEBB-participating entities reviews the recently-released final regulations for the Shared Responsibility provision of the ACA. In particular, this bulletin will highlight changes from the previous proposed regulations. Due to these changes, three of the four previous bulletins above have also been revised to incorporate the latest information.
 
Bulletin #6 - July 15, 2014
This sixth ACA Bulletin for OEBB-participating entities reviews the IRS reporting requirements intended to enforce the individual and employer mandates and support the determination of subsidy eligibility.
 
 
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Towers Watson Presentations/Webinars

 
On April 16, 2014, Towers Watson presented a webinar for all interested OEBB educational entities and employee representatives to update them on the Affordable Care Act and the latest guidance on measuring FTE for the purpose of compliance with federal healthcare reform regulations.
 
A PDF of their presentation slides is available below. We hope to post a recording of the actual webinar soon.
 
Questions regarding any of these tools or the information provided should be forwarded to OEBB via email at: denise.hall@oregon.gov
 
 
April 16, 2014 Presentation Slides -
ACA Update and Full Time Employee Measurement
 
NOTE: Due to technical difficulties during the April 16 presentation to OEBB entities, a recording of that exact presentation is not available. This recording is based on the same information, but was presented to a different audience five days earlier.
 
We apologize for any inconvenience this may cause. We plan to schedule more webinars for OEBB entities on similar subjects in the near future. 
 
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On December 19, 2013, Towers Watson presented a webinar for all interested OEBB educational entities and employee representatives.  The webinar provided information on measuring FTE for the purpose of compliance with federal healthcare reform regulations. 
 
A PDF of their presentation slides is available below, along with two slides outlining shared responsibility penalties that was shared with the OEBB Board at its December 2013 meeting, and a recording of the actual webinar. 
 
Questions regarding any of these tools or the information provided should be forwarded to OEBB via email at: denise.hall@state.or.us
 
 
December 19, 2013 Presentation Slides -
Full Time Employee Measurement
 
 
 
 
 
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On November 14, 2013, at the OASBO conference, Towers Watson presented information on measuring FTE for the purpose of compliance with Healthcare Reform regulations. A PDF of their presentation slides is available here:
 
November 14, 2013 OASBO Presentation Slides
Full Time Employee Measurement
 
 
 
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On October 3, 2013, Towers Watson presented a webinar containing information on measuring FTE for the purpose of compliance with Healthcare Reform regulations. A PDF of their presentation slides is available here:
 
 
Due to technical difficulties, the webinar was unable to be recorded. We are working on scheduling a second webinar on this same topic and hope to successfully record that session. 
 
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In February 2013, Towers Watson presented a webinar containing information on healthcare reform and how it specifically affects OEBB-participating entities. For entities who were unable to attend, links to the presentation slides, a recording of the February 28 webinar, and a PDF of related questions and answers have been provided below.
 
 
 
 
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PCORI Fee

The Affordable Care Act (Public Law 111-148, amended by Public Law 111-152), imposes fees on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to help fund the Patient-Centered Outcomes Research Institute (a.k.a., the PCORI fee).
 
One of the services that OEBB is providing for participating educational entities is support with a number of issues related to Health Care Reform.  Specifically, the $1.00 PCORI fee has been collected by Moda Health (formerly ODS Health) and Kaiser Permanente through the monthly 2012-13 premiums.  As the medical plans available through OEBB are fully insured, it is the insurance companies’ responsibility to make the payment on behalf of their membership, and they are doing so.  The premiums for 2013-14 plan year include both the federal and state Health Care Reform fees and Moda Health and Kaiser Permanente will be making those payments on behalf of entities under OEBB as well.
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FAQ's - Frequently Asked Questions

 

This document was created in February 2013 to summarize the questions and answers that arose during the Towers Watson webinars held that month. 

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