Under the Affordable Care Act, all workers and their families will have access to affordable health insurance regardless of income or employment situation. To help protect both workers and employers when it comes to getting affordable health care coverage, our agencies − the Labor Department’s Employee Benefits Security Administration (EBSA) and its Occupational Safety and Health Administration (OSHA) − recently announced some new rules.
EBSA will have the power to stop fraud and abuse in Multiple Employer Welfare Arrangements. A MEWA is an arrangement in which multiple employers come together to provide health insurance for their employees. Sometimes they are the only viable option for employers who are trying to do the right thing by offering health benefits to workers. But too often we see that the people who administer MEWAs take advantage of the goodwill of employers and workers by skimming premium payments or refusing to pay claims.
EBSA has been involved in many cases where MEWAs have been operated by individuals who drained them of their assets through excessive administrative fees or outright embezzlement. This has left participants and their families with unexpected unpaid health care bills. Under the Affordable Care Act, EBSA will now have the authority to issue a cease-and-desist order when it is apparent that fraud is taking place. In certain cases, we will also be able to seize assets in order to recover employer and worker premium payments. The new rule also strengthens reporting and filing requirements for MEWAs, so we will have more information about when and where these arrangements are operating.
Additionally, last week OSHA issued a rule implementing whistleblower protections for workers who have been fired or penalized for reporting violations of the Affordable Care Act. Also, when a worker receives a premium tax credit or cost-sharing reduction through a Health Insurance Marketplace (or Exchange), it may expose that his or her employer failed to provide health care coverage as required by the act. Employers might face tax penalties as a result, and OSHA’s new rules prohibit retaliation against workers in these cases, too.
These rules are important stepping stones in ensuring that the new health coverage options come with better protections for workers and employers, as well as increased transparency and accountability in the health care marketplace.
Phyllis Borzi is the assistant secretary of labor for employee benefits security. David Michaels is the assistant secretary of labor for occupational safety and health.
Tags: Affordable Care Act, cost-sharing reduction, Employee Benefits Security Administration (EBSA), health care, health care rights, health insurance, Health Insurance Exchange, Health Insurance Marketplace, Multiple Employer Welfare Arrangements (MEWAs), Occupational Safety and Health Administration, premium tax credit, whistleblower