Sunday, July 7, 2013

After the Delay, What Exactly Must an Employer Do To Verify Employee Eligibility?

Short answer: nothing.  But it is 'hoped' that employers will help employees fill out their Obamacare applications (which will lead to employer fines should the subsidized plan continue into 2015).  Here is how the bureaucrats envision this in 2014.  How do you think it will play out?  
Under the final rule, an applicant for premium tax credits will be required to attest whether or not he or she has employer coverage, and if so its cost and extent.  The application form includes an appendix for this information.   The applicant can, but is not required to, ask the employer to provide information to fill out this form.  The employer is not required to help, but it is hoped that employers will help their employees fill out these forms and make pre-populated forms available to employees.
Once the exchange receives this information, it will check available databases to verify the information, including Office of Personnel Management data for federal employees and the state’s SHOP exchange data.  If the exchange finds information incompatible with the applicant’s attestation, it will ask the applicant to provide evidence to resolve the inconsistency.  In most instances, however, there will be no electronic data available to confirm the attestation.  In these cases, the exchange will select a statistically significant random sample of cases in which it only has the attestation and, after notice to the applicant, contact the employer to verify the information.  If the employer provides information incompatible with the applicant’s claims, the exchange will ask for further proof.  In cases where the employer does not respond, however, or that are not part of the random sample, the exchange will rely on the applicant’s attestation.
HHS will offer to perform this verification procedure for the states, but will not be able to do so technically until 2015.  Because some states were relying on HHS being able to do this for them, the states are excused from conducting the sampling procedure until 2015 as well. [Emphasis added.] 

Update 7/8/13: The Wall Street Journal is calling this the 'Liar' Subsidies.   

The Wall Street Journal: ObamaCare's 'Liar' Subsidies 
On the heels of last week's one-year suspension of the Affordable Care Act's employer mandate to offer insurance to workers, the Administration is now waiving a new batch of its own ObamaCare prescriptions. These disclosures arrived inside a 606-page catch-all final rule that the Health and Human Services Department published on July 5—a classic Friday news dump, with extra credit for the holiday weekend. HHS now says it will no longer attempt to verify individual eligibility for insurance subsidies and instead will rely on self-reporting, with minimal efforts to verify if the information consumers provide is accurate.