Benefits

SMBs in the Healthcare Industry: There is a New Affordable Care Act Requirement for Your Business

November 15, 2016

Companies that are primarily engaged in providing or administering health care services or coverage have one more Affordable Care Act (ACA) notice requirement to worry about.  Effective October 16, 2016, healthcare companies must post a notice stating that they do not engage in discrimination that is prohibited by ACA Section 1557.

What is ACA Section 1557?
Section 1557 prohibits discrimination on the basis of race, color, national origin, gender (including gender identity), age, or disability under any health programs and activities. The intent of Section 1557 is to help advance equity and reduce discrimination in the healthcare context. Section 1557 has been in effect since the enactment of the ACA in 2010.

Section 1557 includes five primary requirements for healthcare companies:
1. Prohibit gender discrimination in healthcare. This includes a requirement to treat individuals in a manner that is consistent with their gender identity.

2. Must give individuals with disabilities access to healthcare programs and activities.

3. Individuals with limited English proficiency must have access to healthcare programs and activities.

4. Post notices and statements of nondiscrimination to communicate that the company does not engage in any discrimination that is prohibited by Section 1557. These notices should include translations for individuals with limited English proficiency.

5. Companies with 15 or more employees must establish a grievance procedure and assign a compliance coordinator to allow individuals to file complaints.

 Does ACA Section 1557 apply to any company that offers group health insurance to its employees?
No, companies that are not in the health care business are not subject to ACA Section 1557 or the notice requirements.  ACA Section 1557 only applies to companies that are primarily engaged in providing or administering either health services or health insurance coverage, or if the company receives funding from the U.S. Department of Health and Human Services (HHS).

Is there a model notice available?
HHS has posted model notices that companies may use. These come in English and are also translated into 64 languages.  Translated nondiscrimination statements are posted on the same site. You may download the notices, statements, and translations here

How does a healthcare company comply with the notice requirement?
Companies are required to post the notice in a conspicuous physical location where the company interacts with individual patients and clients, as well as on the company’s website. They must also include the notice in any significant publication or communication, such as a newsletter or eblast.  If a company has 15 or more employees, they are required to include in these postings the name of the compliance coordinator who has been designated to help resolve grievances.

Translations for at least the top 15 non-English languages spoken in the state where the company does business must be added to the notice to inform individuals of the availability of language assistance services. If you don’t happen to know the top 15 non-English languages spoken in your state, HHS has posted a  state-by-state translation resource here so you’ll know which translations to include.

For shorter communication methods, such as postcards, the nondiscrimination statement from the HHS site may be substituted for the full notice. When using the statement, companies only need to include translations for the top two non-English languages spoken in the state.

 For more information about ACA Section 1557
Detailed information about Section 1557 is posted on the HHS website. This includes fact sheets, training materials, and translated resources.

This communication is for informational purposes only; it is not legal, tax, or accounting advice; and is not an offer to sell, buy, or procure insurance.

This post may contain hyperlinks to websites operated by parties other than TriNet. Such hyperlinks are provided for reference only. TriNet does not control such web sites and is not responsible for their content. Inclusion of such hyperlinks on TriNet.com does not necessarily imply any endorsement of the material on such websites or association with their operators.

By Sheryl Southwick

Sheryl Southwick is executive director of benefits compliance for TriNet

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