PPACA/Health Care Reform

Health Care Reform Resources

It’s not enough to merely comply with the new provisions of Health Care Reform.  Smart employers understand that while it is important to minimize costs, it’s equally important to maximize the critical impact that this law will have on the organization’s ability to attract and engage top talent and remain competitive in the war for talent.  Kushner & Company offers solutions that go beyond mere compliance, and offer insights and strategies to create competitive advantage.

The Patient Protection and Affordable Care Act of 2010 (PPACA) and the subsequent regulations contain not only new rules impacting the provision of health benefits by employers, it also provides a once-in-a-lifetime opportunity to reassess and align the overarching total rewards and HR strategies with the organization’s strategic goals and objectives.


Reference these white papers, blogs, and videos with solutions to some of Health Care Reform's most challenging issues


White Papers

Formal Guidance from IRS on Delayed Provisions of PPACA

Employer Mandate (Pay or Play) and Reporting Requirements Delayed until 2015

Health Care Reform's New Measurement, Administrative and Stability Periods Design

Health Care Reform's New Employer Exchange Notice

90 Day Eligibility Period

Five Things You Need to Do Now to Prepare for Health Care Reform


Five Mistakes Your Company Should Avoid When Implementing Health Care Reform

Kushner to speak on panel for CBS News WNEW 99.1 FM Healthcare Town Hall

SHRM Offers Webinar on Benefits Education featuring Ben Cohen, CEBS

Gary Kushner's article "Time to Get Strategic" is featured in the August 2013 Special Section on Health Care Reform in SHRM's HR Magazine

Will PPACA Drive Earlier Retirement?

Are You Focused on the Most Important Part of Health Care Reform?

Small Employers May Be Making Uninformed Decisions on Health Care Reform


Health Care Reform: Employer Play or Pay (or Not)

After Health Care Reform, Should an Employer Continue to Offer Health Benefits?

The New Nondiscrimination Rules in Health Care Reform

Health Care Reform: Quantitative and Qualitative Analyses


New!  To request your complimentary PPACA Tool Kit authored by Kushner & Company and published by SHRM, contact us online (use the Contact Us link at the end of this page).


Health Care Reform: Beyond Compliance into Strategic Advantage

(Available as a keynote, 2 hour program, or six hour workshop)*

This high-energy program will provide not only the tools every business leader needs in order to step through the minefield that is health care reform from a compliance standpoint, but also provide the framework and tools to assess the impact of offering (or not offering) health benefits on talent acquisition and talent management strategies of the organization.

  • Module 1 – 2016 is Right around the Corner, What is Coming, and Are You Ready?
  • Module 2 – Placing Health Benefits in a Strategic Context within Your Organization (and Five Health Care Reform Strategies that will Fail)
  • Module 3 – Qualitative Analyses for Implementing Health Care Reform Requirements
  • Module 4 – Quantitative Analyses (both financial and non-financial) for Implementing Health Care Reform in Your Organization
  • Module 5 – Building Your Implementation and Communication Plan

*Strategic Management Recertification Credits through HRCI

The Kushner & Company Consulting Process

Because Kushner & Company believes that all business functions are interrelated, every new opportunity begins with an interview session.  This interview provides information about the unique successes and challenges you face as an organization, particularly in dealing with the PPACA. 

Data Collection

The quantitative analysis is performed on the data provided in this initial collection period.  Examples of requested data include employee census information for all employees of the organization and any affiliates or members of a controlled group; detailed health plan information; health plan documents; health premium and/or self-funded experience; employee payroll contribution information; government filings; and other applicable employee benefit communications.

Strategic Linkage to HR and Organizational Goals/Objectives

This step involves meeting with key leaders to determine HR and organizational goals and objectives, with a particular focus on total rewards strategies and their impact on other talent acquisition and talent management strategies.  Kushner & Company then takes that direction to strategically align the health and prescription drug benefit programs to assist in achieving those objectives within the parameters of PPACA, and answering questions such as “do we continue to offer health benefits to our employees, or if not, what (if anything) would we need to replace it with in order to recruit, retain, and engage our workforce?”

The strategic discussion is conducted as an on-site visit and walks through a series of questions designed to elicit the necessary formal or informal strategies throughout the organization, and how benefits align and drive those strategies. 

Demographic Analysis

Analysis of the demographics of an employer begins with the census file of all employees, including eligible and non-benefit eligible employees obtained during the Data Collection phase.  Kushner & Company examines a number of demographic factors:

  • Compensation for affordability calculation, likeliness of subsidy and/or Medicaid eligibility, and likeliness of enrollment in group plan.
  • Average hours worked, average months worked, and employment status for determining full time status for new eligibility rule impact.
  • Employee age for areas of concern such as coverage under a parent’s plan, early retirement, and Medicare availability.
  • Employee home location for exchange availability and impact.

PPACA Quantitative Analysis

  • Assess the projected cost impact if health plans were changed from their current design to ones that meet the 60 percent minimum actuarial value and affordability plan design in 2014. 
  • Examine current plan eligibility structure for current and future compliance.
  • Review waiting periods.
  • Explore employee classifications.
  • Determine full time status.
  • Determine whether the organization is subject to the Employer Responsibility (“play or pay”) requirements. 
  • Calculate the projected cost of the Cadillac Tax beginning in 2018.

PPACA Qualitative Analysis

  • Determine which plans are subject to the provisions of PPACA.
  • Determine if health plans should remain grandfathered by assessing the impact of the seven provisions of the PPACA that only applies to non-grandfathered health plans.
  • Identifying the PPACA compliance issues with the existing plans.
  • Examine whether dental and/or vision plans should be incorporated or separate plans.
  • Review any Health Reimbursement Arrangements (HRAs) to see if they meet the new requirements.
  • Examine PPACA’s impact upon existing wellness programs.

Project Deliverables

The deliverable is a detailed report highlighting the analyses specific to the communicated needs of your organization.  The report outlines recommendations regarding strategic alignment of the health plans to the overall talent acquisition and talent management strategies of the organization.  Functionally, we make targeted recommendations to create alignment with strategic objectives and/or ensure compliance with regulatory provisions within PPACA.  Lastly, based on those recommendations, we provide a detailed timeline and recommended implementation plan with appropriate plan design and eligibility changes.

Due to the changing nature of PPACA regulations, and the dynamic nature of your workforce, consulting engagements also include up to one hour of consulting time via phone or webinar per month for six months following completion of the analysis.  These calls or webinars will enable Kushner & Company to address any questions or concerns that you may have, as well as update you on the most recent PPACA guidance issued.


The Kushner & Company Expert Speakers/Consultants

Gary KushnerGary B. Kushner SPHR, CBP is the President and CEO of Kushner & Company, a leader in providing consulting on HR strategy, including health care reform and other employee benefits issues.  He is an internationally recognized expert in the field, and is one of the nation's most sought-after speakers on HR Strategy and Health Care Reform.  Gary serves on faculty with the Society for Human Resource Management (SHRM), and is sought by other organizations to provide insightful learning events on health care reform and other pressing HR issues. He has advised four U.S. Presidents on health care and has testified before the U.S. Senate Finance Committee, the U.S. House Ways and Means Committee and the U.S. House Small Business Committee on HR-related issues.

Gary Kushner is also a frequent resource to the news media including the Wall Street Journal, the New York Times, Associated Press, Knight-Ridder, the Kiplinger Washington Newsletter, CNN News, Fortune, MSNBC and Good Morning America. Additionally, he serves on the Editorial Review Board of HR Management magazine.


New! To request a complimentary ACA Tool Kit authored by Kushner & Company and published by SHRM, contact us online by using the Contact Us link at the bottom of this page.


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