Employers and employees alike are well aware of the complexities involved in the implementation of the Affordable Care Act (ACA). The results from our most recent survey show that about 40% of organizations rate their employees’ understanding as either poor or very poor. Even though the ACA is now more commonly becoming “the law of the land,” understanding of the law is consistently low at the plan participant level. Why is this the case?

The International Foundation deployed its seventh annual survey in a series of how single employer plans are being affected by ACA. The 2016 Employer-Sponsored Health Care: ACA’s Impact gave respondents the opportunity to share their communication initiatives, obstacles in employee communication and the most common questions that they received. The feedback highlights ACA communication pain points.

ACA Understanding

Obstacles to Employee Communication
Employers are facing a number of obstacles in their communication efforts. Most prominent is confusion among employees, cited by two-thirds of respondents (66.6%). Employers also struggle with a lack of interest among employees (52.3%) and employees having difficulty with each new piece of the law and regulations (41%). Employers are similarly struggling with keeping up with new pieces of the law and legislation (30.6%), which exaggerates employee communication struggles.

[Related: Overview of ACA, One-Hour E-Learning Course]

Most Common Employee Questions
Surveyed employers were asked to communicate the most common ACA questions they received from employees. Overall, the survey found that the most common responses were those that impacted employees at a personal level. The most common questions they received regarded taxes and 1095 forms, cited by 62% of respondents. The 1095-B form shows that minimum essential coverage is being offered by the employer, while the 1095-C is for applicable large employers that are subject to the shared responsibility provision. (It should be noted that the survey was conducted during the period when employees were to receive their 1095 forms). Other common questions are listed below:

  • How does the law affect me? Do I need to change anything? – 36.9%
  • How will our benefits change? Are these changes because of ACA? – 31.3%
  • What will this cost me? Why are my costs going up? – 30.4%

The next most common questions relate to specific provisions of the ACA.

  • How do the exchanges work? Am I eligible? Are they free? Could I qualify for a subsidy? How does exchange coverage compare with my current coverage? – 18.2%
  • Is the company planning to drop coverage? – 12.4%
  • Can my child stay on the plan longer? – 12.4%
  • Are we dropping spousal/dependent coverage – 10.1%

Employer Communication Initiatives

Popular ACA Communication ChannelsEmployers are using a number of methods to communicate ACA provisions to their workers. They most commonly communicate during their annual enrollment period through e-mails sent to employees, posts on organizational websites, and specially written communication pieces. These pieces are often distributed through payroll inserts, sent to employees’ and retirees’ homes or through some other means. Employers also often organize special meetings (26.5%), communicate ACA implications throughout the year (24%), and distribute regularly scheduled organizational newsletters (16.6%).

Despite these efforts, the number of employee questions regarding ACA is increasing. Over 58% of respondents have noted an increase in ACA-related questions in the past 12 months. Over one in three respondents (36.9%) noted no change in ACA-related questions over this period, while less than 5% have noted that questions have decreased.

[Related: New Health Care Reform Law: What Employers Need to Know – A Q&A Guide]

When evaluating these figures, it is important to note that your plan participants receive ACA education primarily from two sources: the media and their employer. As the employer, this represents a prime opportunity for you to lead that charge of education. An educated workforce will make more informed health care decisions, better utilizing their health care dollars.

2016 Employer-Sponsored Health Care: ACA’s Impact is the seventh survey in a series on how corporate health benefit plans are being affected by the Affordable Care Act. Survey responses were received from human resources and benefits professionals representing a wide base of U.S. employers from nearly 20 different industries and ranging in size from fewer than 50 to more than 10,000 employees.

Justin Held, CEBS
Educational Program Specialist/Research Analyst at the International Foundation


Justin Held, CEBS

Senior Research Analyst at the International Foundation

Favorite Foundation service: Research Surveys

Benefits related topics that interests him most: Health care economics, the Affordable Care Act, apprenticeship training

Favorite Foundation Conference Event: Lowell Catlett’s economic updates

Personal Insight: Justin loves everything baseball, visiting and checking off ballparks as he travels. He can shake any bad mood caused by a Brewers’ loss by going for a good long run.

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