By: Neil Mrkvicka​ and Julie Stich​

Employee interest in the Affordable Care Act (ACA) has spiked in the last 12 months, according to the 2014 Employer-Sponsored Health Care: ACA’s Impact—the International Foundation’s fifth survey in a series on how single employer plans are being affected by ACA.

Respondents say the most common questions from employees are related to the health insurance exchanges (e.g., 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?) Below are the ten most common questions employees are asking about ACA along with some answers to help guide employer responses. 


Employee Question​ ​Employer Response
​​1.​ ​ ​​How do the exchanges work? Am I eligible? Are they f​ree? Could I qualify for a subsidy? How does exchang​e coverage compare with my current coverage?
It depends on a lot of factors such as the individual’s and employer’s state, the individual’s income and the employer’s coverage, but the exchanges will not be free for most employees.
​2.  How does the law affect me? Do I need to do anything?

​It depends, but significant actions are likely not required from the majority of employees covered by employer-sponsored health plans.
​3.  What will this cost me? Why are my costs going up?

It depends on the employer’s changes, but the survey reveals many employers are shifting costs to employees in one form or another.​
​4.  Is the company planning to drop coverage?

It depends, but most likely not. Fewer than 1% of survey respondents say they definitely will not provide coverage to all full-time employees in 2015, and only 2% say they are unlikely to.
​5.  How will our benefits change? Is this benefits change because of ACA? It depends on the employer. While ACA calls for increased benefit coverage and lower out-of-pocket costs in certain areas, some employers are decreasing benefit levels to combat or avoid costs associated with ACA.
​6.  Can my child stay on the plan longer?

Yes. Effective in 2010, adult child coverage is required to age 26.
​7.  ​Do I have to get coverage if I don’t have it now? When will there be an open enrollment opportunity? 
Yes. Individuals need some form of coverage or they will face penalties. For most employers, the open-enrollment period is held in late summer or fall, but this varies. The next open enrollment period for the exchanges is in November.  
​8.  Will I have an average 30 hours per week and qualify for benefits in 2015?

It depends on the employee and the employer, but just 9% of all surveyed employers are adjusting hours so fewer employees qualify for the full-time employee medical insurance requirement—An additional 8% plan to in the next year.
​9.  Are we dropping spousal/dependent coverage? It depends, but most likely not. Just 4% of organizations have dropped spousal coverage because of the ACA—An additional 6% plan to in the next year.
10.  How does the law impact the future of the company?  It depends. Employers gave a wide range of responses to open-ended survey questions on the effect of ACA. Overall, two-thirds of organizations believe the ACA will have a negative effect on their future while only 14% anticipate a positive effect. However, the vast majority of organizations do not intend to make broad workforce adjustments due to the ACA.​

Aside from answering questions as they come up, how are employers communicating about ACA? Respondents included a range of communication vehicles, including:

  • Annual enrollment materials
  • Emails sent to employees
  • Company website
  • Special meetings and special written communication.

​ Larger organizations are more likely to communicate via annual enrollment and company websites, while smaller organizations are more likely to communicate throughout the year and through special meetings.

[Related: ACA’s Impact on Global Workforces]

Participant confusion and lack of interest are the biggest obstacles to communicating about ACA. Some of the common obstacles mentioned among “other” responses were employees forming ideas after listening to media pundits (positive and negative), government’s inability to stick to its own deadlines and general language barriers explaining ACA to non-English-speaking populations.

One half of organizations believe their employees’ understanding of ACA is just average, while about one-third rate their employees’ understanding as poor or very poor. On the other hand, more than two in five organizations believe ACA has increased their employees’ engagement/interest in their health care. Smaller employers are more likely to report more participant questions, greater employee understanding of ACA and increased participant employee engagement/interest in their health care compared with larger organizations.  

What has been your experience in communicating about ACA with employees? Share your communication challenges and successes in the comments below.

 Take advantage of ​ACA Uni​versity​​​​—​a free member service
offering webcasts and many other resources to help you
work through th​e changes ACA brings to the industry. 

Neil Mrkvicka

Senior Research Analyst at the International Foundation

Favorite Foundation service/product: Our member surveys!

Benefits-related topics that catch his attention: Health & wellness, financial wellness/security, behavioral economics/psychology

Favorite Foundation moments: Foundation research survey release days.

Personal Insight: He’ll easily get lost in a good economics book or statistical analysis, but quiet Neil lives life out loud—give him an athletic competition, a new adventure or a chance for a good laugh and he’s there.


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