The Supreme Court decision upholding healthcare reform puts companies on notice that compliance avoidance is no longer an option.

In a 5-4 decision, the U.S. Supreme Court upheld the major provisions of the Patient Protection and Affordable Care Act, signaling that companies need to finalize their plans for implementing the long list of requirements it imposes on employers beginning in a few months. “The key thing for employers, particularly those that have been sitting on the fence and taking a wait-and-see approach, is now you really need to start thinking about your strategy,” says Sharon Cunninghis, leader of U.S. health and benefits for consulting firm Mercer. Companies need to tally up the near-term requirements and the long-term requirements through something of a health-care checkup of their own, she says.

This fall, according to Cunninghis, companies need to be prepared to distribute a uniform summary of benefits and coverage during their open enrollment period to clearly explain options and requirements to employees. They need to be tracking information now that will be reported in W-2 forms in 2013, she says, and they need to get up to speed on requirements around women's preventive services, contributions to flexible spending accounts, changes in Medicare payroll taxes for high-income earners, and a variety of others.

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Looking further out, companies need to get focused on the 40-percent excise tax that will take effect in 2018 on healthcare costs that exceed certain thresholds to consider ways they will manage the costs of their health care program, says Cunninghis. Of course, companies should also keep their eye on the political process, she says. “Employers also should continue to monitor actions of Congress and the administration, especially in light of the November elections,” she says.

Mercer and other observers say the Court's decision validating the individual mandate in healthcare reform removes one of the big uncertainties that has stalled implementation. Still the law faces a contentious political outlook, according to Mercer. Employers need to stay on track—or get on track—in complying with the law as enacted to avoid facing penalties, says Cunninghis.