Base salaries at nonprofits don’t always keep pace with those in the corporate sector, but associations often pride themselves on above-average benefits, including healthcare plans. So they need to be mindful of the changes the Affordable Care Act brings: Starting in 2014, employers that don’t offer affordable coverage will be penalized, and in 2018 so-called “Cadillac” plans face excise taxes as well.

“You have to go through a process of talking with your HR department about the ACA,” says Justin Moore, PT, DPT, vice president for government affairs at the American Physical Therapy Association. “We asked, ‘Do we need to make any business decisions now about what our offerings are? If we’re going to reduce them, what would we provide as additional benefits?’ ”

Small-staff associations will see the fewest changes, because penalties apply only to employers with 50 or more full-time-equivalent employees. Such employers that offer no coverage will pay $2,000 annually times the number of full-time employees, minus 30. A similar penalty applies in cases where the employer covers less than 60 percent of healthcare expenses for a typical population, or where the employee has to pay more than 9.5 percent of family income to receive employer coverage.

Employers that had healthcare plans in place by March 23, 2010, can consider their plans “grandfathered” in without penalties. But slight alterations to policies can remove a plan’s grandfather status.

Moore recommends that association HR departments search beyond their providers for ways to keep healthcare plans affordable. Small-business tax credits may be available, as well as grants for workplace wellness initiatives.