Catsby, there is more to this issue than ACA. Telemedicine can be impacted by ACA, ERISA, and COBRA. There may even be state law issues to deal with, but I am not an expert on each state.
Generally speaking, when a telemedicine program is integrated into the group plan these issues are satisfied because of its inclusion in the plan. When offered as a stand-alone it is viewed as a separate plan and the employer needs to satisfy ERISA requirements, create a separate COBRA process, and abide by ACA. Abiding by ERISA and COBRA is not very difficult, nor expensive. The ACA excepted benefit piece may be because of the requirements. To meet this threshold, the plan must; not provide significant medical care benefits, not be coordinated with the group plan, be cost free to the participants, and does not have any cost sharing.