Transcript 2010 Lisa Duquette New National Health Insurance Law..

Health Care Reform Discussion
Lisa J. Duquette
Program Administrator
[email protected]
August 17, 2010
SCHOOLCARE
HEALTH BENEFIT PLANS
Health Care Reform
Senate Bill HR 3590: Patient Protection and Affordable
Care Act
+
Reconciliation Bill HR 4872: The House Reconciliation Act
=
Final Health Reform Law
Signed March 23, 2010
SCHOOLCARE
HEALTH BENEFIT PLANS
Today’s Focus
Near term effect on
NH schools
Insight into future
issues
SCHOOLCARE
HEALTH BENEFIT PLANS
Provisions Effective
First
plan year starting on or after September 23, 2010
(6 months)
July 1, 2011
–
NH school group health plans subject to insurance reforms
SCHOOLCARE
HEALTH BENEFIT PLANS
2010

3/30/2010 Elimination of Imputed Income
§IRC 105(b) amended to exclude taxability of
medical benefits for adult dependents children

6/1/2010 Early Retiree Reinsurance Program
reimbursement for 80% of cost for retirees age 55 64 who have claims in excess of $15,000 and below
$90,000. (Program ends in 2014 or when the $5B funding is
exhausted)
SCHOOLCARE
HEALTH BENEFIT PLANS
2011

1/1/2011 OTC medications – unless
prescribed by a doctor over-the counter
medications are no longer eligible for
reimbursed pre tax reimbursement from FSA,
HSA, or HRA
SCHOOLCARE
HEALTH BENEFIT PLANS
2011 – July 1st!

Increase age limit to age 26 for uninsured
dependents
–
No tax dependent requirement
–
Married/unmarried
–
NOT child or spouse of dependent
–
Up to 1/1/2014 grandfathered plans may exclude
dependents if eligible for employment based coverage
Be sure payroll system is updated
Ensure FSA administration includes expense reimbursement for
a dependent child until the year in which the child attains age
SCHOOLCARE
27
HEALTH BENEFIT PLANS
2011 – July 1st!

Lifetime on essential benefits prohibited

Annual dollar limits on essential benefits prohibited
(presumption that # of visits, # of procedures, and limits on
cost are permissible)

Cost sharing on preventive care prohibited
(grandfathered plans exempt)
Increased premium cost of 1-4% for
improved plan provisions
SCHOOLCARE
HEALTH BENEFIT PLANS
2011 – July 1st!

Automatic Enrollment Requirements for employers
with 200 or more FT employees
–
–

No regulations have been issued by DOL yet
Some interpret that this provision will be effective 1/1/2014
CLASS Act – national voluntary long term care
program…need more HHS guidance
–
employers required to automatically enroll employees and
facilitate payroll deductions
–
employees must opt-out of program if not wishing to participate
–
pays cash benefits averaging $50 per day
–
five year (5) vesting period
SCHOOLCARE
HEALTH BENEFIT PLANS
2011 – December 31st


W-2 reporting of the value of
employer provided coverage
(issue in January 2012)
Information only
Need to accumulate
information required
for reporting.
SCHOOLCARE
HEALTH BENEFIT PLANS
2012

9/30/2012 Tax Assessments on group health
plans of $2 per participant for “comparative
effectiveness research”
–
–
–
Applies to self-funded and insured plans
Reduced to $1 per participant 9/30/2013
Scheduled to “sunset” for plan years ending after 9/30/2019
Increased cost from
assessments passed along to
employers/employees
SCHOOLCARE
HEALTH BENEFIT PLANS
2013 – 2014

1/1/2013 FSA max limits reduced – may
not exceed $2,500

2014 - prohibits waiting periods greater
than 90 days
Consider current collective
bargaining agreement terms
SCHOOLCARE
HEALTH BENEFIT PLANS