Healthcare Reform

  • Small business healthcare tax credit
  • Tax-free coverage to children under age 27 (see below regarding coverage mandate to age 26)
  • Early retiree reinsurance
  • Temporary high risk pool
  • HHS Consumer web portal
  • Dependent coverage for children under age 26
  • Patient protections (primary care provider designations, ER services, etc.)
  • Preventive health services
  • Preexisting Condition Exclusion prohibition for those under age 19
  • Annual/lifetime limits prohibited on essential benefits
  • Rescission prohibition
  • Nondiscrimination for insured plans Application/enforcement delayed pending additional guidance.
  • Appeals process
  • Automatic enrollment No specific effective date. In sub-regulatory guidance, the DOL has indicated that employers are not required to comply with this requirement until regulations are issued.
  • Four-page summary of benefits and coverage Compliance not required until model coverage summaries developed. Under the law, must be implemented not later than 24 months after the date of enactment (must be developed by Regulatory Agencies).
  • Quality of care reporting Regulations to be issued by March 23, 2012
  • Technical assistance for employer-based wellness programs
  • Prescription Drug Discounts - Part D
  • Expansion of Preventive Services under Medicare
  • HSA/Archer MSA penalty tax increase
  • Simple cafeteria plans
  • OTC drug limits
  • Bringing down cost of coverage (reporting and rebates) - Minimum Loss Ratios
  • Small business grants to provide wellness programs
  • W-2 reporting (The IRS issued Notice 2010-69 making the reporting of the cost of group health plan coverage on W-2s optional for tax year 2011. The IRS will be publishing guidance on the new requirement later this year.)
  • New, voluntary options for Long Term Care Insurance
  • W-2 reporting (Mandatory for 2012 tax year)
  • Distribution of Uniform Summary of Coverage
  • Annual report to HHS and plan participants regarding quality of care
  • Expanded Form 1099 Requirement
  • Health FSA cap
  • Notice of exchange
  • Co-ops
  • HIPAA electronic transaction standards
  • Increase in Code � 213 medical deduction
  • New hospital insurance tax of 0.9 percent on high income individuals*
  • New 3.9 percent Medicare payroll tax on unearned income for high income individuals*
  • Begin comparative effectiveness fee of $2 per participant
  • Notices to employees about Exchange and subsidies
  • Loss of tax exclusion of Medicare Part D drug subsidy

*$200,000 individual, $250,000 joint

  • Increase in Small business healthcare tax credit
  • Fair health insurance premiums
  • Health insurance reporting coverage
  • Transparency in coverage (QHP) reporting
  • Individual mandate
  • Employer Shared Responsibility
  • Exchanges
  • Prohibition on excessive waiting periods
  • Guaranteed availability of insurance coverage
  • Guaranteed renewability of coverage
  • Nondiscrimination based on health status
  • Coverage for clinical trials
  • Nondiscrimination against healthcare providers
  • Comprehensive health insurance coverage
  • Cost-sharing limitations
  • Preexisting Condition Exclusion prohibition (for all)
  • High cost coverage tax