March 2010
- President Obama Signs Patient Protection and Affordable Care Act
September 2010
- Dependent children covered to age 26
- Insurance companies no longer able to deny coverage to children with pre existing conditions
- No annual benefit limits
- No lifetime limits on key benefits
September 2011
- Insurance companies requesting more that 10% increase must submit to Federal reviewers
July 2012
- Claims and appeals processes implemented
August2012
- Medical Loss Ratio Rebates – if an insurance company fails MLR test must rebate over charge to insured (80% for small business-85% for large business)
- Preventative health services for women with no cost sharing
September 2012
- Summaries of benefits and coverages must be provided to all insureds and new enrollees
December 2012
- Form w-2 must include the value of group health plan benefits provided to employees
January 2013
- FSA (Flexible Spending Account) limit at $2500 per year
- Employers can not take a deduction for retiree Rx drug expenses
- FICA tax increase by 3.8% on high income individuals
- Medicare tax increase by .9% for high income individuals
March 2013
- Employees must be notified of the availability of State Health Insurance Exchanges (Has been postponed until late summer of 2013)
July 2013
- For plan years ending after October 2012 or before October 2019 self insured groups and insurers must pay fees per covered life of $1 (increasing to $2 for plans years ending after October 2013)
December 2013
- Employer group health plans must HIPAA certify requirements for rules on electronic transactions between providers and health plans
Effective Date Not Specified
- Employer group health plans must provide an annual report disclosing information of plan benefits and reimbursement structures that improve health outcomes (regulations remain unissued)
January 2014
- “Pay or Play” employers with 50 or more ees must offer a minimum level of affordable health care coverage or pay a penalty ( the penalty has been postponed to January 2015)
- “Pay or Play” Individual Mandate- most individual taxpayers must have health coverage or purchase through the Exchange or pay tax penalties
- Wellness incentives may be increased by employer to 30% of average costs
- Employer imposed waiting periods can be no longer than 90 days
- Employer group plans may not impose pre existing condition exclusions
- Employer group plans may not impose annual dollar limits on essential benefits
Expected in January 2014
- Large employers (over 200 ee) must automatically enroll new ees in the group health
- Insured employer group plans may not discriminate in favor of HCEs (highly compensated employees)
January 2018
- “Cadillac Tax” will require employers to pay an excise tax if coverage through group plan exceeds annual cost of $10,200 for a single or $27,500 for family coverage (numbers will be adjusted for inflation)