HEALTHCARE REFORM:THE AFFORDABLE CARE ACT

2010

2011 2

012

The ACA is signed into effectby President Barack Obama.

Maximum tax credit for small

businesses that offer health care

benefits (based on percentage of

premium costs for two years).

Dependent children

allowed to stay on parent's

insurance until age 26.

rule requires insurers to provide

rebates based on spending 80% or

85% of premiums on medical care.

No lifetime limit on

healthcare coverage.

No pre-existing exclusions

for children under age 19.

Insurers barred from requiring

co-pays for preventive care

and vaccinations.

The U.S. Supreme Court upholds

major provisions of the ACA.

Health plans must begin

implementing rules for secure,

confidential electronic exchange of

health information.

Numerous provisions to improve

quality and lower costs within

Medicare, Medicaid and Children's

Health Insurance Program (CHIP).

35%

80/20

HEALTHCAREPULSE

2014

The majority of ACA

provisions go into full effect.Open Enrollment for 2014

begins on the federal

exchange: Healthcare.gov

2013

2015

Insurers cannot refuse to

sell/renew policies due to

pre-existing conditions.

Group health plans must be

certified "qualifed health

plans" offering a certain

minimum of benefits.Age rating takes effect for

employers with less than

50 employees.Individual mandate for health coverage.

Medicare and Medicaid

payments tied to the quality of

care they provide.

2017

2016

Full implementation of the Employer

Mandate or "Pay-or-Play" penalty.

Out-of-Pocket maximum

increased:

$7,150 for self-only

$14,300 for familySmall group expansion repealed &

small group remains 50 or less.

United Healthcare announces it

will be exiting most of the state

exchanges it operates in by 2017.

Percent of employees (and their

families) who must be offered

coverage under employer

shared responsibility provision

(50+ employees)

Coverage affordability

adjusted for inflation, for

health plans beginning on

January 1st. New SBC template for health

plans with open enrollment

periods/plan years beginning

on or after April 1, 2017.Reinsurance fees do not apply

for 2017 and beyond.

(2016 fees will be paid in

2017)

States can apply for "innovation waivers"

or 1332 waivers that allow them to modify

key parts of the ACA.

95%

9.69%

Forms 1094 & 1095 begin.

austinbenefits.com