ppaca: important dates
TRANSCRIPT
BancorpSouth Insurance Services, Inc. is a wholly owned subsidiary of BancorpSouth Bank. Insurance products are • Not a deposit • Not FDIC insured • Not insured by any federal government agency • Not guaranteed by the bank • May go down in value
©, 2012, BancorpSouth Insurance Services, Inc.
Brian [email protected]
225-215-9479
Health Care Reform TimelineWright & Percy Insurance
• Temporaryhighriskpool• Earlyretireereinsuranceprogram• Smallbusinesstaxcredit• Dependentcoverageforadultchildrenuntilage26
• Nopre-existingconditionexclusionsforindividualsuntilage19
• Rescissionsprohibitedexceptforfraudornon-payment
• Lifetimedollarlimitsprohibited• Annualdollarlimitsrestricted• Preventiveserviceswithnocostsharing(G)
• PediatriciansasPCPs,directaccesstoOB/GYNs(G)
• ERcoverageasin-network,nopriorauthorization(G)
• Appealsprocessandexternalreview(G)• MedicarePartDrebateforbeneficiariesinthegap
2010
• Annualratereviewprocess• Medicallossratio(MLR):85%forlargegroup;80%forsmallgroupandindividual
• HSAs/HRAs/FSAs:limitationsforOTCmedications
• Increasepenaltyfornon-qualifiedHSAwithdrawals
• Smallbusinesswellnessgrants• Annualfeeonpharmaceuticalmanu-facturersbegins
• DiscountsinMedicarePartD“donuthole”
• Nondiscriminationrulesapplytoinsuredplans(G)(implementationdelayed)
• Auto-enrollmentforGroupswith200+FTEs(implementationdelayed)
2011 • SummaryofBenefitsandCoverageandUniformGlossary
• Expandedwoman’spreventiveservices(G)
• 60dayadvancenoticeofmaterialmodification
• AccountableCareOrganizationrequirements
• QualitybonusbeginsforMedicareAdvantageplans
• Comparativeeffectivenessfee($1permember/year)
• Administrativesimplificationbegins• 1stmedicallossratiorebatestobepaidbyAugust
2012
• Exchangenoticestoemployees• Employerstoreportvalueofemployer-
sponsoredhealthbenefitsonW2s• FSAcontributionslimitedto$2,500• Highearnertaxbegins• Annualfeeonmedicaldevicesales
begins• DeductionforexpensestothePartDsubsidyfor“qualifiedprescriptiondrugplans”eliminated
• Comparativeeffectivenessfeeincreasesto$2permember/year
2013 • Healthbenefitexchanges• Guaranteedissueandrenewalrules(G)• Noannuallimits• Nopre-existingconditionexclusions• Ratingrestrictions(G)• Individual&employermandates• Taxcreditsandsubsidiesforindividualsandsmallemployers
• Standardizedessentialhealthbenefits• Waitingperiodlimit(90days)• Mandatorycoverageforclinicaltrials(G)• Reinsurancefee• Annualinsuranceindustrytax• OOPlimitsmustcomplywithOOPlimitsforHSAqualifiedplans(G)
• Deductiblecapscannotexceed$2kforindividualand$4kforfamily(G)
• ICD-10codeadoption
2014
• StatescanopenExchangetoCHIPeligibles(2015)andallemployers(2017)
• Sunsetofcomparativeeffectivenessfee(2017)
• High-valueplanexcisetax“CadillacTax”begins(2018)
• Insuranceindustrytax(through2018)
• MedicarePartD“Donuthole”closed(by2020)
2015 & BEYOND
(G)=Notapplicabletograndfatheredplans.Note:Someprovisionsapplyonlytofullyinsuredplans.Thisisforinformationalpurposesonlyandisnotintendedtobeusedaslegaladvice.BancorpSouthInsuranceServices,Inc.isawhollyownedsubsidiaryofBancorpSouthBank.Insuranceproductsare•Notadeposit•NotFDICinsured•Notinsuredbyanyfederalgovernmentagency•Notguaranteedbythebank•Maygodowninvalue©,2013,BancorpSouthInsuranceServices,Inc.
Rev.2/8/2013