roundtable discussion – 9/9/2010. reform today & near future mandatory reforms – examples...
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Roundtable Discussion – 9/9/2010
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Reform today & near future
Mandatory reforms – examples impacting now: Accommodate breast-feeding mothers on-site –
must provide a private place other than restroom• <50 employees may have exemption
Required mandates (preventive care, dependent age limits, exclusion of lifetime limits) increasing rates by around 4% for current/next renewal
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Reforms for 2011
Value of benefits to be reported on W-2sNo pre-tax reimbursements from HSA, FSA or
HRA for over-the-counter Rx without prescription
Tax increase for non-qualified HSA withdrawals moves from 10% to 20%
Automatic enrollment in assisted living programs (CLASS Act); employees may opt out
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To Grandfather or not to Grandfather
Not grandfathered: Non-discrimination
testing Preventative care
benefits @ 100% New claims appeal
processes Adult children (to age
26) with access to other coverage
All Plans regardless of grandfathered status: Eliminate pre-ex for
children under 19 Eliminate lifetime and
annual maximums Eliminate rescissions
(except for fraud) Adult children (to age
26) without access to other coverage
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2014 – The big year
Health Insurance Exchanges come on line Requirement to offer coverage (50 or more
employees) Penalties range from $2,000 to $3,000 per employee
if no coverage offered or deemed “unaffordable” Waiting period cannot be more than 90 days Treasury reporting; enrollment, premiums, number
of full time EE’s each month
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