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What’s Happening with Healthcare Reform in 2010 and Beyond?

Healthcare Reform Timeline

Sterling Health Services Administration has developed this high level timeline for healthcare reform implementation over the next several years.

In this blog and on our Healthcare Reform Resource Page, we’ll also provide updates as more information on how the legislation will impact the industry and our clients becomes available.

We also frequently post information on healthcare reform on our Facebook Page. Check it out and become a Sterling HSA Fan and access the latest healthcare reform news and articles as well as tips on financing your healthcare and investing in your health.

2010

• Eligible dependents may be covered until age 26 (6 months after enactment)
• Individuals previously uninsurable will have market access (90 days after enactment)
• Qualifying small employers may receive tax credit for plan sponsorship filed at the end of the year on the business tax return unless they are a tax-exempt firm (6 months after enactment)
• Eliminate pre-existing condition limitations for new coverage for children (6 months after
enactment)
• Eliminate annual and lifetime internal plan maximums (6 months after enactment)

2011

• Rebates and credits and discounts for Medicare Part D plan holders (2011 and later years)
• Carriers must meet expense ratios and pay rebates when not met
• Over the counter drugs will no longer be eligible under FSAs, HRAs, or HSAs
• Employers must show the premium value of coverage on employee W-2
• New “Simple” Cafeteria Plans may be written to avoid discrimination testing
• New Long Term Care coverage will go into effect
• 10% excise tax increased to 20% for non-qualified expenses from HSAs

2013

• Maximum allowance for a Cafeteria Plan health expenses is $2,500
• Additional Medicare taxes on investment income and higher brackets
• Taxes on health carriers, medical device manufacturers and drug companies

2014

• Employers with 50 or more full-time employees must “pay (penalty) or play (coverage)” -the fine is $2,000 per year per full-time employee if health insurance coverage isn’t offered
• Most Americans must also “pay or play” with acceptable coverage levels
• Health Insurance Exchanges (multi or single state pools) will be created as an additional market opportunity, joined by the private plans with which they will still compete

Please contact your Sterling HSA sales representative with questions or concerns about how healthcare reform will affect you and your business.

Visit our website for information on Sterling Health Services Administration and check out our Facebook Page for the very latest news on healthcare reform.

No Comments by Sterling HSA on September 1, 2010
filed in Flexible Spending Accounts, Health Reimbursement Accounts, Health Savings Accounts, Healthcare Reform, Medicare
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18 Key Healthcare Reform Provisions That Could Affect You Immediately

Note: These provisions were published on March 20, 2010 by the Office of Speaker Nancy Peloisi.

18 Key Healthcare Reform Provisions that Could Affect Your Immediately

Below are some of the key provisions that will take effect immediately under the new healthcare reform legislative package.

1.  SMALL BUSINESS TAX CREDITS

Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)

2.  BEGINS TO CLOSE THE MEDICARE PART D DONUTHOLE

Provides a $25 rebate to Medicare beneficiaries who hit the donuthole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand name drugs in the donuthole; also completely closes the donuthole by 2020.)

3.  FREE PREVENTIVE CARE UNDER MEDICARE

Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

4.  HELP FOR EARLY RETIREES

Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment.

5.  ENDS RESCISSIONS

Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

6.  NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS

Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

7.  BANS LIFETIME LIMITS ON COVERAGE

Prohibits health plans from placing lifetime caps on coverage.  Effective 6 months after enactment.

8.  BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE

Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

9.  FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS

Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.

10.  NEW, INDEPENDENT APPEALS PROCESS

Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.

11.  ENSURING VALUE FOR PREMIUM PAYMENTS

Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policy holders. Effective on January 1, 2011.

12.  IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL)

Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool. Effective 90 days after enactment.

13.  EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE

Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

14.  COMMUNITY HEALTH CENTERS

Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.

15.  INCREASING NUMBER OF PRIMARY CARE DOCTORS

Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

16.  PROHIBITING DISCRIMINATION BASED ON SALARY

Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

17.  HEALTH INSURANCE CONSUMER INFORMATION

Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in fiscal year 2010.

18.  CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM

Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

For additional information, please visit our Health Care Reform Resource Page.

To talk with us about these changes or to schedule a speaker on this topic, please contact us.

Find more healthcare reform news, articles, and more on our Facebook Page.

No Comments by Sterling HSA on July 30, 2010
filed in Healthcare Reform
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Your Introduction to Healthcare Reform Changes

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act were signed into law in March 2010. As a result of what is better known simply as “Healthcare Reform”, various agencies and interest groups have begun the difficult work of implementing the new law.

Changes are being made even before the law requires as employers, healthcare consumers, and the health insurance industry prepare for January 2011. Starting then and for the next several years, changes in healthcare delivery and financing legislated in 2010 will be rolled out.

As information is available that impacts the clients and partners of Sterling HSA, we’ll post it here and on our Healthcare Reform Resource Page.

To talk with us about these changes or to schedule a Sterling HSA speaker on this topic, please contact us.

You can also find the latest healthcare reform news and articles on our Facebook Page.

No Comments by Sterling HSA on July 23, 2010
filed in Healthcare Reform
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