There is no denying that this is a historic day and was a nerve racking morning for those of us who were glued to the SCOTUS blog as the Supreme Court ruled on Health Care Reform. Word on the court's decision was then pushed out by nearly everyone and with the prevalence of social media, the news instantly made it to computers and smartphones thanks to email, Facebook and Twitter. Our objective with this post is to bring you some clarity and perspective given the Supreme Court's decision.
As an employer or benefits plan administrator what do I need to do?
As of today, nothing new is required for employers who have been implementing the Health Care Reform measures to date. This may be a surprising answer given the excitement of today's events, but the reality is that most health plans have already been modified to comply with Health Care Reform. New regulations will continue to be implemented and employers will not feel most of these changes until their next plan renewal. It is best to use your time now to strategize and plan with your benefits broker/consultant for future Health Care Reform compliance.
However, with such a historic event affecting all health plans, we recommend employers consider drafting a communication to employees regarding how the Supreme Court's decision may impact their health coverage. We have drafted a sample communication here that employers can use to share with their employees:
The Supreme Court has issued their decision upholding the Health Care Reform Law, stating that the law is constitutional. This historic decision is unique in that it affects everyone, since we are all consumers of the health care system. We wanted to take a minute to share with you that this decision will not have an immediate impact on your employer-sponsored coverage. Since 2010 we have been modifying our health plan to comply with Health Care Reform. These changes have included covering in-network preventive care at 100%, removing the pre-existing condition limitation for children under age 19 and extending coverage to dependent children to age 26. In the coming years there are many additional provisions that the Health Care Reform Law will require us to implement. We are working with our Employee Benefits Consultant to implement each provision under our continued strategy to provide employees with comprehensive health coverage at an affordable cost.
What Health Care Reform measures are on the horizon?
A few measures will be implemented in 2012 and 2013 that require an employer's attention with an onslaught of provisions scheduled for 2014. We will be dedicating future blog postings to each specific topic as we have done in the past. The following is a timeline of the scheduled measures from 2012 to 2014:
August 1 - Insurers report and issue Medical Loss Ratio rebates. Employers face a compliance issue on determining how to allocate any money received from the insurance carrier.
September 23 - Uniform Summary of Benefits and Coverage must be issued to all new applicants and enrollees. Employers must implement the specific format, distribution timing, and alternative language accommodation requirements.
October 1 - Patient Centered Outcomes Research Institute (PCORI) fee imposed on insurers in the amount of $1 per covered life per year in the first year and $2 per covered life in subsequent years.
FSA Medical Account limit set at $2,500 per covered employee
W-2 health care cost reporting for employers furnishing more than 250 W-2 forms
Notice to employees regarding the State Health Care Exchanges
Medicare Tax increase by 0.9% and Net Investment Income Tax of 3.8% on earnings over $200,000 for individuals and $250,000 for married couples
2014 & Beyond
Individual tax credit and cost sharing subsidy
Employer "Play or Pay" mandate
Insurer and self-funded plan TPA reinsurance payments
Wellness programs incentives increase to 30%
Elimination of pre-existing condition exclusions
No benefit waiting periods that exceed 90 Days
Benefit mandates for individuals and small groups
State Exchanges for employers with less than 100 employees
State Exchanges for large group employers (2017)
40% excise tax on "Cadillac Plans" (2018)
We strive to be a resource for you on the details on Health Care Reform. We will continue to publish blog posts that detail all of the above provisions so you are aware of the compliance requirements and required action items. You may also contact us directly at 650-363-7237 or firstname.lastname@example.org for more information.