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6

ANSWERS

to the question:

iNFOGRAPHIC

“What should I be doing
about the AFFORDABLE
CARE ACT right now?”

1
2
3

Do what you should
be doing already.

Recent changes should already be in place. The
additional 0.9 percent Medicare tax for wages over
$200,000, Health FSA salary reduction contribution limit
of $2,500 and W-2 health care coverage reporting (if the
employer had 250 or more W-2s in the prior tax year).
Major medical plans should also be providing a
Summary of Benefits & Coverage, the ACA’s equivalent
of the nutrition facts label. Click here for a timeline.

Understand the Health
Insurance Marketplace.

The Marketplace is formerly known as the exchange.
The enrollment period starts on October 1, 2013.
Employers must send an informational notice in late
2013 to all current employees and new hires.
More information on the notice is available here.

Stop doing some things.

!

Next year will signal the death of preexisting condition
exclusions for medical plans, regardless of age. Also,
lifetime and annual limits will be prohibited on essential
health benefits. A good summary can be found here.

One Source. InfiniteSolutions.

4
5
6

©2013 Infinisource

Get well.

Wellness program incentives will be enhanced in 2014,
increasing from 20 to 30 percent of coverage cost. The
incentive can be up to 50 percent for tobacco
cessation incentives. The primary regulations are here.

Don’t wait forever.

For plan years starting in 2014, group health plan waiting
periods cannot exceed 90 days. Special rules exist for
part-time and variable hour employees. Notice 2012-59
addresses this issue.

Prepare for the fees.

The ACA has a high price tag, and 2014 will see
employers and insurance carriers starting to pay the
bill. Carriers must pay $1 per participant to pay for
Patient-Centered Outcomes Research (PCOR). PCOR
fees are due from employers if they have an applicable
self-insured medical plan. Reinsurance fees will be due
from carriers for 2014-2016, estimated to be $63 per
covered life per year. Self-insured medical plans will be
responsible for the fee. Guidance is available here.

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What Should I be Doing About the Affordable Care Act?

  • 1. 6 ANSWERS to the question: iNFOGRAPHIC “What should I be doing about the AFFORDABLE CARE ACT right now?” 1 2 3 Do what you should be doing already. Recent changes should already be in place. The additional 0.9 percent Medicare tax for wages over $200,000, Health FSA salary reduction contribution limit of $2,500 and W-2 health care coverage reporting (if the employer had 250 or more W-2s in the prior tax year). Major medical plans should also be providing a Summary of Benefits & Coverage, the ACA’s equivalent of the nutrition facts label. Click here for a timeline. Understand the Health Insurance Marketplace. The Marketplace is formerly known as the exchange. The enrollment period starts on October 1, 2013. Employers must send an informational notice in late 2013 to all current employees and new hires. More information on the notice is available here. Stop doing some things. ! Next year will signal the death of preexisting condition exclusions for medical plans, regardless of age. Also, lifetime and annual limits will be prohibited on essential health benefits. A good summary can be found here. One Source. InfiniteSolutions. 4 5 6 ©2013 Infinisource Get well. Wellness program incentives will be enhanced in 2014, increasing from 20 to 30 percent of coverage cost. The incentive can be up to 50 percent for tobacco cessation incentives. The primary regulations are here. Don’t wait forever. For plan years starting in 2014, group health plan waiting periods cannot exceed 90 days. Special rules exist for part-time and variable hour employees. Notice 2012-59 addresses this issue. Prepare for the fees. The ACA has a high price tag, and 2014 will see employers and insurance carriers starting to pay the bill. Carriers must pay $1 per participant to pay for Patient-Centered Outcomes Research (PCOR). PCOR fees are due from employers if they have an applicable self-insured medical plan. Reinsurance fees will be due from carriers for 2014-2016, estimated to be $63 per covered life per year. Self-insured medical plans will be responsible for the fee. Guidance is available here.