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Healthcare Reform

Healthcare Reform Information

What does health care reform encompass?

The Patient Protection and Affordable Care Act (PPACA), was signed into law in 2010 and has been updated annually. The ACA (as it is also known) is predominantly focused on lowering the number of uninsured Americans and reducing the cost of health care in the United States. Below we have listed just a few of the key elements of the Affordable Care Act. For a much more comprehensive list and additional information, please contact us.  

How does health care reform affect you and your company?

  • How the ACA impacts your company depends on how many employees you have. Employers with 51+ full time equivalent employees must offer affordable, minimum essential coverage or pay a fine.
  • In addition, employers with 51+ full time equivalent employees are responsible for end of the year tax reporting via the issuance of 1094 and 1095 C documents.
  • Employer's waiting periods can be no longer than 90 days.
  • Expands coverage to include the 10 essential health benefits including pediatric dental and vision on all plans.
  • Created the Covered California Exchange (and in other states) the Federal Exchange marketplace.
  • Children can remain on their parents' plan until age 26.
  • Health care will be available for individuals with pre-existing conditions. Starting in 2014, cancellations and non-renewals based on chronic illness are illegal. This includes both adults and children.
  • Preventative services, such as annual physical exams and blood pressure screenings, will be available on all plans at no cost.
  • Small businesses can receive a 2 year tax credit to offset the burden of offering health coverage.     
  • An 80/20 rule requires insurance carriers to spend at least 80 percent of premium dollars on medical treatment, rather than on administration costs. If they do not meet this requirement, they must offer a rebate to customers.
  • Lifetime and annual dollar limits on essential medical treatments will be phased out by 2014, which means that consumers will no longer be denied coverage once their medical expenses reach a certain dollar amount.
  • The gap, or donut hole, in Medicare’s Part D prescription drug program will close in 2020, making drugs more affordable. Until then, seniors will receive savings on both brand-name and generic drugs.

Get started today!

Our agency can help you create a health care program to both cover your needs and meet government requirements. These are volatile times in the health insurance industry. We are here to answer your questions and guide you to a viable solution. Call us to today to get started!

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