Healthcare Reform

The majority of us are aware that there are a lot of changes pending in response to healthcare reform.  No one was making a move on the issue unless/until Obama was re-elected.  While the Affordable Care Act doesn't go into effective until 2014, with his re-election there is now increased activity and focus on the issue. In July of this year Governor Rick Perry announced that Texas would not establish or participate in a health care exchange.  That allows some of us "off the hook" with respect to a few requirements of ACA.

 

So, here we are.  Even before 2014, there are a few requirements that fall into place in 2013 that we need to be aware of.  These requirements include:

 

1. Summary of Benefits and Coverage (SBC) Statements.  All plans are to supply plan participants with SBCs and a glossary of commonly used terms during this year's open enrollment period.  Moving forward, firms that distribute SBCs to workers in a county where 10% or more of the population speaks the same non-English language need a "prominently displayed statement" in the non-English language about how workers can access the plan's language services.  In reviewing the "2012 Culturally and Linguistically Appropriate Services (CLAS) County Data, if your organization resides in Harris County you're looking at an 18% Spanish population.
2. W-2 Reporting.  Employers issuing 250 or more W-2 forms have to include the value of each individuals health plan benefits on their forms. 
3. Let's talk about the hidden "$64.00 per head" fee that employers may face in 2014.  It appears as though the fee will be based on the level of participation in your health plan.  The information is rather vague at this time as to how that fee is collected or its effective date.   The money from the fee will be pooled in an account managed by the HHS.  The funds will be used to reimburse insurance companies who end up covering a large share of individuals with pre-existing conditions.  The fee is expected to be phased out after 2016 - unless Congress votes to extend it - and will decrease very year.  In 2015 the fee is expected to drop to about $42 per participant per year and further decrease to $26 per participant in 2016. 

Keep your eyes on the healthcare reform issue - more changes could be around the bend!