| March 23, 2010 |
- President signs PPACA into law
- Small business health care tax credit
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| June 23, 2010 |
- Early Retiree Reinsurance Program
- Pre-Existing Condition Insurance Plan (PCIP) provides coverage options to individuals who have been uninsured for at least six months because of a pre-existing condition (High risk pool)
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| September 23, 2010 |
- Adult children coverage to age 26
- No pre-existing condition exclusions for enrollees under age 19
- Restricted annual limits on essential benefits
- No lifetime limits on essential benefits
- Prohibits policy rescissions except for fraud and material misrepresentation of a material fact
- Cost sharing prohibited for certain prevention and wellness services (non-grandfathered plans)
- Emergency services without prior authorization treated as in-network (non-grandfathered plans only)
- Non-discrimination rules extended to insured plans (excludes grandfathered plans)
- Medicare Part D Donut Hole rebate
- HHS health insurance information portal
- Revised appeals process
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| November 2010 |
- Amendment to regulations on grandfathered plans – Employers that offer the same level of coverage through a new issuer can remain grandfathered as long as the coverage does not violate the other rules for maintaining grandfathered status
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| January 2011 |
- No reimbursement for over the counter drugs unless prescribed
- Increased penalty for non-medical HSA withdrawals
- Workplace wellness grants established
- Form W-2 reporting of value of benefits will be optional for employers (for W-2 issued in Jan. 2012 with respect to 2011)
- Insurers will be required to maintain medical loss ratios of 80% for small group plans and 85% for large group plans
- IRS delays enforcement of non-discrimination health care reform provisions
- People with Medicare receive discounts on brand name drugs
- Free preventive services for seniors on Medicare
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| February 2011 |
- Obama administration allows exemption for religious employers to provide contraception as part of no cost preventive services for women
- Auto enrollment for groups with more than 200 full-time employees (implementation delayed; employers will not have to meet this requirement until 2014).
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| April 2011 |
- 1099 Reporting Requirement repealed
- Free Choice Voucher repealed
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| May 2011 |
- Early Retiree Reinsurance Program stops taking applications
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| October 2011 |
- CLASS Act implementation halted by Obama administration
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| January 2012 |
- Accountable Care Organizations (ACOs) are introduced to better coordinate patient care
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| June 28, 2012 |
- The U.S. Supreme Court upholds the healthcare reform law
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| August 2012 |
- Medical loss ratio rebates to be paid by August 1
- No cost preventive services for women (including contraception)
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| September 2012 |
- Summary of Benefits and Coverage needs to be provided to consumers beginning on or after September 23, 2012
- A uniform glossary of terms needs to be included with the Summary of Benefits and Coverage
- All plans must provide notice of plan changes 60 days prior to effective date
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| October 2012 |
- Comparative effectiveness research fee assessed ($1.00 per member per year)
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| January 2013 |
- Maximum amount of contribution to a flexible spending account is capped at $2,500
- Medicare tax increase for high-earners
- Form W-2 reporting of value of benefits (for 2012 Forms W-2, employers with fewer than 250 Forms W-2 are not required to report the value of benefits).
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| February 16, 2013 |
- Federal Pre-Existing Condition Insurance Plan suspends acceptance of new enrollment applications due to lack of funds
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| March 2013 |
- Employer notification regarding exchanges (provision delayed in January 2013, timing for distribution of notices will now be late summer or early fall of 2013)
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| October 2013 |
- Comparative effectiveness research fee assessed (increases to $2.00 per member per year)
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| January 2014 |
- State based exchanges
- Individual mandate to purchase health insurance
- Guaranteed issue in individual market
- Employer mandate (50+ employees) to provide health insurance
- Tax credits and subsidies for individuals and small employers
- Standardized essential health benefits go into effect
- No annual limits
- No pre-existing condition exclusions
- 90 day limit on waiting periods for coverage
- Grandfathered group health plans must provide dependent coverage for children up to age 26. Adult children can stay on their parent’s employer plan even if they have other employer sponsored coverage available.
- Increased wellness program incentives
- Insurer tax – a new tax will be assessed against health plans and insurers which will get passed to consumers through increased premium rates
- Medicaid expansion
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| 2017 |
- States may allow large employers to purchase coverage from health insurance exchanges
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| 2018 |
- Cadillac plan excise tax on high value insurance policies
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