Health care reform timetable
03/06/2013

The Patient Protection and Affordable Care Act was upheld by the Supreme Court last year and is now the law of the land. The following is the timetable for key provisions of the law to be enacted.

Already enacted

  • Small employer tax credit
    • Must have 25 or fewer employees and the average annual wages paid to those employees must not exceed $50,000 per employee.
    • Employer may receive a 35 percent tax credit for the cost of health care benefits coverage for those employees. The credit will increase to 50 percent beginning in 2014, but will expire in 2016.
  • Employers with more than 200 employees must automatically enroll them in insurance.
  • Plans must cover first-dollar preventive care, such as immunizations or screening for diseases like breast or prostate cancer.
  • Fully insured health plans, like those offered by most small businesses, may not discriminate in favor of highly compensated employees.
  • Adult children must be covered up to the age of 26 in plans that offer dependent care.
  • Plans cannot cancel coverage except in cases of fraud.
  • Plans may no longer set lifetime limits on essential benefits. Some reasonable limits on annual benefits are permitted until 2014.
  • Children with pre-existing conditions cannot be excluded from dependent coverage.
  • Employers are responsible for reporting the total cost of medical benefits (dental and vision are excluded) an employee receives in a year on the employee’s W-2 form.
  • If you offer a flexible spending plan as a health benefit to your employees, no reimbursements will be allowed for over-the-counter drugs and flex accounts are capped at $2,500 beginning in 2013.

2014

  • Exchanges to be up and running.
  • Employer mandate.
  • Individual mandate.
  • Affordability provisions.
  • Guaranteed issue, no pre-existing condition exclusions.
  • No lifetime limits on coverage
  • A 90-day waiting period limit.