PPACA Implementation Timeline - UFPC.com

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January 15, 2013
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
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Plan Years on or after September 23, 2010
• Expanded definition of “dependent” child (to age 26).
• No lifetime limits and restricted annual limits.
• No preexisting condition for children.
• No rescission of coverage except for fraud.
• Internal and external appeals process.
• Coverage of preventive care.
• Small Business Tax Credit (eff. 1/1/2010).
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
2

Plan Years on or after January 1, 2011
• Health FSAs cannot reimburse un-prescribed over-the-counter
drugs.
• Minimum medical loss ratio for insurers – required rebates if
the share of premium spent on clinical care is less than 85
percent.
• Awarding grants to states to begin setting up health insurance
exchanges.
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
3

Plan Years on or after January 1, 2012
• Uniform coverage summaries for consumers.
• Full implementation of internal claims and appeals and
external review rules.
• Form W-2 reporting requirement (for employers w/250 or
more employees).
• 2013 calendar year for employers with less than 250
W2’s issued
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
4

Plan Years on or after January 1, 2013
• States must indicate to HHS whether the state will operate an
American Health Benefit Exchange.
• Health FSA maximum set at $2,500 (subject to adjustment for
cost-of-living).
• Medicare tax increase (from 1.45% to 2.35%) for individuals
with earnings over $200,000 or married couples filing jointly
over $250,000.
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
5

Plan Years on or after January 1, 2014
• Individual mandate takes effect.
• Individual tax credits for premium and cost-sharing
subsidies for certain low income individuals and families.
• Health insurance exchanges are opened.
• Guaranteed availability of insurance, with premium
variation based only on age, geographic area, family
composition, and tobacco use.
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
6

Plan Years on or after January 1, 2014
• No annual limits on value of coverage.
• No preexisting condition exclusions.
• No medical underwriting
• Community Rating in small group
• Pay or Play model for employers over 50 employees
• Creates essential health benefits package.
• Employer mandate takes effect, including automatic enrollment.
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
7

January 1, 2018
• Excise tax on insurers of employer-sponsored health plans
with aggregate expenses that exceed $10,200 for
individual coverage and $27,500 for family coverage.
Disclaimer: The content provided in this update is for informational purposes only and is subject to change. No warranty or representation, express or implied, is made with regard to the accuracy or
the completeness of the information contained in this update; this information does not constitute legal or professional advice on any subject matter.
Responsibility for the use of this information is solely that of the user.
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