Healthcare Reform Bill Summary
Healthcare Reform Bill Summary
Part VII
Health insurance plan changes that impact individuals and employers (both fully insured and self-funded plans unless otherwise noted) over the next few years:
High-Level Overview Health Reform Law: Key Provisions for Large Employers
Medicare and Medicaid-related provisions
- Retiree drug subsidy. Beginning in 2013, employers may no longer deduct the retiree drug subsidy when offering qualified coverage under Medicare Part D.
- Part D donut hole. Provides $250 rebate for Part D enrollees who enter the “donut hole” coverage gap (2010 only); 50 percent brand discount on drugs in the gap beginning in 2011. The donut hole is eliminated by 2020.
- Medicaid. Beginning in 2014, states are required to provide health insurance premium assistance and wrap-around benefits to any Medicaid beneficiary who is offered employer-sponsored coverage, if it is cost-effective to do so.
Other
- Administrative simplification. The law also requires HHS to adopt a single set of operating rules for electronic transactions to create uniformity (e.g., health insurance claims or equivalent encounter information, eligibility and claims status, enrollment and disenrollment, premium
payments, and referral certification and authorization). Group health plans will have to certify compliance with these standards.
- CLASS Act. Creates a new government-run voluntary long-term care insurance program (CLASS Program). Employers must automatically enroll employees and facilitate payroll deductions. Employees may choose not to participate.
Revenue-raising provisions
- Starting July 1, 2010, impose a 10 percent tax on tanning services.
- Beginning in 2011, the pharmaceutical industry will pay annual industry fees. The fee will be phased in and will hold steady at $2.8 billion a year after 2019.
- Beginning in 2013, manufacturers of medical devices will pay a 2.3 percent excise tax on sales of medical devices.
- Beginning in 2013, the Medicare payroll tax rate will increase by 0.9 percent for individuals who make more than $200,000 and couples that make more than $250,000.
- A new 3.8 percent tax will be added on income from interest, dividends, annuities, royalties and rents for those at the same income threshold.
- Beginning in 2014, a non-deductible health insurance premium tax will be imposed on insurers ($8 billion in 2014, $11.3 billion in 2015 and 2016, $13.9 billion in 2017 and $14.3 billion in 2018. After that, it will increase in an amount proportional to overall health insurance premium growth).
Not to be used for implementation purposes
IMPORTANT: This document is designed to provide a general overview of the new health reform law. It does NOT attempt to cover all of the law’s provisions and should NOT be used as the legal advice for implementation activities. We encourage you to seek any professional advice, including legal counsel, regarding how the new requirements will affect your specific plan.
This summary provided by Humana One Health Insurance and Humana Small Business Health Insurance.
Summary Of Health Care Reform Bill
Summary Of Health Care Reform Bill
Part III.
Health insurance plan changes that impact individuals and employers (both fully insured and self-funded plans unless otherwise noted) over the next few years:
IN 2018:
- Taxes. A new excise tax goes into effect for high-value, “Cadillac” health insurance plans: 40 percent for amounts over $10,200 for individuals and $27,500 for family health insurance plans, paid by health insurance companies and health plan administrators.
Medicare and Medicaid-related provisions
- Part D donut hole. Provides a $250 rebate for Part D enrollees who enter the “donut hole” coverage gap (2010 only). Beginning in 2011, there will be a 50 percent brand discount on drugs in the gap. Members will pay less for generic drugs in the gap as well: 93 percent in 2011, which phases down to 25 percent by 2020. The donut hole is eliminated by 2020.
- Retiree drug subsidy. Beginning in 2013, employers may no longer deduct the retiree drug subsidy when offering qualified coverage under Medicare Part D.
- Medicaid. Beginning in 2014, states are required to provide health insurance premium assistance and wraparound benefits to any Medicaid beneficiary who is offered employer-sponsored health insurance coverage, if it is cost-effective to do so.
- Medigap. The National Association of Insurance Commissioners will create new model plans for benefi t packages C and F that include nominal cost sharing. The new models will be available in 2015.
Other
- Administrative simplification. The law also requires HHS to adopt a single set of operating rules for electronic transactions to create uniformity (e.g., health insurance claims or equivalent encounter information, eligibility and claims status, enrollment and disenrollment, health insurance premium payments, and referral certification and authorization). Group health insurance plans will have to certify compliance with these standards.
- CLASS Act. Creates a new government-run voluntary long-term care insurance program (CLASS Program). Employers must automatically enroll employees and facilitate payroll deductions. Employees may choose not to participate.
Revenue-raising provisions
- Starting July 1, 2010, impose a 10 percent tax on tanning services.
- Beginning in 2011, the pharmaceutical industry will pay annual industry fees. The fee will be phased in and will hold steady at $2.8 billion a year after 2019.
- Beginning in 2013, manufacturers of medical devices will pay a 2.3 percent excise tax on sales of medical devices.
- Beginning in 2013, the Medicare payroll tax rate will increase by 0.9 percent for individuals who make more than $200,000 and couples that make more than $250,000.
- A new 3.8 percent tax will be added on income from interest, dividends, annuities, royalties and rents for those at the same income threshold.
- Beginning in 2014, a non-deductible premium tax will be imposed on health insurance comapnies ($8 billion in 2014, $11.3 billion in 2015 and 2016, $13.9 billion in 2017 and $14.3 billion in 2018. After that, it will
increase in an amount proportional to overall health insurance premium growth).