Healthcare Reform Summary Timeline
Healthcare Reform Summary Timeline
Here is the Healthcare Reform Summary Timeline of what you can expect to happen over the next few years as the new law is implemented. This report was published by Humana but applies to all the insurance carriers plans. Read this REPORT on how Healthcare Reform will impact your plan at your next renewal.
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Health Care Reform – Summary of Legal Challenges
Health Care Reform – Summary of Legal Challenges
1. The act’s duties and requirements are not enumerated powers of the federal government under Article 1, Section 8, and therefore beyond the scope of the federal government.
2. In the act, the executive branch of government is granted powers not authorized under the Constitution.
3. Nearly all Americans are required, under the act, to purchase health insurance from private companies that in turn will be regulated by the federal government; a violation of the Commerce Clause with no precedence.
4. Punitive action against citizens for failure to comply violates the 5th Amendment, taking rights without “due process.”
5. The act violates Article 1, Section 9 of the Constitution, which limits the types of taxes that Congress can levy.
6. The act violates states’ rights, the 10th Amendment, in regulating the health care industry, including health insurance, and placing all regulations under the federal government.
These are just a few of the problems with the new health.insurance reform. America will get a good feel for the status of its justice system, by closely watching these health care reform cases progress through final resolution in the Supreme Court.
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.
Facts About Healthcare Reform Bill
Facts About Healthcare Reform Bill
Part VI
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 IN 2011:
- Medical loss ratio (MLR). An insurer must publicly report on its MLR and spend at least 85 percent of large group health insurance premiums on medical services or provide rebate payments to enrollees.
- Spending accounts. Health savings accounts (HSAs) and flexible spending accounts (FSAs) may no longer be used to purchase over-the-counter drugs unless prescribed by a doctor. increases tax for nonqualified HSA withdrawals from 10 percent to 20 percent, and for Archer MSA withdrawals from 15 percent to 20 percent.
- HHS studies. HHS is required to study the group health insurance plan markets to compare employer characteristics and determine whether the new health insurance market reforms are likely to cause adverse selection in the large group market or to encourage small and midsize employers to self-insure. HHS and the Department of Labor must also collect information on self-funded health insurance plans. These studies could lead to additional employer reporting requirements.
- Uniform explanation of coverage. Within 12 months of the law's enactment, HHS, in consultation with the National Association of Insurance Commissioners, will develop uniform standards and definitions for summaries of benefits and coverage explanations. Within 24 months of enactment, group health insurance plans must provide enrollees and applicants with coverage documents that meet these standards. Additionally, enrollees must be notifi ed 60 days in advance of any material modification to coverage that wasn't included in the most recent summary.
IN 2012:
- Comparative effectiveness fee. A new fee is imposed on group health insurance plans to fund comparative effectiveness research ($1 per participant through 2013; $2 through 2019).
- Release of Medicare claims data. The private sector may purchase standardized data extracts of Medicare Parts A, B and D claims data to combine with their own claims data to evaluate provider performance measures on quality, efficiency, and the effectiveness of care.
IN 2013:
- FSA contributions. Contributions to flexible spending accounts are limited to $2,500 a year.
IN 2014:
- Pre-existing conditions. Group health insurance plans can no longer impose pre-existing conditions exclusions for any person of any age.
- Annual limits. Annual limits on essential health benefits are prohibited.
- Guaranteed issue. Health insurance companies must accept every employer who applies for health insurance coverage.
- Clinical trials. Coverage of routine patient care costs is mandated for participation in approved clinical trials (does not apply to grandfathered plans).
- Exchanges. State health insurance exchanges are up and running for small businesses and individuals. States can allow large employers to participate beginning in 2017. (Note: the federal definition of a large employer is an employer with 101 or more employees. States can modify the definition to 51 or more employees until January 1, 2016).
- Cost-sharing limits. Cost sharing imposed under group health insurance plans is limited to current health savings account amounts (does not apply to grandfathered plans).
- Waiting periods. Waiting periods cannot exceed 90 days.
- Wellness. Expands health insurance plan wellness incentives up to 30 percent of total coverage costs (up to 50 percent with HHS approval).
- Essential benefits. Essential benefit plan is created, which mandates the level of benefits that must be included in health insurance plans offered in the exchange, as well as in the individual and small group health insurance markets outside the exchange. (Self-funded health insurance plans and grandfathered plans are exempt from this requirement).
- Reinsurance. A temporary reinsurance program will be established for the individual market and funded by individual and group health insurance plan assessments ($25 billion in 2014-2016).
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 plans, paid by health insurance companies and plan administrators.
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.