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Healthcare: 2012 v. 2013 v. 2014

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Hutchins Allen and Company shares key healthcare provisions effective in 2013 and beyond.

Many employers wonder what is required versus what is optional under health care reform. Here is a checklist of what is currently in effect.

Already in effect:

  • Employers that offer health care coverage must offer it to employees’ adult children through age 26.
  • Employers offering health insurance are responsible for making sure that:
  • The insurance covers 100% of the cost of preventative services such as mammograms and colonoscopies;
  • The insurer does not (and cannot) place any “lifetime limits” on health coverage;
  • The insurer does not (and cannot) exclude children age 19 or younger from coverage due to pre-existing conditions; and
  • Employees are informed that coverage cannot be rescinded retroactively (with few exceptions).
  • Over-the-counter medications can be purchased with FSA, HRA or HAS funds only with a doctor’s prescription.
  • Employers with fewer than 25 full-time equivalent employees with an average wage below $50,000 a year may be eligible for tax credits for sponsoring health coverage.
  • Starting with the first open enrollment on or after Sept. 23, 2012, employers must obtain from their insurers and issue to employees a Summary of Benefits and Coverage (SBC).
  • For 2012, insurers must issue the first Medical Loss Ratio (MLR) rebates. This is a complicated area; check with your carrier.

Starting in 2013:

  • Health Care FSAs that operate on a calendar-year must comply with a $2,500 limit on employee contributions beginning in 2013.

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