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- Employees are informed that coverage cannot be rescinded retroactively (with few exceptions).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.