Official Health Reform Website
The US government has launched a website to make key provisions of the law clear to the general public – us!
Ready for Reform Resources
Shargel has designed this simple tool to assist you determine your readiness for reform. Answer these ten questions and call us for assistance.
Critical action steps to prepare your business for what’s to come in 2014.
Visit our facebook page for weekly updates on the latest news regarding healthcare reform.
Health Reform Related Articles
Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act
A readable but detailed review of upcoming employer requirements under the Affordable Care Act.
Covered CA is our new insurance marketplace specifically designed for small businesses with 50 or fewer full-time equivalent employees. The website now contains useful basic information. Plans and pricing will be available by October 1st for January 1st, start date.
Insurance Carrier Healthcare Reform Employer Information Sites
2012 Benefits Changes for Most Employer Plans
Women’s Preventive Care
Starting with plans effective on or after August 1, 2012, employers with non-grandfathered health plans will be required to cover women’s preventive services without cost sharing,
Services for women include:
- Well-woman visits
- Screening for gestational diabetes
- Testing for human papillomavirus (HPV)
- Counseling for sexually transmitted infections
- Screening and counseling for human immunodeficiency virus (HIV)
- FDA-approved contraception methods and contraceptive counseling
- Breastfeeding support, supplies and counseling
- Screening and counseling for interpersonal and domestic violence
Summary of Benefits and Coverage
Starting September 23, 2012, health insurance issuers and group health plans are required to provide an easy-to-understand summary about a health plan’s benefits and coverage
Employee Notification of Value of Coverage
Employers are required to report the value of the employer-sponsored coverage on employees’ W-2s for 2012 (postponed for employers with less than 250 W-2’s) .
Reductions in Flexible Spending Account Contributions
In 2013, employee contributions to Flex Spending Accounts will be capped at $2,500 annually, with the cap adjusted annually to the Consumer Price Index.
Benefits Changes Now in Effect for Most Employer Plans
Full coverage for Preventive Care
All plans now cover at no cost many preventive health services for children and adults.
Covered age appropriate preventive services include:
- Blood pressure, diabetes, and cholesterol tests
- Many cancer screenings, including mammograms and colonoscopies
- Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
- Routine vaccinations against diseases such as measles, polio, or meningitis
- Flu and pneumonia shots
- Counseling, screening, and vaccines to ensure healthy pregnancies
- Regular well-baby and well-child visits, from birth to age 21
Elimination of lifetime limits and annual limits
Lifetime limits on most benefits are prohibited in any health plan or insurance policy and the new law restricts and phases out the annual dollar limits on all job-related plans.
Controls on Health Insurance Premiums 2011 / Rebates 2012
For small employer plans, (less than 50 employees) the law requires that at least 80% of the premium dollars be spent on health care and quality improvement. For large employer plans (not self-insured) the requirement is 85% of the premium.
Employers and individuals received rebates for any premiums collected that did not meet these minimums. Rebates were sent by August 1, 2012. The Kaiser Family Foundation estimates that through the rebates $1.3 billion was returned to consumers and businesses across the country. That number breaks down to an average of $127 per person for individually insured people, $76 per person for small businesses, and $72 per person for large businesses.
Small Employer Health Care Tax Credits began in 2010
New tax credits were designed to assist small businesses and nonprofit organizations afford the cost of providing health insurance for their employees. If you employ fewer than 25 employees and your average annual wages are below $50,000, you may qualify for a small business tax credit of up to 35% (up to 25% for not-for-profits) to offset the cost of the health insurance you provide for your employees. You may exclude owner compensation in the calculation of average annual wages.
Supreme Court Decision
The US Supreme Court upheld the constitutionality of the health reform law, June 28, 2012. This white paper summarizes the issues involved and the implications for employers. PDF Health Care Reform: Entire PPACA Held Constitutional. Our blog describes the Wins for Californians.
Health Reform Under Attack
This white paper by Susan Shargel, published in January, 2011, clearly describes the significance of the Affordable Care Act to small and mid-sized businesses.