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Health Care Reform Overview

June 27th, 2013 Posted in Educational Forum

HEALTHCARE REFORM HIGHLIGHTS
IN EFFECT FROM 2012 (8/01/12 for non-grandfathered plans)
Most plans must cover certain preventive services for women with no copayments, co-insurance, or deductibles – well-woman visits; counseling for interpersonal & domestic violence; screening & counseling for certain sexually transmitted diseases & viruses; pregnancy services; certain contraceptive methods.

WHAT TO EXPECT IN 2013
Contributions to Flexible Spending Accounts are limited to $2,500 per year.
Medical Devices are taxed 2.3% – exemptions include eye glasses, contact lenses and hearing aids.
Medicare payroll taxes are increased – for income +200k it’s increased by 0.9%.
Employers must provide notice of health insurance exchanges – which begin 1/1/14. Also, they must inform employees of their potential eligibility for federal assistance (due to their income level) if applicable.
10/01/13 to 3/31/14 – open enrollment period for small employers and qualified individuals for health insurance exchange (the “shop for your plan” period).

WHAT TO EXPECT IN 2014
Health insurance exchanges will start (continue) for individuals and small employers to compare/shop for standardized health packages.
Employers must offer employees minimum essential coverage (if employ 50 or more FT employees) penalty for every FT employee over the first 30.
Premium tax credits – available for people with (larger of) incomes above 100% of federal poverty level or Medicaid eligibility, and below 400% of federal poverty level if not eligible for or offered other coverage.
Most individuals must have insurance (there are some exceptions for those who cannot find affordable insurance and certain religious groups) – or pay a penalty that will increase each year for the first three years.
Medicaid eligibility increases – to 133% of federal poverty level (for non-elderly individuals).
Pre-Existing conditions will no longer be excluded from coverage – premiums will only vary due to age, geography, family size and tobacco use. There will be no annual dollar value limits on amount of coverage for individual.
Medicare Part D enrollees – will have a decrease in their out-of-pocket costs for prescription drugs; additional drug discounts will phase in thru 2020; Medicare share of costs will increase – closing donut hole in 2020.
Health plans must provide first-dollar coverage for preventive services such as annual checkups (applies to non-grandfathered and new plans).
Dependent coverage must continue to be available for eligible dependent children to age 26 (no student requirement).
No more lifetime limits on coverage for essential benefits.

THIS IS ONLY A BRIEF SUMMARY- REMEMBER:
SEEK THE ADVICE OF A PROFESSIONAL TO ANSWER YOUR QUESTIONS!
Carol N. Brown, CSA 386-848-0543 CarolNBrown@aol.com  www.carolnbrown.com

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