Dependent Coverage - Extends dependent coverage for adult children up to age 26 for all individual and group policies.
Medical Loss Ratio Rebate – Requires health plans to report the proportion of premium dollars spent on clinical services and other related costs. Insurers are required to provide rebates for coverage to employers, who can use the rebate to reimburse employees, reduce future premiums, or improve plan benefits.
Restrictions on Cafeteria Plans - Increases tax on distributions from HSA that are not used for qualified medical expenses from 10% to 20%.
Summary of Benefits and Coverage – Requires private individual and group health plans to provide a uniform summary of benefits and coverage (SBC) to all applicants and enrollees. The goal is to help consumers compare health insurance coverage options before they enroll and understand their coverage once they sign up.
Elimination of Employer Medicare Tax Deduction – Eliminates the tax-deduction for employers who receive federal subsidies for Medicare Part D retiree drug payments.
Employee Notice of Coverage Options – Requires employers to provide all employees with a notice describing the health coverage available through insurance exchanges. (Open enrollment begins 10/1/13)
Limit to FSA Contributions – Limits the contribution amount for a flexible spending account to $2,500, with an annual increase by the cost of living adjustment.
Medicare Tax Increase – Increases the Medicare Part A (hospital insurance) tax rate on wages by 0.9% (from 1.45% to 2.35%) on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly. Also imposes a 3.8% assessment on unearned income for higher-income taxpayers.
W-2 Reporting – Requires employers issuing 250 or more Forms W-2 in the preceding calendar year to report the cost of coverage under an employer-sponsored group health plan.
Automatic Enrollment – Employers with 200 or more employees are required to enroll employees into the employer’s group health insurance plan automatically.
Health Insurance Exchanges – Creates state-based health insurance exchanges that individuals and small businesses with up to 100 employees can use to apply for qualified coverage.
Individual Insurance Requirement – U.S. citizens and legal residents are required to have and maintain health insurance, or pay a fine starting at $95/person or 1% of income in 2014, increasing to $695 in 2016.
Limit on Waiting Period – 90 day maximum waiting period for health coverage.
Nondiscrimination Rule – Prevents employer group health plans from discriminating in favor of highly compensated employees.
Pre-Existing Conditions / Annual Limits – Prohibits pre-existing condition exclusions and annual limits on the dollar value of coverage.
Wellness Incentives Program – Permits employers to offer employees rewards of up to 30% (potentially increasing to 50% for programs established to reduce or prevent tobacco use) of the cost of coverage for participating in a wellness program and meeting certain health-related standards.
Employer Shared Responsibility – Assess a penalty of $2,000 per full time employee on employers with 100+ employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Employers with 100+ employees that provide coverage but have at least one full-time employee who receives a premium tax credit will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full time employee. In both cases, the first 30 employees are exempt.
Employer Shared Responsibility (50-99 employees) – Delays the ESR penalty for employers with 50 to 99 employees until January 1, 2016.
2018 – Tax on High-Cost Insurance - Imposes a 40% excise tax on employer-sponsored health plans if group health coverage exceeds the following estimated limits: $10,200 for individual coverage and $27,500 for family coverage.