15 Things you did not know about health reform law
by Tony Novak, CPA, MBA, MT,
revised October 7, 2012
Many of us are still discovering the details of the complex 2010 federal health reform law and how those new laws will affect us for years to come.
Here are 15 little-known details of the health reform
law that may affect your health benefits in the near
- The "Cadillac Plan" tax does not become effective until 2018.
The employer, and not the individual, is responsible
for calculating and collecting the excise tax on
Cadillac health plans.
- Health Savings Account plans now have the same
level of policy owner risk as other types of health
plans. The maximum out-of-pocket expense limitations
are now the same for all health plans regardless of
whether they include a Health Savings Account
- Grandfathered plans are exempt from providing preventative care and wellness benefits
as well as many of the other coverage provisions that are now included in other health plans.
- Employer-provided health benefits will be
available to employees who typically work a minimum
of 30 hours per week (40 hours per week is typically
required for eligibility now).
- Rehabilitation services are considered "essential benefits" that must be included in health plans sold on the state insurance exchange.
- Chiropractic care is not classified as an "essential benefit"
and will not be included in the basic health
insurance plans sold on the state insurance exchange.
- Employers must provide paid break time for nursing mothers who want to express milk.
- Health plans may include lifetime limits on non-essential health benefits.
- A referral may not required for OB/GYN care.
- The $13,170 adoption credit was a temporary benefit
that expired in 2011.
- Pre-existing conditions may still be excluded from coverage for adults who have had a significant gap in prior coverage
until a waiting period is satisfied.
- Businesses with less than 25 employees may be eligible for a tax credit
for offering a group health plan.
- Employers with more than 200 employees are
required to automatically enroll employees in their
health plan unless the employee takes steps to opt
- The long term care insurance provision of the
reform law was later abandoned by the U.S.
Department of Health and Human Services as being
- Some types of health plans are exempt from
many provisions of the health reform law. These
include grandfathered plans, short term medical
insurance plans, small business health plans,
uninsured health plans, supplemental health
insurance, mini-med or defined benefit health plans
and self-funded employer plans.
Remember that state insurance laws significantly
impact the application of these federal laws so check
with your enrollment adviser on any specific issues that
may affect your own anticipated health care planning.
Affordable Care Act restricts pay to executives
Embracing the state insurance exchange
Consumer health reform timeline
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