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Health Care Reform

The new health care reform legislation has and will cause many changes to the health insurance industry. If you have any questions, check the web site links below or feel free to call us for clarification. We will give you our best interpretation of the law. You may also want to talk to your accountant and/or attorney for more information.

Please understand that all of this information is subject to change!

Changes for 2010

Changes for 2011

  • Over-The-Counter Medicine
    • Expenses incurred for OTC medicine will require a prescription
    • HRA / Health FSA / HSA
    • Changes will be effective January 1, 2011
  • W-2 Wage Reporting
    • Effective for plan years beginning on or after January 1, 2011
    • Part of the Revenue Provisions are within PPACA
    • Aggregate value of benefits paid by employer will be reported on W2
    • Employees will not be taxed on this value
  • Also in 2011
    • Simple Cafe' Plan
    • National Public LTC Plans
    • Expanded income tax on income or compensation
    • More information will be provided once it is released
  • Fully insured health plans were subjected to medical loss ratio (MLR) requirements. Individual and small-group insurers must adhere to an 80% MLR and large-group insurers must adhere to an 85% MLR. Plans that do not meet this requirement each year will have to pay policy holders rebates by August of the following year.Rules proposed in January 2013 would change the rebate due date to September 30 effective with 2014 MLR reporting.
  • The tax penalty on distributions from Health Saving Accounts (HSAs) that are not used for qualified medical expenses increased form 10% to 20%.
  • Reimbursements for over-the-counter drugs under HSAs, medical FSAs, HRAs and Archer MSAs were prohibited without a prescription
  • Small employers were allowed to adopt new “simple cafeteria plans.”
  • HHS determined that it could not meet the fiscal sustainability requirements in the law relative to the Class Act public long term care program. This provision was repealed as a part of the “Fiscal cliff” legislation enacted in December 2012.
  • HHS, in conjunction with the Department of Labor (DOL), issued a study on the large-group market, and the DOL began annual studies on self-funded plans using data collected from Form 5500.

Changes for 2012-2013

Changes for 2014


Crawford County 20/20 Roundtable PowerPoint Presentation 6-5-2013


Other links of interest:


Summary of Potential Employer Penalties Under PPACA


Model Exchange Notice for Employers who offer health


Model Exchange Notice for Employers who do not offer health coverage


 If you want more information regarding how your carrier is interpreting these, go to your Carriers website.