Update October 2011

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PPACA Update Provisions Effective 2010 Appeals and External Review Dependent Coverage to age 26 Doctor Choice Annual and Lifetime Maximum $ Limits Emergency Care Preventive Services without Cost Share

Provisions Effective 2011 Carrier Medical Loss Ratio 85% Large Groups 80% Small Groups Over the Counter Drugs FSA, HSA No longer reimbursed unless Rx HSA Distribution Tax Penalty PPACA Update

Provisions Effective 2012 W-2 Reporting 2012 Tax Year Report in January 2013 Small Employers with less than 250 W-2’s are exempt 60 Day Plan Change Notification Required Standardization of Coverage Documents Page Limits Lay Person Language Uniform Definition of Standard Terms Description of Coverage Include Limitations, Reductions, Cost Sharing Provisions, Web Links for actual Contract download $1,000 per Enrollee Penalty Carrier Requirement PPACA Update

Provisions Effective 2013 FSA Limits $2,500 Maximum on Health FSA $5,000 Dependant Care Limit PPACA Update

Provisions Effective 2014 American Health Benefit Exchange Option for Individuals and “Small Employers”. Main objective is to make Health Insurance more affordable, accessible, and easy to purchase. Four Main Coverage Levels: PPACA Update Coverage LevelBenefit Equivalent Platinum90% Gold80% Silver70% Bronze60%

Provisions Effective 2014 Essential Health Benefit Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental Health & substance abuse disorder services (including behavioral health treatment) Prescription drugs Rehabilitative & habilitative services and devices Laboratory services Preventive & wellness services & chronic disease management Pediatric services, including oral and vision care PPACA Update

Provisions Effective 2014 Individual Mandate US Citizens required to have “Minimum Essential” Coverage. Subject to Tax Penalty Calculated Monthly Paid Annually $ $325 – 2015 $ PPACA Update

Provisions Effective 2014 Employer Mandates 50+ If no Coverage offered to any Full-Time Employee receiving Premium Assistance. $2,000 Annual Fee for each Full-Time Employee (minus 30) If Coverage offered but Full-Time Employee receives Premium Assistance. lesser of $3,000 per employee receiving assistance or $2,000 per employee (minus 30) Full-Time Employees defined as 30+ Hours. PPACA Update

Provisions Effective 2014 Financial Assistance Premium Tax Credit Cost Sharing Subsidies Auto-Enrollment Requires Employer with 200 Full-Time Employees to enroll Employees into the Health Plan. PA – Status Hearings being held Decision on whether to offer State or Federal Program PPACA Update

What’s Next! Supreme Court – Individual Mandate Challenge June 2012 ? CLASS Act – (Voluntary Long Term Care) Originally estimated 86 Billion of total 210 Billion in savings from Health Care Reform Participants premiums for 5 years were factored in, but no accounting for payments. PPACA Update