2011 MEDICAL SEMINAR
WHAT DO WE BELIEVE? Media “Experts” Government HealthCare.gov
Breaking it down… FOUR COMPONENTS: Market Reform Individual Responsibility Employer Responsibility Revenue Raisers
PATIENT PROTECTION ACT/RECONCILIATION Employers with 50+ will be fined if no coverage Provide dependent coverage up to age 26 May not deny coverage for pre-existing conditions Automatic enrollment High Risk Pool
IMPORTANT FEATURES No Pre-X Limitations on limitations Emergency room services Required preventative care Employers with 25 or less W-2 reporting Breaks for breastfeeding?? Student Loans???
WHAT IS THE TIMELINE? 2010 Putting information for Consumers online Restriction of the use of annual dollar limits on coverages Prohibiting rescission of coverage due to technical errors Requirement for coverage for preventative services Coverage of dependents up to age 26 Reinsurance program for donut hole Tax credits for small employers providing coverage Pre-Existing conditions Prohibiting lifetime dollar limits on essential benefits
2011 Health insurers must make rebates to enrollees if medical loss ratios are lower than specified levels Providing significant discounts and preventative care for Seniors Community Care Transitions Program Independent Advisory Board Reporting of group health coverage costs on W-2 Grants for small employers End of reimbursement for non-prescription drugs
2012 This is the year the dust settles just a bit…
2013 Cadillac coverage will be taxed up to 40% Employees share of Medicare tax rate on wages increases by an additional 0.9% New money for state Medicaid programs
2014 Pre-existing prohibitions will expand to all individuals Eliminating annual limits on coverage Advance of tax credits for uninsured State Insurance Exchanges must be operational! Free Choice Voucher Small business tax credit increases Individuals have obligation to play or pay