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Small Business Health Tax Credit

01/01/2010 - 01/31/2010

A credit available to small businesses that have fewer than 25 FTE employees and pay less than $50,000 per FTE in an annual wages. The goal of the tax credit is to reduce the cost burden of health insurance coverage for small employers in the hopes of expanding coverage to employees of small businesses.

Senate bill signed into law

03/01/2010 - 3/30/2010

The Affordable Care Act passed by Senate & House

Tanning Tax

6/1/2010 - 6/30/2010

A 10% tax on indoor tanning will take effect.

Insurance reform

9/1/2010 - 9/30/2010

Adult children may stay on parent’s plan until age 26

The law requires plans to allow non-dependents to stay on their parents policy until the age of 26. Until 2014, adult children are not allowed to stay on their parent’s plan if they are offered employer sponsored coverage.

Preventive Care
All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance
Lifetime limits and annual limits prohibited

Consumer Assistance Program (CAP) Grants

10/1/2010 - 10/30/2010

States will be eligible to apply for CAP grants to set up or expand independent offices to provide consumers will the assistance they need to navigate the changing private health insurance system.

Help consumers enroll in health coverage
Help consumers file complaints & appeals
Provide education on consumer rights and responsibilities
Collect date & report problems to HHS in order to make the

system run more efficiently

Managing Cost of Premiums & MLR Rebates

1/1/2011 - 1/30/2011

Insurance companies that sell plans to individuals and small businesses must use at least 80% of the premiums on benefits and quality improvements. If the insurance company fails to meet this standard due to high administrative costs or profits, they will be required to provide a rebate to the consumer.

HSA Penalty*

1/1/2011 - 1/30/2011

The penalty for making non-qualified purchases with an HSA increases to 20%.

Market Basket & Productivity Adjustments*

1/1/2011 - 1/30/2011

With varying effective dates, reduces annual market basket for inpatient hospital, home health, skilled nursing facility, hospice and other Medicare providers.

HSA & FSA limits

1/1/2011 - 1/30/2011

Consumers can no longer use HSAs and FSAs to purchase certain items, including most over-the-counter medication unless prescribed by physicians.

Medicare Advantage*

1/1/2012 - 1/30/2012

MA payments are frozen for 2011. Beginning in 2012, a new system of blended benchmarks will be phased in.

Physician Ownership*

1/1/2012 - 1/30/2012

Physicians are prohibited from self referring to hospitals in which they have an ownership interest.

There are limited exceptions, including an exception to the growth restrictions for grandfathered physician owned hospitals that treat the highest percentage of Medicaid patients in their county (and are not the sole hospital in the county).

Comparative effectiveness*

9/1/2012 - 9/30/2012

A fee will be placed on insurance policies to fund comparative effectiveness research.

FSA limits*

1/1/2013 - 1/30/2013

FSA limits*
Cafeteria plan FSA contributions will be limited to $2,500 (inflation adjusted after 2013.)

Medicare Payroll Tax*
• The Medicare payroll tax on wages and self-employment income in excess of $200,000 ($250,000 joint) will increase by 0.9%, and also applies for the first time, to net investment income.
• Earners in excess of $200,000 ($250,000 joint) will pay an additional 3.8% Medicare tax on investment income. The income thresholds are not indexed to inflation.

Fewer Deductible Medical Expenses*
New limits are placed on the deductibility of medical expenses on individual income tax returns.

Elimination of Deductible*
The existing employer tax deduction for the Part D subsidy is eliminated.

W-2 Reporting*
Employers will be required to report the value of employees’ health benefits on W-2s. To provide transitional relief, the IRS is not currently requiring employers with fewer than 250 employees to comply with this requirement.

Exchanges are scheduled to begin enrollment

10/1/2013 - 10/30/2013

Exchanges are scheduled to begin enrollment