IF I HAVE <50 EMPLOYEES


Health Reform I have less than 50 employees. What applies to me?

If you employ part time employees working less than 30 hours per week, use the Group Size Calculator to help determine if your group has more or less than 50-full-time-equivalent employees.  (Green Text = Requires action by the employer)

2010:

 

 

  • Mandate to cover specific benefits in the small group market – preventive, no preexisting for children, no lifetime limit, limited annual maximum, no rescission, dependent to age 26 – 2010

 

 

  • Existing plans grandfathered as of date of enactment from some, but not all, of the new plan requirements – 2010
  • Non-discrimination requirements for insured plans – 2010
  • An internal and external appeals process – 2010
  • No prior authorization for emergency services – 2010
  • Plans must allow designation of a primary care provider – 2010
  • Small employer tax credits (does your company qualify?) – 2010

 

 

2011:

 

 

  • FSA, HSA, HRA definition of medical expenses – 2011

 

 

  • Increase penalty to 20% for non-health withdrawals from an HSA or Archer MSA – 2011

 

 

 

 

2012:

 

 

  • Increase Medicare payroll tax by 0.9% on earned income in excess of $200,000/$250,000 (unindexed); wages received after December 31, 2012

 

 

  • Impose fee on health insurance and fully self-funded employer plans to fund comparative effectiveness research – 2012

 

 

  • 3.8% investment tax on unearned income for taxpayers with AGI in excess of $200,000/$250,000 (unindexed) – taxable years after December 31, 2012
  • Uniform explanation of coverage – November 1, 2012
  • Notice of material modifications – September 2012

 

 

2013:

 

  • Elimination of tax deduction for retiree drug subsidies to employers – 2013
  • Employee Notification of the Exchange – March 1, 2013
  • Limit salary deferrals to FSAs to $2,500 – 2013, then indexed to inflation
  • Eliminate deduction for Medicare Part D employer subsidy – 2013
  • Raise 7.5% adjusted gross income (AGI) floor on medical expense deduction to 10% – 2013

 

2014:

  • No preexisting condition exclusions for all participants – 2014
  • Guaranteed issue – 2014
  • Guaranteed renewability – 2014
  • Must cover minimum benefit package – 2014
  • Allows HIPAA wellness discount up to 30%(50%at Secretaries’ discretion) – 2014
  • Limits on out-of-pocket cost sharing, maximum deductibles – 2014
  • Coverage of routine costs associated with clinical trials – 2014
  • Prohibition on waiting periods more than 90 days – 2014
  • Must provide a minimum actuarial value for benefits – 2014
  • File an annual report with HHS on employer and plan information – 2014
  • Eliminate annual limits on benefits – 2014
  • Limits premium underwriting – 2014
  • Plan disclosure of claims payment policies and rating practices – 2014
  • New SHOP Exchange for small-group and individual markets – 2014 (Contact Us For Assistance With The Exchange)
  • Limits on underwriting – 2014
  • W2 reporting – 2013 tracking to be reported 2014
  • IRS reporting ‐ 2014

2018:

  • 40% excise tax on high-cost plans – 2018