Now that 2014 is here — or as we like to call it — the biggest year of requirements since March of 2010, what can business owners actually expect from this monumental health reform year?
- Coverage Kicks In: Millions of Americans have been signing up, or attempting to sign up, for a health insurance plan since the exchanges opened on October 1, 2013. Those lucky people can now take advantage of their health plan and the related federal subsidies.
- Individual Mandates Get Real: The mandate is here and if you’re not enrolled in a qualified health plan either via the individual market or through an employer or other group plan by March 1 you can expect a bill for $95 or 1% of your income, whichever is higher, to arrive on your doorstep later this year, unless you fall into one of the excepted categories, of course.
- Insurance Exchanges: In every state, the health exchange must be up and running. Obviously “up and running” is a loose term.
- Insurance Subsidies: Premium tax credits and cost-sharing reductions kick in for those who are eligible.
- Medicaid Expansion Begins: The Supreme Court ruled to expand the program. As a result, in 2014 as many as 3.9 million more low-income Americans will have access to the public assistance program.
- Small Business Tax Credit: Under PPACA, small businesses are eligible to apply for a small business tax credit that would help purchase health coverage for their employees. The credit is supposed to expand to more businesses. The catch: very few small businesses actually qualify for the credit and now they can only use it to buy SHOP exchange coverage.
- Individuals and Businesses take the HIT: The new national premium tax, which will ultimately be a pass through fee from the insurer to all consumers of fully insured individual and group health insurance, goes into effect. The tax will collect $8 billion in 2014, increasing to $14.3 billion in 2018 and increasing based on premium trends thereafter.
- Ninety-Day Maximum Waiting Period: This requirement for all employer plans goes into effect.
- Cost-sharing Limits: Group health plans, including self-funded plans, may not have out-of-pocket costs that exceed the annual HSA contribution maximum.
- Annual or Life Time Limits Are No More
- Greater Wellness Discounts: Employers may now offer a discount of up to 30% for employee participation in a wellness program.