The Affordable Care Act includes many changes scheduled for implementation over the next few years. We are dedicated to keeping you informed and will provide you with regular updates* and what it means for your business and you personally.
Annual Open Enrollment for Individual and Family Plans has ended for 2019. However, Individuals and Families can apply and obtain health insurance coverage during Special Enrollment Periods if there is a Qualifying Life Event after this annual open enrollment period. Qualifying Events include the following:
Acquired Legal Guardianship, Adoption, Birth, Qualified Medical Child Support Order, Death of primary enrolled member causing loss of coverage, Divorce or legal separation, Eligibility for state premium assistance under Medicaid or CHIP, Exceeding lifetime limits on medical plan, loss of other health coverage except for non-payment of premium, Marriage or Registered Domestic Partnership, loosing dependent status, no longer residing in health plan service area, and plan discontinuation.
We can assist you in evaluating the best Individual and Family Plan to meet your needs.
Requirement: Summary of Benefits and Coverage (SBC). Employers must provide a summary of benefits and coverage (SBC) to all participants on the first day of the first open enrollment period that begins on or after September 23, 2012 for those enrolling or re-enrolling in group health plan coverage through open enrollment and on the first day of the first plan year that begins on or after September 23, 2012 for enrollments occurring outside of an open enrollment period. What happens if employers do not comply: Failure to provide the SBC could result in a fine of $1000 per enrollee.
Requirement: W-2 Reporting of premiums. This is in effect, right now, for employers who filed 250 or more W-2's in calendar year 2011. Employers who filed fewer than 250 W-2's are exempt from this reporting requirement until further guidance is issued.
Medical Flexible Spending Account Limits (FSA's). For plan years beginning on or after, January 1, 2019, the amount an employee may contribute to a medical FSA on a pre-tax basis is capped at $2,700.
Women's Preventive Health. The definition of preventive care was expanded to include additional services for women as groups and individual policies renew on or after August 1, 2012. Member cost-sharing and dollar limits are eliminated for certain services when received in-network. These services include contraceptives, breast pumps and support, gestational diabetes screening, and screening and counseling services for things such as HPV, domestic violence, HIV, and sexually transmitted diseases.
Listed below are several links to informational sources if you wish to access more detailed information about Health Care Reform. In addition, PLEASE do not hesitate to contact our office if you have any questions.
While every attempt has been made to ensure the accuracy of this information as of most recent website update, federal and state rules and interpretations of the ACA continue to evolve, and every employer's circumstances are unique. We may need to work in consultation with your legal and tax advisors.