Roundtable Discussion – 9/9/2010

Reform today & near future

Mandatory reforms – examples impacting now: Accommodate breast-feeding mothers on-site –

must provide a private place other than restroom• <50 employees may have exemption

Required mandates (preventive care, dependent age limits, exclusion of lifetime limits) increasing rates by around 4% for current/next renewal

Reforms for 2011

Value of benefits to be reported on W-2sNo pre-tax reimbursements from HSA, FSA or

HRA for over-the-counter Rx without prescription

Tax increase for non-qualified HSA withdrawals moves from 10% to 20%

Automatic enrollment in assisted living programs (CLASS Act); employees may opt out

To Grandfather or not to Grandfather

Not grandfathered: Non-discrimination

testing Preventative care

benefits @ 100% New claims appeal

processes Adult children (to age

26) with access to other coverage

All Plans regardless of grandfathered status: Eliminate pre-ex for

children under 19 Eliminate lifetime and

annual maximums Eliminate rescissions

(except for fraud) Adult children (to age

26) without access to other coverage

2014 – The big year

Health Insurance Exchanges come on line Requirement to offer coverage (50 or more

employees) Penalties range from $2,000 to $3,000 per employee

if no coverage offered or deemed “unaffordable” Waiting period cannot be more than 90 days Treasury reporting; enrollment, premiums, number

of full time EE’s each month