Page 5 - 2017 Trust Brochure

Affordable Care Act Implementation Timeline

2010 Loss of tax exclusions of Medicare Part D drug subsidy
Grandfathered Plan Requirements Increase in Code § 213 medical deduction
Early retiree reinsurance New Medicare hospital insurance tax of 0.9% on high income
Temporary high risk pool individuals*
HHS Consumer web portal New 3.8% Medicare payroll tax on unearned income for high income
Preexisting Condition Exclusion prohibition for those under age 19 individuals*
Annual/lifetime limits prohibited on essential benefits (some annual limits First payment of Patient Centered Outcomes Research Institute Fee is
may apply until 2014) due. Fee increases from $1 per participant to $2 per participant for plan
Rescission prohibition years beginning on or after November 1, 2012.
Preventive health services Notice to employees about Exchanges and subsidies
Dependent coverage for children under age 26 Co-ops
Nondiscrimination for insured plans application/enforcement – delayed *$200,000 individual, $250,000 joint
pending additional guidance. Agencies have indicated that employers
are not required to comply with this requirement until regulations are 2014
issued. Exchanges
Appeals process Transparency in coverage (QHP) reporting – reporting begins after
Patient protections (primary care provider designations, ER services, QHPs have been in place one calendar year
etc.) Fair health insurance premiums
Ensuring that consumers get value for their dollars (rate review) Guaranteed availability of insurance coverage
Automatic enrollment – no specific effective date. In sub-regulatory Guaranteed renewability of coverge
guidance, the DOL has indicated that employers are not required to Preexisting Condition Exclusion prohibition (for all enrollees)
comply with this requirement until regulations are issued. Nondiscrimination based on health status
Small business healthcare tax credit Nondiscrimination against healthcare providers
Tax-free coverage to children under age 27 (see above regarding Comprehensive health insurance coverage
coverage mandate to age 26) Cost-sharing limitations
Prohibition on exercise waiting periods
2011 Coverage for clinical trials
Expansion of Preventive Services under Medicare Annual/lifetime limits prohibited on essential benefits
OTC drug limits Increase in small business healthcare tax credit
Simple cafeteria plans Provision of additional information (Quality Reporting) – reporting
HSA / Archer MSA penalty tax increase required no earlier than reporting required for QHPs
W-2 reporting (voluntary for 2011 tax year) (see above)
Bringing down cost of coverage (reporting and rebates)-Minimum Loss Individual mandate
Ratios
Small business grants to provide wellness programs 2015
Employer Shared Responsibility
2012 Health Insurance reporting coverge
New, voluntary options for Long Term Care insurance (postponed First payment of Transitional Reinsurance Fee is due
indefinitely) First payment of Health Insurance Providers Fee is due
Distribution of four-page Summary of Benefits and Coverage and First Vol. report for Form 6055 (for minimum essential coverage)
Uniform Glossary due for 2014 in 2015- mandatory in 2016 for 2015.
Quality of care reporting – delayed pending regulations First Vol. report for Form 6056 (concerning offers of coverage)
W-2 reporting (mandatory for 2012 tax year) due for 2014 in 2015-mandatory in 2016 for 2015.

2013 2020
HIPAA electronic transaction standards High cost coverage tax
Health FSA cap (Cadillac tax on high cost healthcare plans)

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