Healthcare Reform Update

Healthcare reform has been a topic of concern for business owners and individuals alike, the importance of knowing the upcoming changes can save you money, but more importantly being aware of the changes will alleviate a lot of potential compliance issues.  Working in the insurance industry handling employee benefits—I find myself talking to a lot of business owners and Human resource executives.  One prevalent concern, regardless of what industry people work in, is health insurance and the changes that are coming over the next few years.  Having answered many questions on this topic, I’ve become well-versed on the changes in the law and more importantly, the penalties that are levied for non-compliance.

Taking a look at the prior years, there have been some changes that are important for both businesses and individual subscribers to understand:

  • No Cost-Sharing from well-visits—this allows individuals’ one well-visit per year at no cost.  (Annual Physical is covered by health plan) This is essential, because most physicians will still try and charge you for your annual physical. 
  • Standardizing Qualified Medical Expenses—this places restrictions on what can be covered by FSA’s. More specifically, over the counter drugs are now excluded from being a qualified medical expense, and thus cannot be utilized with your FSA.

Looking ahead to 2013 and beyond:

  • Limiting annual contributions for FSA’s—This provision takes a previously unlimited spending amount and places the cap at a $2,500 annual limit.  (2013)
  • Reforming Health Insurance Regulation—Prohibits healthcare providers from imposing limitations due to pre-existing conditions for all covered persons for factors such as gender or health status.  Premiums can only vary by age, geography and tobacco use. (2014)
  • Eliminating Annual Limits—Healthcare plans can no longer be limited in the amount of health coverage an individual may receive annually.(2014)
  • Promoting Employer Responsibility—Requires employers with 50 or more employees who don’t provide coverage for their employees to pay $2,000 per full-time employee(2014)
  • Establishing Health Exchanges—Massachusetts has been well ahead of the curve with this piece of reform.  This mandates that all states must now set up health insurance exchanges where individuals and small businesses can review options and purchase coverage for themselves.  Much like the Massachusetts Health Connector.  (2014)

Health insurance is going to drastically change in the next year and even more in 2014.  Being aware of the upcoming changes is paramount in ensuring that your business is free from State and Federal penalties.  More importantly will be that your business makes your employees aware of these changes so that they can prepare themselves financially in order to receive the care that they need.  If you have any questions, or would like more information on the topic of health insurance or reform, contact your insurance broker, or reach out to your local agent so that your business can be well prepared for the reform changes that are fast approaching.