Filed Under:Health Insurance, Individual Health

PPACA: Deadlines Are Coming

(Graphic by Anna Langova.)
(Graphic by Anna Langova.)

William Gallagher Associates Insurance Brokers Inc. has tried to boil the news into a short note: U.S. employers will face many health benefits compliance deadlines in the coming year.

Some employers and brokers may have been closing their eyes, putting their fingers in their ears and hoping the U.S. Supreme Court would make the deadlines associated with the Patient Protection and Affordable Care Act of 2010 (PPACA) go away.

The court ruled June 28 that the U.S. Constitution does give Congress the authority to impose a tax on individuals who fail to own a minimum amount of health insurance starting in 2014, and that Congress does have the authority to use promises to new funding to encourage states to expand access to state Medicaid programs.

Opponents continue to fight PPACA implementation in Congress, at the state government level, at the polls, and in the courts.

Although the Supreme Court now has rejected some cases challenging the constitutionality of PPACA, others are working their way through the courts, and new cases could crop up.

But, for now, at least, PPACA is the law of the land.

The law of the land will require insurers that failed to spend 85% of the 2011 revenue from large group plans and 80% of the 2011 revenue from small group plans on health care and quality improvement efforts to send the plans rebates by Aug. 1, according to William Gallagher, Boston.

William Gallagher also discusses other upcoming PPACA benefit plan dates of interest:

  • Plan years starting on or after Aug. 1: New women's preventive coverage requirements take effect.
  • Plan years starting on or after Sept. 23: Affected insurers and plans are supposed to start providing summaries of benefits and coverage (SBCs).
  • Plan years starting on or after Jan. 1, 2013: Employers with flexible spending accounts (FSAs) are supposed to start capping employees' FSA contributions at $2,500 per year.
  • Jan. 1, 2013: Employers that issues more than 250 Form W-2 forms to employees will have to start reporting the total cost of employer-sponsored health coverage in W-2 Box 12.
  • July 31, 2013: Plan sponsors and insurers will have to start paying a fee to fund research concerning how effective, and how cost-effective, various treatments other. The initial fee is set to be $1 per member per plan year.

The firm also notes that some of its clients may get letters from the U.S. Department of Labor about PPACA audits.

"Any clients receiving a letter from the [department] should retain counsel to help them with the audit process," the firm says.

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