The New Health Care Reform Law

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Slide 1: 

The New Health Care Reform Law: Impact Now and in the Future May 2010

Slide 2: 

WS&Co. Introductions Jennifer Lunski, Esq., Vice President, Compliance Officer Woodruff-Sawyer & Co David Broome, Vice President, Benefits Practice Woodruff-Sawyer & Co.

Patient Protection and Affordable Care Act (HR 3590) : 

Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plans

Significant Changes : 

Significant Changes From Enactment through 2011 Grandfathering of Existing Plans Consumer Protections Mandated Benefits Small Business Tax Subsidies Insurer Rating Regulations Calendar Year 2013 Tax Increases Calendar Years 2014 and 2017 Employer Reporting to HHS Employer and Individual Mandates & Penalties State-based Healthcare Exchanges Small Business and Individual Subsidies Calendar Year 2018 Plan Design Taxation

Cost Control and the New Law : 

Cost Control and the New Law What may increase Employer costs? Additional Reporting and Administration Mandatory Benefits Levels Expanded Dependent Eligibility Auto Enrollment & Mandatory Coverage Pass Through Taxes and Fees (from Insurers, Pharma & Others) Loss of Gov’t Subsidies Insurer Underwriting Restrictions What may decrease Employer costs? Guarantee Issue and Renewability New Gov’t Subsidies & Tax Credits Individual Mandate (theoretically)

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Patient Protection and Affordable Care Act (HR 3590) : 

WS&Co. Proprietary & Confidential Patient Protection and Affordable Care Act (HR 3590) Summary of Actions & Impacts on Fully Insured Group Plan

Penalties & Enforcement Practices : 

Penalties & Enforcement Practices Penalties: Participants have the right to sue under ERISA to enforce their rights and the IRS can impose a $100 per participant per day excise tax on each violation.  The IRS tax issued Form 8928 in 2009 for paying this tax and made it self assessed.   Enforcement: DHHS IRS DOL

Near Term Employer Actions : 

Near Term Employer Actions Before the next renewal, starting October 1, 2010 Adult Dependents are eligible to enroll Insurers will adjust benefit levels and make other changes Determine applicability of grandfathered plans Determine applicability Federal Retiree Program Perform non-discrimination testing of certain H&W plans Revise Employee Communication Materials Establish process for reporting to gov’t agencies Before January 2011 Prohibit reimbursement of Non-Prescribed drugs (HSA, HRA & FSAs) Apply for Wellness Grant (small employers) Allow for Auto-enrollment (200 or more employees)* Revise Plan Documents, SPDs, Enrollment Materials, etc. Evaluate Federal LTC program

Slide 16: 

David Broome, Vice President, Benefits Practice Woodruff-Sawyer & Co 415.402.6520 dbroome@wsandco.com Jennifer Lunski, Esq., Vice President, Compliance Officer Woodruff-Sawyer & Co. 415.265.3479 or jlunski@wsandco.com

Slide 17: 

Thank You!

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