Health Care Reform: Five Things You Should Do Now
Posted by Valley Insurance Associates, Inc. on Wed, Oct 19, 2011 @ 01:30 PM
1) Get ready for new reporting requirements scheduled to take effect in 2012.
- Employers with greater than 250 employees will be required to report the cost of employees’ health benefit coverage on their 2012 W-2 forms. (Informational only, employees will not be taxed.)
- Employers must provide an easy to understand uniform coverage document that follows standards established by the Department of Health and Human Services. Those who chose not to comply with this requirement will face a fine of up to $1,000 per member. This requirement is effective no later than March 23, 2012.
- Employers must inform members of certain material changes to health benefit plans 60 days in advance of when the change becomes effective. Those who choose not to comply with this requirement will face a fine of up to $1,000 per member.
- By March 2013, employers must provide all employees with information about Health Benefit Exchanges.
2) Leverage tax credits if you are a small business. The Small Business Health Care Tax Credit is designed to encourage small businesses to offer health insurance coverage for their employees. In 2014, the tax credit will be increased and is available only to those employers that purchase insurance through an Exchange.
3) Understand the medical loss ratio requirement. Carriers must report the percentage of premium dollars spent on clinical services, quality improvement, patient care and other related services. This applies to fully insured individual and group plans only. The medical loss ratio means that 80 percent of small group premiums and 85 percent of large group premiums go toward these areas. If the ratio falls below that percentage, health insurance companies must issue member rebates.
4) Be aware that group and individual health insurance plans now have a standard appeals process if a claim, coverage or health care service is denied. The appeals process is now available for both fully insured and self-funded plans.
5) Determine how Health Benefit Exchanges could impact how you offer coverage to your employees in the future. Although Exchanges are not in place until 2014, it’s important to think about them now.
Sources: United Healthcare “The Road to Reform”
Anita Lind is a guest writer for the Valley View Blog. She can be contacted via email at alind@viainsurance.com.