Health care reform: impact on small and large businesses, individuals.

• Author: Puyear, Joy A.
• Position: Regulatory update

The Patient Protection and Affordable Care ACT (FEACA), signed into law March 23, 2010, was amended by the Health Cane and Education Reconciliation a week later. The final, amended version the Affordable Care Act (ACA) enacted changes in how individuals and businesses will purchase and use health insurance. These changes will roll out over Your wars and more, with most taking place in 2014.

Sec, 4980H was added to the Internal Revenue Code as a result of the PPACA, The Supreme Court upheld the PPACA, declaring that Congress has the right to tax citizens, thus the ACA is a tax.

For months beginning Jan. 1,2014, large employers are required to offer an affordable minimum essential health insurance or be potentially subject to a See. 4980H--or "pay to play"--penalty. As of Jan. 1,2014, most individuals over the age of 18 must acquire minimum insurance coverage or pay a penalty.

All health care plans must provide a comprehensive "Essential Health Benefits" package that falls into one of four coverage levels: Bronze, Silver, Gold or Platinum (low to high). Small business (those with less than 50 full-time and full-time equivalent employees) are not penalized for not providing health insurance.

Specific changes of the ACA include:

Existing Plans

* Kids stay on parent's policy to age 26.

* No lifetime benefit maximums.

* No annual limits for essential benefits.

* Coverage can be rescinded only for fraud.

New Plan Requirements

* 100 percent coverage for preventive care.

* Children under age of 19 cannot be denied for pre-existing conditions.

* No prior authorization or increased cost-sharing for emergency care.

Health Insurance Cost

* Medicare Part A tax rate on wages jumps to 2.3 percent in 2013 for certain individuals.

* If you have fewer than 25 employees and the average wage is less than 550,000, you may be eligible for tax credits.

* A reinsurance for employers with retirees program will be available for employers providing insurance to retirees over 55 and no! eligible for Medicare,

Health Reform Implementation

* 80 percent of premiums must be spent on health care/quality improvement for group and individual Health plans; 85 percent for large group plans.

* HSA, FSA and MSA restrictions: Over-the-counter drugs without a prescription can no longer be reimbursed, and the non-medical use tax increases to 20 percent.

* Employers issuing 250 or more W-!s for tax year 2011 must report the value of health insurance for 2013.

* Open enrollment for...