What health care reform changes should employers be thinking about right now?

The following health care reform changes are already effective for 2010:

  • For federal tax purposes, imputation of income no longer required for health coverage of children age 26 or younger
  • Breaks required for nursing mothers
  • Adoption assistance program limit can be increased
  • Early Retiree Reinsurance Program available
  • Small employer tax credit available to employers with less than 25 FTEs

The following health care reform changes are effective for plan years beginning on or after September 23, 2010 (January 1, 2011 for calendar-year plans):

For all plans (including grandfathered plans)

  • Coverage of adult dependents to age 26 (but grandfathered plans may exclude those eligible for another employer-sponsored health plan)
  • Restrictions on lifetime and annual dollar limits
  • Limited rescission of coverage
  • No pre-existing condition exclusion for children under age 19
  • Insured plans must report medical loss ratio and possibly provide rebates to participants

For non-grandfathered plans only

  • Nondiscrimination testing for insured plans
  • Preventive care without cost-sharing
  • Appeals and external review
  • Provider choice rules
  • Must cover emergency services without prior authorization and without out-of-network surcharges
  • Transparency in coverage disclosures

For more information, see Health Care Reform: What Employers Need to Know Now.

Today’s post was contributed by Maureen Maly and Cynthia Lee.

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