time moves forward, so does the timeline for implementing each stage of
the Patient Protection and Affordable Care Act. Many of the provisions
take effect January 1 of 2014, so you’ll want to go ahead and start
planning now for them.
The National Federation of Independent Business has created a list of each of the provisions set for 2014. Here’s a summary.
Individual mandate tax: The
individual mandate tax begins, requiring almost all individuals to
purchase health insurance or to pay a penalty in lieu of coverage.
Businesses with 50 or more full-time employees or full-time equivalents
may face employer mandate penalties. One employee qualifying for
subsidies can trigger annual employer penalties of $2,000 or $3,000.
This affects both offering and non-offering businesses.
Health Insurance Tax (HIT):
A tax will fall on health insurance plans purchased in the
fully-insured market (mostly small businesses and individuals).
Employers with self-insured plans (mostly big businesses, labor unions,
and governments) will not have to pay this tax.
Essential Health Benefits (EHB):
Small-business and individual insurance policies must cover a list of
“essential health benefits.” The law specifies that the Secretary of HHS
shall determine the list of benefits. However, a regulation written
subsequent to the law’s passage shifted that role at least temporarily
to the states.
Individual Health Insurance Premium Tax Credits: Individuals
can qualify for premium credits by the following criteria: (1)
Household income must be less than 400% of the federal poverty level (2)
Employee share of employer-sponsored health insurance premium exceeds
9.5% of total household income and (3) Employer-sponsored coverage does
not meet actuarial value requirements.
Health insurance exchanges:
American Health Benefits Exchanges open for individuals. Small Business
Health Options Plan (SHOP) Exchanges open for small businesses.
Insurance market reforms:
Insurance reforms take effect, and insurers cannot impose coverage
restrictions based on pre-existing conditions. Modified community rating
standards go into effect for individual or family coverage based on
geography, age and smoking status. Insurers must offer coverage to
anyone. The law also limits out-of-pocket cost-sharing.
Deductibles capped: Deductibles
for health plans in the small-group market are capped at $2,000 for
individuals and $4,000 for families, except under certain circumstances.
Also, the federal government has provided a visual timeline showing what’s changing and when. The resource allows readers to view items by selecting blocks on the timeline and offers a full page view as well.