Overview of the key developments of the Affordable Care Act (ACA). Does your business need help with ACA Compliance? Let the experts at Austin Benefits take care of it all, including 1094 and 1095 reporting for FREE!

1. HEALTHCARE REFORM:
THE AFFORDABLE CARE ACT
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The ACA is signed into effect
by President Barack Obama.
Maximum tax credit for small
businesses that offer health care
benefits (based on percentage of
premium costs for two years).
Dependent children
allowed to stay on parent's
insurance until age 26.
rule requires insurers to provide
rebates based on spending 80% or
85% of premiums on medical care.
No lifetime limit on
healthcare coverage.
No pre-existing exclusions
for children under age 19.
Insurers barred from requiring
co-pays for preventive care
and vaccinations.
The U.S. Supreme Court upholds
major provisions of the ACA.
Health plans must begin
implementing rules for secure,
confidential electronic exchange of
health information.
Numerous provisions to improve
quality and lower costs within
Medicare, Medicaid and Children's
Health Insurance Program (CHIP).
35%
80/20
HEALTHCAREPULSE
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The majority of ACA
provisions go into full effect.Open Enrollment for 2014
begins on the federal
exchange: Healthcare.gov
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Insurers cannot refuse to
sell/renew policies due to
pre-existing conditions.
Group health plans must be
certified "qualifed health
plans" offering a certain
minimum of benefits.
Age rating takes effect for
employers with less than
50 employees.
Individual mandate for health coverage.
Medicare and Medicaid
payments tied to the quality of
care they provide.
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Full implementation of the Employer
Mandate or "Pay-or-Play" penalty.
Out-of-Pocket maximum
increased:
$7,150 for self-only
$14,300 for family
Small group expansion repealed &
small group remains 50 or less.
United Healthcare announces it
will be exiting most of the state
exchanges it operates in by 2017.
Percent of employees (and their
families) who must be offered
coverage under employer
shared responsibility provision
(50+ employees)
Coverage affordability
adjusted for inflation, for
health plans beginning on
January 1st.New SBC template for health
plans with open enrollment
periods/plan years beginning
on or after April 1, 2017.
Reinsurance fees do not apply
for 2017 and beyond.
(2016 fees will be paid in
2017)
States can apply for "innovation waivers"
or 1332 waivers that allow them to modify
key parts of the ACA.
95%
9.69%
Forms 1094 & 1095 begin.
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