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Health Care Reform TimelineHealth Care Reform TimelineWright & Percy Insurance•	 Temporary high risk pool•	 Early retiree ...
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PPACA: Important Dates


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PPACA: Important Dates

  1. 1. BancorpSouthInsuranceServices,Inc.isawhollyownedsubsidiaryofBancorpSouthBank.Insuranceproductsare•Notadeposit•NotFDICinsured•Notinsuredbyanyfederalgovernmentagency•Notguaranteedbythebank•Maygodowninvalue©,2012,BancorpSouthInsuranceServices,Inc.BrianBraniganbrian.branigan@bxsi.com225-215-9479
  2. 2. Health Care Reform TimelineHealth Care Reform TimelineWright & Percy Insurance• Temporary high risk pool• Early retiree reinsurance program• Small business tax credit• Dependent coverage for adult childrenuntil age 26• No pre-existing condition exclusionsfor individuals until age 19• Rescissions prohibited except forfraud or non-payment• Lifetime dollar limits prohibited• Annual dollar limits restricted• Preventive services with no costsharing (G)• Pediatricians as PCPs, direct access toOB/GYNs (G)• ER coverage as in-network, no priorauthorization (G)• Appeals process and external review (G)• Medicare Part D rebate for beneficiariesin the gap2010• Annual rate review process• Medical loss ratio (MLR): 85% forlarge group; 80% for small group andindividual• HSAs/HRAs/FSAs: limitations for OTCmedications• Increase penalty for non-qualifiedHSA withdrawals• Small business wellness grants• Annual fee on pharmaceutical manu-facturers begins• Discounts in Medicare Part D“donuthole”• Non discrimination rules apply toinsured plans (G) (implementationdelayed)• Auto-enrollment for Groups with200+ FTEs (implementation delayed)2011 • Summary of Benefits and Coverageand Uniform Glossary• Expanded woman’s preventiveservices (G)• 60 day advance notice of materialmodification• Accountable Care Organizationrequirements• Quality bonus begins for MedicareAdvantage plans• Comparative effectiveness fee ($1 permember/year)• Administrative simplification begins• 1st medical loss ratio rebates to bepaid by August2012• Exchange notices to employees• Employers to report value of employer-sponsored health benefits on W2s• FSA contributions limited to $2,500• High earner tax begins• Annual fee on medical device salesbegins• Deduction for expenses to the PartD subsidy for“qualified prescriptiondrug plans”eliminated• Comparative effectiveness feeincreases to $2 per member/year2013 • Health benefit exchanges• Guaranteed issue and renewal rules (G)• No annual limits• No pre-existing condition exclusions• Rating restrictions (G)• Individual & employer mandates• Tax credits and subsidies for individualsand small employers• Standardized essential health benefits• Waiting period limit (90 days)• Mandatory coverage for clinical trials (G)• Reinsurance fee• Annual insurance industry tax• OOP limits must comply with OOPlimits for HSA qualified plans (G)• Deductible caps cannot exceed $2kfor individual and $4k for family (G)• ICD-10 code adoption2014• States can open Exchange to CHIPeligibles (2015) and all employers(2017)• Sunset of comparative effectivenessfee (2017)• High-value plan excise tax“CadillacTax”begins (2018)• Insurance industry tax (through2018)• Medicare Part D“Donut hole”closed(by 2020)2015 &BEYOND(G) = Not applicable to grandfathered plans. Note: Some provisions apply only to fully insured plans. This is for informational purposes only and is not intended to be used as legal advice. BancorpSouth Insurance Services, Inc. is a wholly owned subsidiaryof BancorpSouth Bank. Insurance products are • Not a deposit • Not FDIC insured • Not insured by any federal government agency • Not guaranteed by the bank • May go down in value ©, 2013, BancorpSouth Insurance Services, Inc.Rev. 2/8/2013