FJG Resources | Employee Benefits | Health Care Reform Resources
Health Reform
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On March 23, 2010 President Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act (PPACA). One week later, on March 30, 2010, the President signed into law H.R. 4872, the Health Care and Education Reconciliation Act of 2010, making numerous changes to the PPACA. Together, these two laws complete Congress's current efforts to enact comprehensive health care reform in the United States.
Much like the health care system it seeks to reform, the PPACA is large and complex. For employer health plan sponsors in particular, the PPACA will have the most significant impact on their role since the enactment of ERISA over 30 years ago. Employers will need to understand the requirements and opportunities presented by the new law in order to address immediate priorities while formulating long-term strategies.
Fleischer Jacobs Group has dedicated this section of our website to post health reform updates for our clients. Please bookmark this page and check back often for new postings related to legislative and regulatory requirements for employers and individuals. Call your Fleischer Jacobs Group representative with questions about any of the health reform provisions we post or if you need help with any administrative or reporting requirements.
Health Reform Patient Bill of Rights
Interim Final Regulations Regarding Pre-existing Condition Exclusions, Life-
time and Annual Limits, Rescissions, and Patient Protections
Health Reform Employer Action Overview
This chart outlines necessary employer actions to the health reform provisions, organized by effective date.
Employer Action Overview April, 2010 >> pdf
Focus on Health Reform
This is a side-by-side comparison of the major health care reform proposals provided by the Kaiser Family Foundation.
Side-By-Side Comparison, KFF, March 22, 2010 >>pdf
Patient Protection and Affordable Care Act FAQs
This is a list of FAQs regarding the health reform legislation passed in March 2010. Updates will be posted as new questions are presented.
Patient Protection and Affordable Care Act White Paper
This document describes the major issues set forth in the combined legislation in the order of implementation time line.
White Paper April 13, 2010 >> pdf
How Will Health Reform Impact Employers in 2010?
The Act will transform the current model for employer-sponsored health coverage, with certain provisions having an impact on employers this year and into future plan years.
Impact on Employers in 2010 >> pdf
How Will Health Reform Impact Employees
This employee-facing document features a high-level overview of how the PPACA will potentially impact them and their families. This communication allows employers to inform and reassure their employees of their focus and commitment to understanding the short-term and long-term implications of the legislation.
Health Reform Application to Specific Plan Types and Markets
This chart identifies major provisions of the law and whether the provision applies to the individual market, self-funded group, fully-insured group, small employer, large employer, or grandfathered plans.
Small Business Health Care Tax Credit Worksheet and FAQs
For tax years 2010 through 2013, small employers will receive a tax credit of up to 35 percent of the employer's contribution toward the employee's health insurance premium if the employer contributes at least 50 percent of the total premium cost or 50 percent of a benchmark premium. If the small business is a non-profit, the tax credit equals 25 percent instead of 35 percent. This document features a qualification worksheet and frequently asked questions
Small Business Tax Credit Worksheet and FAQs >> pdf
Three Simple Steps, IRS >> pdf
Small Group Average Premium for Vermont, Section 45R IRS >> pdf
Small Business Health Care Tax Credit Scenarios IRS >> pdf
Small Business Health Care Tax Credit FAQs>> IRS website
Grandfathered Plans
This document outlines the requirements applicable to grandfathered health plans including how to maintain grandfathered status, what plan design changes jeopardize grandfathered status, and other insights provided by the rule.
Interim Final Rules for Grandfathered Health Plans >> pdf
Nursing Mothers
Effective March 23, 2010, employers must provide a reasonable break time for employees who are nursing mothers to express breast milk for a period of one year following the birth of the child. The employer must provide a place that is shielded from view and free from intrusion of co-workers and the public for use by the employee. A bathroom is specifically excluded as an appropriate place. Employers are not required to pay employees during the time they are expressing breast milk unless mandated under State law. Also, employers with less than 50 employees may be exempt from this requirement if this causes an "undue hardship" by causing "significant difficulty or expense." These terms have not yet been defined.
Early Retiree Reinsurance Program
Retiree Reinsurance Interim Rules- This document summarizes the regulations that have been released regarding the Early Retiree Reinsurance Program, which will go into effect on June 1, 2010. It outlines which plans are eligible for the program, what expenses will be eligible for reimbursement, how the reimbursement funds must be used, and an employer's next steps.
Retiree Reinsurance Interim Rules June 2010 >> pdf
Temporary Retiree Reinsurance Program- Ninety days after enactment, a federal reinsurance program will be available for employers providing insurance for retirees over age 55 years of age, who are not eligible for Medicare. The program will reimburse employers for 80 percent of claims incurred for the retirees between the ages of 55-64 for costs between $15,000 up to $90,000.
Retiree Reinsurance Program >> pdf
Dependent Coverage Interim Rules
The PPACA requires group health plans offering dependent coverage to extend such coverage until dependents reach age 26 (referred to herein as "adult dependents"). The provision is effective for policy (individual) and plan (group) years starting on or after Sept. 23, 2010. If the plan is grandfathered, the provision only applies if the adult dependent does not have other employer-sponsored coverage. After Jan. 1, 2014, the adult dependent must be offered coverage regardless of access to other employer-sponsored coverage.
Dependent Coverage Interim Rules May, 2010 >> pdf
The CLASS ACT
The CLASS Act stands for Community Living Assistance Services and Support Act, and is Title VIII of the Health Care Reform Bill. The plan creates a voluntary government run long-term care insurance program and is effective January 1, 2011. This brochure, created by LTCI Partners, describes how the program will work and how it compares to a private LTC program.