Calvin College, Grand Rapids
I. Summary of health and flex plan changes required for 2013 and 2014.
- Contraceptives and other women’s preventive services
- Cap on employee medical FSA contributions
- 90-day maximum waiting period for group health plan enrollment
- Cap on deductibles and maximum out-of-pocket limits
- Automatic enrollment for larger employers
II. Explanation of nondiscrimination rules for self-funded group health plans, non-grandfathered fully-insured group health plans and Section 125 plans and action steps employers should be taking to ensure compliance.
III. Update regarding required participant notices, including discussion of summary of benefits and coverage (SBC) and notice of state exchange availability.
IV. Summary of employer reporting requirements.
- W-2 reporting of health benefit costs
- Quality of care reporting
- Employer reporting to state exchanges and IRS to implement premium credits and pay or play penalties
V. Explanation of new taxes and fees.
- $1 fee to finance comparative clinical effectiveness research
- Increase in Medicare hospital insurance payroll tax on high income individuals
- New assessments on employer group health plans to pay for temporary reinsurance program under state exchanges
VI. Summary of Health Care Reform provisions designed to assist employers.
- Small employer tax credit
- Medical loss ratio rebates
- Increase in amount of incentive/penalties under wellness programs
VII. Employer response to 2014 pay or play penalty – we will analyze the rules to help you decide whether or not you should discontinue your health plan or keep it but make modifications to minimize any potential pay or play penalty.
- Discussion of how the penalty works
- Explanation of definition of full-time employee for purposes of the rules and employer options in measuring full-time employment
- Discussion of advantages and disadvantages in maintaining group health plan vs. modifying it
- Summary of potential options and designs if discontinue or keep health plan
VIII. Discussion with insurance providers.
- What they are doing to prepare for PPACA
- How it affects employer groups
EXPERT PRESENTERS: James C. Bruinsma, Member, Miller Johnson; Mary V. Bauman, Member, Miller Johnson; Frank E. Berrodin, Member, Miller Johnson. Insurance Providers TBA.