Despite what many of my readers have thought, the senate health care reform bill was signed into law.
Many parts of the bill do not take effect for several years; for example, in 2018, a 40 percent excise tax would be imposed on health insurance premiums exceeding $10,200 for single coverage and $27,500 for family coverage. This tax will apply to the insurers but will, most likely, get passed onto employers and subsequently, employees.
There is so much to learn about what other future provisions are in the bill, but there are few things that take effect soon, and should be communicated to employees.
Flexible Spending Accounts.Starting in 2011, employees no longer will be able to be reimbursed from their FSAs for over-the-counter drug expenses. Then, in 2013, a $2,500 cap on contributions to flexible spending accounts will go into effect.
In succeeding years, the cap would be increased to match the rise in the Consumer Price Index. There is no annual limit under current law, though employers typically impose limits of $4,000 to $5,000 a year.
Health Savings Accounts. Beginning in 2011, the current 10 percent tax on health savings account withdrawals taken prior to age 65 that are not used for reimbursement of healthcare expenses would be raised to 20 percent. Employees need to be aware of the change in the event they are planning on an early withdrawal.
Coverage up to age 26. Within six months after enactment of the legislation, group plans have to extend coverage to employees’ adult children up to age 26 if the adult child is not eligible to enroll in another group plan. Employees need to be aware of this new option and the additional cost they will incur if they elect to cover additional dependents.
In addition, group plans will no have lifetime dollar limits and no restrictive annual limits as defined by regulations. In 2014, waiting periods exceeding 90 days would be banned, as would annual dollar limits on benefits.
Possible changes in retiree prescription coverage. Not immediately, but starting in 2013, employers will not be able to take a tax deduction for retiree prescription drug expenses for amounts equal to the subsidy.
This will be an huge expense for larger employers, and it may cause them to re-evaluate retiree health coverage plans. As employers make decisions on how they will handle these additional costs, plan changes should be communicated to retirees as soon as possible so they can prepare to review their options to enroll in Medicare Part D, if necessary.
As we go forward, I'm certain we will learn more and more how this new legislation will change employer-provided healthcare plans. As with all employee communication, in addition to explaining the changes, employees need to understand why their plan design and costs are changing to avoid a negative backlash on the employer.