Healthcare Reform - Timeline at a Glance

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On March 23, 2010, President Obama signed the Affordable Care Act (ACA) into law. This new law extends health insurance to many Americans who previously did not qualify for coverage. It also impacts those currently participating on an employer or individual plan. Many of the key changes do not take effect for several years. The federal government is regularly releasing new details and regulations associated with the law. Here are some of the key provisions of the legislation that affect health insurance.

PLEASE NOTE: This is not a legal document and is intended for informational purposes only. We have attempted to provide the most accurate information possible, but SelectHealth makes no guarantee regarding its accuracy or completeness.

2010 

Early Retirees Reinsurance—A temporary reinsurance program helps offset employers’ cost of providing health insurance to retirees who are older than age 55 but ineligible for Medicare. 

High-Risk Pools—New high-risk pools are created in each state to provide health insurance coverage for those with pre-existing health conditions who have been without coverage for at least six months.

Small Employer Tax Credit—In order to encourage small employers to offer health coverage for the first time or to maintain coverage they already provide, qualifying businesses may receive a tax credit of up to 35 percent of premium payments.

Expanded Coverage for Young Adults—A subscriber may choose to keep a dependent on his or her plan until the dependent turns age 26, regardless of financial dependency or marital status.

Elimination of Lifetime and Annual Dollar Limits—Lifetime limits on the dollar value of “essential health benefits” are eliminated and annual limits are restricted. (Essential health benefits have not yet been defined by the Department of Health and Human Services.)

No Pre-Existing Conditions (PEC) Exclusions for Children—Children younger than age 19 will not be subject to PEC exclusions. The Department of Health and Human Services has interpreted this provision as requiring guaranteed issue for these children.

Claims and Appeals—The administrative process used by health plans and insurance companies to evaluate claims and appeals is subject to new requirements intended to provide greater protection to claimants.

100% Preventive Care Coverage—Health plans must provide 100% coverage for a defined list of preventive care services and immunizations.

2011

Premium Regulation—Health insurance premiums will be subject to additional regulation by the state departments of
insurance and health insurers will be required to rebate premiums if their “medical loss ratio” (the amount of premium spent on medical expense) is less than 85 percent for large employer groups and 80 percent for small employer groups and the individual market.

OTC Drug Reimbursement Restrictions—Over-the-counterdrugs not prescribed by a doctor will no longer be reimbursable
through flexible spending accounts (FSA) or health reimbursement arrangements (HRA), or on a tax-free basis in
health savings accounts (HSA).

2012

Benefit Disclosure—Employers will be required to disclose the value of benefits provided for each employee’s health insurance coverage on the employee’s W-2 forms.

2013

Flexible Spending Limits—Contributions to flexible spending accounts (FSA) will be limited to $2,500 a year, increased annually by a cost-of-living adjustment.

Administrative Simplification—Health insurers must follow administrative simplification standards for electronic exchange of health information to reduce paperwork and administrative costs.

2014

Shared Responsibility for Coverage—Individuals will be required to carry health insurance or be subject to a fine. Employers with 50 or more workers will also be required to offer health benefits or be subject to a fine.

State-Based Health Benefit Exchanges—Individuals and small employers may purchase a qualified health plan through an Exchange, administered by a governmental agency or non-profit organization.

Guaranteed Issue—Insurers must accept every applicant for health coverage, regardless of health status.

Guaranteed Renewal—Insurers must renew coverage at the option of the employer or individual, regardless of experience.

Rate Reform—Insurers in the small employer and individual markets must determine premiums for coverage using adjusted community rating rules. 

Individual Subsidies—Premium subsidies will be available on a sliding scale for individuals and families with incomes between 133 and 400% of the federal poverty level.