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tax credits, up to a cap of $2,000 multiplied by the number of full-time employees,
excluding the frst 30 employees.
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Required contribution to the temporary reinsurance program
During the frst three years the exchanges are available (2014–2016), a temporary reinsurance
program for the individual insurance market will be funded by a required contribution from all
group major medical plans. The per capita amount is paid for each enrollee by the insurer or
third-party administrators on behalf of self-funded plans.
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Small business tax credit changes
Small business tax credits will expand to 50 percent of a small business’s premium costs for
two consecutive years. These credits are available to businesses with average wages between
$25,000 and $50,000, and fewer than 25 full-time workers (or 50 half-time workers) that offer
health insurance through a health insurance exchange.
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Second wave of Health Insurance Reforms
In addition to these milestones, there will be a second wave of Health Insurance Reforms that
are effective for group health plans, including:
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• Pre-existing condition exclusions will no longer be permitted.
• There will be no annual dollar limits on benefts.
• Small group fully insured plans will be required to offer essential health benefts (does
not apply to grandfathered plans).
• Limits will be placed on out-of-pocket expenses (does not apply to grandfathered
plans).
• Health insurers will be subject to modifed community ratings and guaranteed-issue
requirements.
• Waiting periods in excess of 90 days will be prohibited.
More information regarding this wave of reforms is expected as January 1, 2014 approaches.
IRS reporting requirements for employers
Your business will be required to report information regarding the health coverage of your
employees, including basic employee data, dates and type of coverage; cost-sharing; and
any other information required by the IRS. These requirements apply to coverage offered on or
after January 1, 2014, but the frst report will not be due until 2015. More information on the
requirement and its regulations is expected as January 1, 2015 approaches.
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Cadillac plan tax
A tax will be imposed on insurers and employers with self-funded health plans with annual
premiums that exceed $10,200 for individuals and $27,500 for families.
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The Cadillac tax
is 40 percent of the excess of the annual value of a health plan’s cost above the threshold
amounts set forth above.
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Important Date 5:
January 1, 2018
Important Date 4:
January 1, 2015