This course will review the Affordable Care Act.
The first part of the course will discuss the general requirements of the Affordable Care Act, including those requirements that apply to companies today. Specifically, the course will discuss the extension of dependent coverage to age 26, limits on pre-existing conditions and essential health benefits, coverage of emergency services, cost-sharing restrictions on certain preventive care coverages, the new appeals process, initial authorization by primary care physician restrictions, limits on reimbursements of certain medications, automatic health plan enrollment, additional preventive services, non-discrimination requirements, and more.
The second part of the course will discuss requirements that take effect in 2012 and beyond. Specific topics will include health FSA salary reduction contribution limits, Medicare Part D subsidy elimination, changes to waiting periods, limitations on pre-existing conditions and essential health benefits, restrictions on cost-sharing, clinical trial requirements, wellness programs, new Summary of Benefits and Coverage regulations, new HIPAA certification requirements, state Exchanges, the individual mandate, and more.
Penalties and taxes associated with non-compliance will be reviewed. Among the penalties and taxes that will be reviewed are: the Code section 4980D health plan non-compliance excise tax, the excise tax on HSA distributions for non-medical purposes, the annual fee assessed on plan sponsors, medical loss ratio rebates, medical expenses deduction limit, additional FICA and SECA payroll tax, new investment income tax, $2,000 penalty for each full-time employee who seeks coverage through Exchanges, $3,000/$2,000 penalty for each full-time employee who receives a subsidy because employer’s coverage is unaffordable, annual fee on certain entities that provide health insurance, reinsurance fee, 40% excise tax on “cadillac” insurance plans, and more.