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Highlights, Information, Dates, and References to the AFFORDABLE CARE ACT (PPACA) aka Obamacare

Proposed Actions

  Dates                        Proposed Actions

23 September, 2012

Summary Benefit of Coverage (SBC) requirement begins

Deadline for SBC dispersal to employees- 30 days before the group renewal date

Deadline for a later change- 60 days before the change is implemented

Significant fines for non-compliance

1 October, 2013

Open enrollment on the Exchanges begins

1 January, 2014

Individual and Employer Mandates begin Exchanges begin (may be federal, state or private)

Individuals (No coverage = phased in financial penalty from 2014-2016)

Employers 50+* (penalty based on no coverage offered and/or employees receiving subsidies)--­ Penalty $2000 x full-time employees -30 employees--- If coverage provided is not affordable or does not meet "minimum value", penalty is $3000 per employee for each employee receiving subsidy- penalty indexed after 2014

Employer 50+ When Coverage Provided

Payroll deductions can be no more than 9 i-2% of employee W-2 income

Essential benefits must be covered including pediatric dental and vision

60% actuarial valuation minimum benefit

All coverage is Guaranteed Issue and pre-existing conditions are covered immediately

Premiums will be community rated (will result in huge rating differentials)

Essential Benefits required

New products required (Four levels)

Subsidies begin for eligible participants (133%-400% of Federal Poverty Level)-- $43,320  Single---- $88,200  Family of 4

Insurance fees start

ACA Premium Tax- 2.7%

ACA Reinsurance Tax- $6.35 per member per month


1 January, 2013

Excise Tax on "Cadillac Coverage"-- $10,200 single --$27,500 family -- 40% of "excess premiums

Other Requirements

Based on employees in 2013 for penalties in 2014

Full-time = 30 hours per week- NOT seasonal if work 120 days in year

Part-time employees counted in total to determine full-time, based on monthly part-time hours - 120 = # of full-time equivalent.