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MISSOURI
April 2, 2013 (Source Anthem Blue Cross, Blue Shield of Mo.)
Health care reform is changing the way we do business and serve our clients. That’s why it’s more
important now than ever to stay on top of the changes. And we’re here to help you do that.
Each subhead below links to more details about what’s happened so far in 2013 and what’s coming
next. Or, check out the timeline and FAQs on our
Starting in 2013:
Health plan issuers and sponsors will pay a comparative effectiveness research fee. This fee helps the
government better understand the effectiveness, risks and benefits of treatments. This is for plan
years ending October 1, 2012, and later.
Limits to flexible spending accounts
Workers will only be able to add up to $2,500 per year to their accounts for qualified medical
expenses.
Businesses must tell workers about the health insurance marketplace (also known as exchanges). It is
one more way for workers to compare and buy health plans. Businesses will also tell workers how to
get help with costs through subsidies and tax credits.
Businesses must report the value of their health plans on W-2s. This was optional in 2012. Employers
must report the value if they had 250 W-2s in 2013. Employers with less than 50 W-2s have until 2014
to show the value. Although employers must report this, the value is not taxed.
Starting in 2014:
The law says all legal U.S. residents must have basic health coverage, if they can pay for it.
Employers have to offer “minimum essential coverage”
In 2014, businesses have to offer “minimum essential coverage” if they have 50 or more full-time
workers. The U.S. Chamber of Commerce has developed
this penalty calculator to help determine
whether companies must offer coverage and what the penalty might be based on the number of
full-time employees
The insurer fee is built into the cost of fully insured coverage but doesn’t apply to self-funded plans.
This fee funds premium subsidies and Medicaid expansion.
Another fee called the reinsurance fee applies to both fully insured and self-insured plans. It aims to
stabilize premiums for coverage in the individual market and lower the effects of adverse selection.
Health plans can’t be better for highly paid workers. Health plans can’t be based on eligibility, the
level of benefits or on a worker’s wage.
Today “small group” includes businesses with one to 50 workers. But with health care reform,
business will be considered “small group” if it has one to 100 workers. States may put off this change
until 2016.
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Good Information t This article applies to:
Wisconsin, Ohio, Nevada, New Hampshire, Missouri, Maine, Kentucky, Indiana, Connecticut, and Colorado.
Small group (2-50 employees), Large group (50-1000 employees), and Individual (under 65)
Contact us for more information