Under National Health Care Reform, the Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and many employees may be wondering how it will impact WHOI benefits. Because WHOI already offers comprehensive benefits to employees, Health Care Reform will have little impact on our benefits in 2011. Many of the major changes under the Reform will not go into effect until later years. Further, many of the changes do not affect employers in Massachusetts as they are already in place under the Massachusetts Health Care Reform.
Changes effective January 1, 2014
Effective January 1, 2014 under The Affordable Care Act ("ACA"), the new Health Insurance Marketplace (originally referred to as the "Exchange") will be made available to consumers. The "Marketplace" will allow individuals to compare and purchase medical coverage online from insurance carriers. Financial assistance will be available to families with household income below a certain dollar amount, however, individuals who are already eligible for employer-sponsored medical coverage that meets certain standards are not eligible for financial assistance through the Marketplace. WHOI's medical coverage meets the standards for "affordable coverage that meets the minimum value requirement." For more information, please visit the dedicated HR/Benefits website page at http://www.whoi.edu/HR/page.do?pid=125836
Changes Effective January 1, 2013
Summary of Benefits Coverage (SBC)—employers who sponsor group medical plans must provide to all eligible plan participants a standardized benefit summary of all their medical plan offerings. The new SBC will be available during WHOI's open enrollment for effective coverage on 1/1/2013 and will be provided annually thereafter. The SBC's will replace the BCBS medical plan summaries provided in the past.
Women's Preventive Care—expansion of no cost services for women's preventive health care services to include FDA-approved contraception methods and contraceptive counseling, screening for gestational diabetes and human papillomavirus (HPV) DNA testing for women 30 years and older. For more information on what is specifically covered, please contact BCBS directly at 1-800-241-0803 or by visiting their website at www.bluecrossma.com.
Healthcare Flexible Spending Account (FSA) - Annual Contribution Limit—contributions to a Healthcare FSA will be limited to $2,500 each year with annual inflation increases. This limit does not apply to the separate Dependent Care FSA.
Changes Effective January 1, 2012
W-2 Reporting of Health Coverage—employers are required to report the full value of employer-provided health coverage on an employee's W-2 - this includes the total annual cost to the employee and employer. This will be provided to employees for informational purposes only and will have no bearing on their taxable income. This will begin with the W-2's issued in January 2013 for the plan year 2012.
Changes Effective January 1, 2011
Dependent Coverage to Age 26—dependents can now be covered on their parent’s medical coverage up until their 26th birthday, regardless of the dependent’s financial dependency, student status, or employment status. In addition, imputed income will no longer apply for covered dependents*. During Open Enrollment this year, employees will have the opportunity to include their adult children, under age 26, in their medical coverage, even if they were previously removed due to age and/or dependency status.
*Under IRS rules, imputed income still applies to children of domestic partners.
100% Preventive Coverage—all WHOI medical plans with BCBS of Massachusetts will cover free preventive care services, requiring no office visit copayment, coinsurance or deductible. More information on what preventive services are included can be found by visiting www.HealthCare.gov/center/regulations/prevention.html or by calling BCBS directly at 1-800-241-0803 or visiting the BCBS of MA website at www.bluecrossma.com.
Healthcare Flexible Spending Accounts - Limits on Over-the-Counter Medications—most over-the-counter medications and drugs (except insulin) will no longer be eligible for reimbursement through a Healthcare FSA without a prescription.