October 3, 2011 Article

Implementation of Health Care Reform

Since it became effective on September 23, 2010, implementation of the Patient Protection and Affordable Care Act of 2010 (Public Law 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152) continues apace.  Despite multiple legal challenges to health care reform, federal agencies tasked with insuring timely compliance continue to write regulations that must be addressed by employers, health plans, insurers and others impacted by these massive changes to our health care delivery system.  First, a refresher on some of the things still to be done:

2012:

Grandfathered  and Non-grandfathered Plans

  • Advance Notice of Changes in Benefits and Coverage – Employers must distribute a uniform summary of benefits and coverage to new plan participants.  If there are any material changes to a plan that are not covered in the most recent summary, participants must be provided with 60 days notice of any such changes.
  • Patient-Centered Outcomes Research Trust Fund Fee – An annual fee of $2 ($1 for plan years ending during 2013) multiplied by the average number of covered lives under a health plan will be assessed to finance a government fund related to comparative clinical effectiveness. This fee specifically applies to both insured (fee is paid by insurer) and self insured (fee is paid by the plan sponsor – usually the employer) plans.

Non-grandfathered Plans Only

  • Quality of Care Reports – Non-grandfathered plans are required to make annual reports available to the public regarding performance measures related to improving quality of care. 

Download the PDF to read the complete article.

Firm Highlights

Publication

Update on Families First Coronavirus Response Bill—Payroll Taxes and Tax Credits

As discussed in our recent update , the Families First Coronavirus Response Act (the “Act”), which is expected to take effect on taking effect April 1, 2020 according to recent Department of Labor guidance...

Publication

Alert: COVID-19 Update for ME and NH Employers

As the landscape of the COVID-19 global pandemic continues to evolve, employers across the country are looking for guidance on how to reduce the impacts on their businesses and their employees. Yesterday, the Maine...

News

Eighteen Preti Flaherty Attorneys Selected as Chambers USA Leaders in Their Field

Eighteen Preti Flaherty attorneys and five practice groups have been selected for inclusion in the 2020 Chambers USA Guide to America's Leading Lawyers for Business , the highly regarded directory of leading attorneys and...

Publication

Return to Work Protocol for Workers Following an Absence Due to COVID-19

This protocol outlines steps to consider when returning an employee or contractor to work after a COVID-19-related absence and applies to situations in which the person: (1) had a positive test result or (2...

Publication

Families First Coronavirus Response Bill

The federal government has enacted the COVID-19 Coronavirus Response Act, requiring employers with fewer than 500 employees to provide paid sick leave and expanded FMLA protections, effective April 2. The Act provides two separate...

Publication

DOL Provides Guidance on Exemption from Paid Leave for Small Businesses

The FFCRA requires certain employers to provide paid sick leave and expanded FMLA benefits due to COVID-19 but provides that businesses with fewer than 50 employees may be exempt if the obligation would jeopardize...

Publication

COVID-19 and 401(k) Plans—Ability to Suspend Employer Contributions

As a result of the COVID-19 epidemic, many employers are looking to conserve cash in order to continue operations.  Some may wonder whether they can suspend employer contributions to 401(k) plans. Suspension of contributions...

Publication

Preti Flaherty COVID-19 Resources

In response to the ongoing COVID-19 pandemic, Preti Flaherty's attorneys have maintained a constant stream of the most up-to-date information and resources for our clients, business partners, and others struggling to navigate these complex...