Well I finally decided to start a blog.  I am constantly asked questions about Health Insurance and Health Care reform.  I figured if I was getting so many questions, it was really only the tip of the iceberg of people that didn’t understand the implications or the new laws.  So …  I decided to do the next best thing to standing on a street corner and shouting out answers … thus, here is my blog.  This forum is the best way to disseminate information to my contacts, clients and friends.

With the recent election behind us, Health Care reform is here to stay.  In fact the State of California has already created its Health Care Exchange called “Covered California”.  So whether you like it or not,  you as the consumer need to make sure you are well informed in order to navigate through these uncharted waters. 

To start I am going to attach a timeline of what and when we can expect the new Health Care Act to be rolled out.  As you can see 2014 is the year a majority of the plan goes into effect.


Employee Notification of Changes – Beginning March 1, 2013, employers must provide employees written notice of Exchanges, Premium Subsidies and Free Choice Vouchers

Flexible Spending Accounts – $2,500 cap on the health FSA

Medicare Tax – Affects individuals earning more than $200,000 and joint filers earning more than $250,000

Fee on Health Plans – Health plans will be assessed a fee to fund a Patient-Centered Outcome Research program

Retiree Prescriptions – Reduce employer deduction for retiree prescription drug expenses


Employer Requirement to Offer Minimum Essential Coverage (50+ Employees) – The new health care reform law does not require employers to offer health coverage to their employees.  However, large employers will be subject to a penalty beginning in 2014 if they do not.

Individual Mandate – Individuals will be fined, beginning in 2014 for not having approved health care coverage.

State-based Exchanges for Individuals and Small Groups – Exchanges established for individual and small group (1-100 employees or 1-50 employees, depending on state law.)

Small Employer Tax Credits Available Only in Exchange – For eligible small businesses that purchase coverage through the exchange, there will be a tax credit of up to 50% of the employer’s contribution toward the employee’s health insurance premium if the employer contributes at least 50% of the total premium cost

Employer Reporting Requirements – Employers must annually report to the Secretary of the Treasure whether they offer health coverage to their full-time employees and dependents

Mandated Coverage – Non-grandfathered group health plans and Exchange plans meet certain mandated levels of coverage including out-of-pocket cost sharing (tied to HAS qualified plan limits)

Pre-Existing Conditions – Prohibit all pre-existing condition exclusion (including grandfathered plans)

Benefit Waiting Periods – Prohibit waiting periods in excess of 90 days (including grandfathered plans)

Rating – Modified community rating for individual and family coverage in the small group market

Wellness Program – Wellness program incentive may increase to 30% of the cost of coverage for a reward based program

Health Insurance Carriers – New fees imposed in  health insurance carriers

Small Group redefined as 1-100 – Small group will be redefined as 1-100 employees, however, for the employer responsibility requirements it is 50 employees or less.

Hope this answers some questions … more to come …
~~ John