The Affordable Care Act (ACA) was signed into law on March 23, 2010 with its adoption, the ACA has presented a set of group health plan standards and health insurance, known as "market reforms."
in general to implement on 1 January 2014, these reforms were limits placed on certain benefits, treatment of basic preventive care, limited waiting periods, coverage depends extent, and communications written employees, among others.
This article outlines the time the respect of market reforms is needed,
[1945011commentlesplansderemboursementdel'impactdesréformesdumarchéetdespénalitéspournon-conformité] When compliance with the required market reforms ?with few exceptions, group health plans must comply with market reforms.
a plan or arrangement is considered a group health plan where the employer's funds are conditioned on the medical expenses of an employee. Even in the most informal circumstances, a group health plan is established when the money employers are specifically used for medical expenses.
Once the group health plan is established, the plan is required to comply with market reforms.
What is the impact of individual health insurance reimbursement?
For decades (see the chronology), employers offered health benefits by reimbursing employees for medical expenses audited, including Medicare premiums. Because the conditions of their employer finance the medical expenses incurred by the employee, the refund scheme is a group health plan.
As a group health plan, repayment plans are required to comply with the following market reforms.
lifetime limits of Prohibition and annual limits on essential health benefits
Before the ACA, plans were generally allowed to place life and annual limits - the dollar limits - on how the plan would go for health services covered or for the duration of an individual was enrolled in plans (lifetime limit) or a year plan (annual limits). Under the ACA, both lifetime and annual limits on essential health benefits (EHB) are prohibited.
Cost sharing Not for preventive health services
plans must provide coverage for certain preventive health services, without imposing cost-sharing.
0 days waiting period
The ACA prohibits Plans to establish waiting periods longer than 0 days. A "waiting period" refers to the period of time that must pass before an eligible individual is allowed to participate in the plan.
Extension of coverage dependent
The ACA requires plans that offer coverage to dependents such coverage available to children under 26. This includes coverage for both married and unmarried adult children under age 26.
Summary of benefits and coverage (SBC )
the ACA requires each plan provides a SBC to people prior to enrollment and on each plan period. The SBC is a short document to describe the benefits of health plans in simple language.
What is the penalty for non-compliance?
Compliance with market reforms applied by the potential excise tax under Internal Revenue Code §4980D. If non-compliance with the requirements of the health plan of some groups (including market reforms) is determined, the employer may be valued at $ 100 per day, per employee excise tax.
These costly fines make it imperative that employers provide a consistent plan.
Conclusion - a Way conforms to reimburse individual health insurance
to reimburse employees for individual health insurance and comply with reforms market, employers can use a refund of health care plan (HRP) as ZaneHealth. HRP is carefully designed to satisfy market reforms discussed by only allowing reimbursement of insurance premiums (not essential health benefits), and some prevention services (no cost sharing). In addition, an HRP allows waiting periods of 0 days, the cover dependents up to 26 years, and provides participants with a summary of benefits and coverage.
What questions do you market reforms and their impact on repayment plans? Leave a comment below.
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