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Health Care Reform Implementation Timeline |
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January 1, 2010 |
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New federal rate review process is established |
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National risk pool is created 90 days from enactment |
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Temporary retiree reinsurance program is established |
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Small business tax credit is established |
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HHS Secretary establishes new national risk-pool |
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States approve (or disapprove) new rate filings |
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HHS Secretary and states create new rate review process |
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Expansion of the adoption credit and adoption assistance program |
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HHS Secretary establishes temporary retiree reinsurance program |
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Rebates for the Part D "Donut Hole" |
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October 1, 2010 |
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Prohibits lifetime benefit limits |
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Allows restricted annual limits for essential benefits |
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Recessions are prohibited except for fraud or intentional
misrepresentation |
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Cost sharing obligations for preventive services are prohibited |
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Dependent coverage up to age 26 is mandated |
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Internal and external appeal processes must be established |
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Discrimination based on salary is prohibited |
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New health plan disclosure and transparency requirements are
created |
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Coverage for emergency services at in network cost sharing level
with no prior authorization is mandated |
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Pre-existing condition exclusions for dependent children are
prohibited |
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Reporting health coverage costs on form W-2 |
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Grandfathered Plans |
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Increased access to home and community based services |
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Discounts in the Part D "Donut Hole" |
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January 1, 2011 |
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Uniform coverage documents and standard definitions are
developed by HHS |
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85% MLR for large group (with refund) is mandated |
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80% MLR for individual and small group (with refund) is mandated |
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Increased access to home and community based services |
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Discounts in the Part D "Donut Hole" |
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Reporting health coverage costs on form W-2 |
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Increased additional tax for withdrawals from Health Savings
Accounts and Archer Medical Savings Account Funds for Non
Qualified Medical Expenses |
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No Reimbursement for OTC drugs unless prescribed |
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Creation of a Simple Cafeteria Plan to provide a vehicle through
which small businesses can provide tax free benefits to their
employees |
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March 23, 2012 |
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Uniform explanation of coverage |
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60 day notice in advance of material modifications |
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4 page pre-enrollment coverage document sent outlining benefits
and exclusions |
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January 1, 2013 |
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80% MLR for individual and small group (with refund) is mandated |
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Health insurance fee to fund Comparative Effectiveness is
imposed |
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Reduced limit health flexible savings account contributions to
$2,500 per year |
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States approve or disapprove new rate filings |
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HHS Secretary and states approve or disapprove premium rate
increase requests |
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Additional hospital insurance tax for high wage workers
($200k/individual income; $250k married filing jointly) |
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Eliminated deduction for employer Part D Subsidy |
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Medicare tax increase for high-earners |
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Increased threshold for claiming itemized deduction for medical
expenses |
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No deduction for retiree drug subsidy |
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January 1, 2014 |
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Annual fee for patient-centered outcomes research on insured and
self insured plans to fund the patient centered outcomes
research trust fund |
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Guarantee issue is required |
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Rating restrictions that, among other things, limits use of age
as a rating factor are imposed |
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Individual and employer responsibility requirements are
established |
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Individual affordability tax credits are created and small
business tax credits are expanded |
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Essential benefit plan is created |
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Pre-existing condition exclusions are prohibited |
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Co-Ops are established |
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Lifetime and annual dollar limits are prohibited for essential
benefits |
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Coverage for approved clinical trials is mandated |
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States approve or disapprove new policy forms |
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State based exchanges |
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90 day limit on waiting periods |
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Retiree reinsurance program ends if money has not already run
out |
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January 1, 2015 |
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Health insurance provider fee imposed $11.3 billion |
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January 1, 2016 |
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Health insurance provider fee remains at $11.3 billion |
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January 1, 2017 |
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Health insurance provider fee increases to $13.9 billion |
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January 1, 2018 |
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Health insurance provider fee increases to $14.3 billion** |
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High cost insurance excise tax is established |
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