2016 Updated Healthcare Reform Timeline (Version 16)

2016 Updated Healthcare Reform Timeline (Version 16)

PPACA

If you want to see 10 pages of health reform in a 1 page timeline (well, 1 page for Employer and 1 page for Employees) then please visit our website (www.apbenefitadvisors.com/news).  But, if you are looking for details specific to just a certain year or plan, then you can’t do better than this implementation timeline from The Kaiser Family Foundation.

Also, we’ve had several requests for a condensed version of the Employer Mandate rules and examples.  That is included here too.

AP Benefit Advisors’ Timelines & Employer Mandate Details

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**Don’t forget that the IRS indexed the Shared Responsibility fines under the Affordable Care Act. (See our 12/21/2015 post for complete details).

Department also update the payments due under ACA’s Shared Responsibility Structure

  • Question 13:  Under § 4980H(c)(5), in the case of any calendar year after 2014, the applicable dollar amounts of $2,000 and $3,000 under § 4980H(c)(1) and (b)(1) are increased based on the premium adjustment percentage as defined in § 1302(c)(4) of the Affordable Care Act (4.213431463 for 2015* and 8.316047520 for 2016**) rounded to the lowest multiple of $10. What are those amounts for calendar years 2015 and 2016?
  • Answer 13:  For calendar year 2015, the adjusted $2,000 amount in §4980H(c)(1) is $2,080 ($2,000 x .04213431463 = $84.27 plus $2,000 rounded down to $2,080), and the adjusted $3,000 amount in §4980H(b)(1) is $3,120 ($3,000 x .04213431463 = $126.40 plus $3,000 rounded down to $3,120).  For calendar year 2016, the adjusted $2,000 amount in §4980H(c)(1) is $2,160 ($2,000 x .08316047520 = $166.32 plus $2,000 rounded down to $2,160), and the adjusted $3,000 amount in §4980H(b)(1) is $3,240 ($3,000 x .08316047520 = $249.48 plus $3,000 rounded down to $3,240). Treasury and IRS anticipate that adjustments for future years will be posted on the IRS.gov website.
  • 2015  Sledge-hammer fine $2,080
  • 2015  Tack-hammer fine $3,120 ($260/month)
  • 2016  Sledge-hammer fine $2,160
  • 2016  Tack-hammer fine $3,240 ($270/month)

2017 Out-of-Pocket Maximums Reminders (these are on the timeline and the HSA-chart above):

  • The 2017 annual out-of-pocket maximums will be $7,150 for individual coverage and $14,300 for family coverage.
  • For HSA-qualified plans the annual out-of-pocket maximums will be $6,550 for individual coverage and $13,100 for family coverage