Employers Remain Uncertain on Impacts of PPACA
Employers will have a number of obligations and opportunities as the heart of the Patient Protection and Affordable Care Act of 2010 (PPACA) is implemented in 2014. If they are only listening to the chatter of the debates, they are not getting the whole story. This health care reform law is complicated, and each employer will need to base its employee benefit and total compensationdecisions on its particular situation.
As Members of United Benefit Advisors, we understand PPACA and small businesses in greater depth than other leading organizations and is offering free tools to help with the top PPACA compliance concerns facing employers. A free download of UBA's PPACA Decisions Executive Summary, part of UBA's PPACA Advisor series, is available. The summary includes:
- An overview of PPACA
- Decisions employers need to make regarding PPACA
- Obligations employers must fulfill between now and 2014
To access the PPACA Executive Summary, CLICK HERE
UBA Member Firms are counseling employers on changes they should already have made to comply with PPACA, which are that health plans:
- May not have a lifetime dollar maximum on any "essential health benefit"
- May not have an annual dollar limit on an "essential health benefit" that is over a certain amount
- Must cover the health care of employee's dependent children until the dependent reaches age 26 - even if the child is married or employed++
- May not exclude pre-existing condition limitations for children under age 19
- May not retroactively rescind health care coverage, except for fraud or material misrepresentation or for nonpayment of premium by certain terminated employees
- Must provide first-dollar health care coverage for specific preventive services+
- Must cover emergency services at in-network level regardless of provider+
- If a primary care physician (PCP) must be chosen, allow each person to choose their own PCP and allow a pediatrician to be the designated PCP+
- Must allow women to see an OB-GYN without a referral+
- Must have a specific and comprehensive process for handling health care claims appeals+
- May not reimburse over-the-counter drugs under a health flexible spending account, an health reimbursement account or an health savings account unless the drug is prescribed by a doctor
+ - Does not apply to grandfathered plans ++ - Limited exception for grandfathered plans
UBA Members are offering intensive decision support to employers based on the size of their company and will be reachingout to employers nationwide with three comprehensive decision-guide tools. Thom Mangan, UBA CEO, is available for comment and in-depth expertise as it uniquely applies to small businesses (under 50 employees), midsize businesses (50-100 employees) and large employers (more than 100 employees). He can speak to the following topics:
- The ramifications of PPACA on businesses
- The most important elements of exchanges, now and in the future
- Employer responsibilities and obligations under the law, future considerations and penalties
About Thom Mangan
Thom Mangan is a 20-year veteran in the employee benefits field, with vast experience in corporate leadership and an extensive background that spans sales, services and operations. Thom has a successful track record with several well-known brands in the employee benefit arena including USI, HUB International and Willis. He has also served as a board member on the Council of Insurance Agents and on the National Broker Advisory Councils of Aetna, Cigna and UnitedHealthcare.
About United Benefit Advisors
One of the nation's top five employee benefits advisory organizations, UBA is a Member-owned alliance of more than 140 premier independent benefit advisory firms with more than 200 offices throughout the U.S., Canada and the U.K. As trusted and knowledgeable advisors, UBA Members collaborate with more than 2,200 professionals to deliver expertise, thought leadership and best-in-classHRconsulting solutions that positively impact employers and make a real difference in the lives of their employees and families. Employers, advisors and industry-related organizations interested in obtaining powerful results from the shared wisdom of our Members should visit UBA online at www.UBAbenefits.com.UBA also produces the UBA Health Plan Survey - the industry's largest and most comprehensive benchmarking survey of plan design and cost available.