While most elements of the new law will be phased in over the next five or so years, certain mandates already are in place.
For plan years beginning on or after Sept. 23, 2010, mandates include the elimination of lifetime dollar limits on essential benefits, coverage of dependent children up to the age of 26, the incorporation of restricted annual limits on essential benefits until 2014, and the elimination of pre-existing condition limitations for enrollees under 19.
• 2011: The Affordable Care Act will require a prescription for over-the-counter drugs and medicine in tax-favored accounts. And while the government initially planned to implement W-2 reporting requirements beginning in January, the IRS said that will not be mandatory in 2011.
Also in 2011, the Community Living Assistance Services and Support Act takes effect. It will enable employees to have an average of $150 or $240 a month, based on salary and age, automatically deducted from paychecks to help save for long-term care.
• 2012: The ACA will require uniform communications standards for employers, as well as a 60-day advance notice of material changes.
• 2013: Medicare taxes will be raised on earnings above $200,000 for individuals and $250,000 for married couples. In addition, contributions to flexible savings accounts will be limited to $2,500 per year and indexed by the Consumer Price Index in following years.
• 2014: States will be responsible for establishing exchanges that will create a marketplace for the purchase of health care insurance. Individuals will be required to have health coverage or pay a penalty. All businesses with more than 50 full-time-equivalent workers will be required to offer coverage or pay a $2,000-per-person penalty over the first 30 employees. Insurance will be available to employees following a waiting period of 90 days. The mandates will include new reporting requirements for businesses with more than 50 employees.
• 2018: “Cadillac,” or high-cost, employer-provided health plans beyond $10,200 for single coverage and $27,500 for families will be taxed.