I am providing links below to two summaries on healthcare reform. These summaries are some of the best I have seen and can be forwarded to your clients and employees.  Each was prepared by the Kaiser Family Foundation. I have found them very helpful.
Health Reform Implementation Timeline
With the enactment of comprehensive health reform, the Kaiser Family Foundation has prepared a timeline detailing when specific provisions of the legislation are scheduled to take effect. 

The implementation timeline reflects the provisions of the Patient Protection and Affordable Care Act, which President Obama signed on March 23, 2010, as well as provisions in the Health Care & Education Reconciliation Act passed by the House and Senate. 

It includes more than a dozen key provisions scheduled to take effect in 2010, including the creation of a national high-risk pool for people with pre-existing conditions that can’t buy insurance on their own, tax credits for small businesses that obtain health coverage for their workers and assistance for Medicare beneficiaries with high drug costs who get hit by the drug benefit’s coverage gap or “doughnut hole,” and continues through 2014, when the major reforms to expand access to health coverage are fully implemented.
 

A copy can be obtained by inserting the link below in your browser:  

 
http://www.kff.org/healthreform/8060.cfm
 
Side-by-Side Comparison of Major Health Care Reform Proposals
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act passed by the Senate on December 24, 2009 and by the House of Representatives on March 21, 2010. The House of Representatives also passed the Health Care and Education Reconciliation Act of 2010, which makes changes to the Patient Protection and Affordable Care Act, and has been sent to the Senate for consideration.
This interactive side-by-side provides detailed, up-to-date summaries of the new health reform law and the reconciliation bill. and other comprehensive reform proposals put forward during the year-long reform debate. In the health reform debate, many proposals for overhauling our health care system have been advanced The online tool allows users to compare the law and other plans with one another across key characteristics. In addition to the summaries offered here, the Kaiser Family Foundation also has prepared detailed descriptions of the Medicare and Medicaid provisions, and a summary of the coverage provisions in the law and other legislation.
A copy can be obtained by inserting the link below in your browser:
http://www.kff.org/healthreform/upload/finalhcr.pdf 

 posted by:

 Bob Cummings, Managing Principal, American Benefits Group

a.k.a. BenefitsBob

What Employers Need to Know

Summary provided by Ceridian Benefit Services

After a detailed analysis of the Patient Protection and Affordable Care Act, Ceridian has identified some key provisions that could have significant impact on all employers and employer-sponsored health benefits plans.

Below are some of the more significant provisions affecting employers with existing plans in the two-bill package. Additional requirements will apply to employer plans adopted after enactment. Although many of the provisions in the bill will not go into effect until 2014, and in one case 2018, some take effect the first plan year following six months after enactment. While six months following the date of enactment is October 1, 2010, for employers with calendar year plans the effective date will be January 1, 2011.

Employer Mandates

Employers who employ more than 200 employees must automatically enroll new full-time employees in coverage. Employers must also provide employees with an opportunity to opt-out of coverage. Clarification on the effective date of this provision is forthcoming.

Effective 2011

A health plan W-2 reporting requirement will be imposed, requiring employers to report the aggregate value of medical benefits, vision, dental and supplemental insurance coverage. It is expected that this requirement would apply to Forms W-2 for the year 2011 that are made available to employees in January 2012.

Effective 2013

Not later than March 1, 2013, employers will be required to give a notice to their employees that they may be eligible to participate in one of the state-based health-insurance Exchanges.

Effective 2014

The Patient Protection and Affordable Care Act requires employers with 50 or more employees to offer coverage to their employees or pay a fine of $2,000 per full-time employee, if even one employee obtains a federal subsidy to buy health coverage from one of the new state-based health-insurance exchanges.* The first 30 employees are exempt from the calculation of the penalty.

The mandate also requires an employer who does provide coverage to pay either of the following: an “assessment” of $3,000 for each employee who qualifies for subsidized coverage from an exchange either because the employer pays less than 60 percent of the full actuarial value of the coverage provided or because the employee’s cost is greater than 9.8 percent of their adjusted gross income; or $2,000 per full-time employee, whichever is less.

* By 2014, the Act requires states to create health-insurance exchanges, which would offer four different levels of qualified health insurance plans. It also would mandate individuals at this time to purchase coverage and provide subsidies for certain individuals to do so.

Mandates Impacting Employer-Sponsored Plans

Effective 2010

Employer-provided group health plans will be required to cover adult children up to age 26, unless they are eligible under another group plan (for years before 2014). This coverage will be nontaxable. Also, the group health plan will be required to eliminate pre-existing condition exclusions for children under age 19.

Employer health plans will be prohibited from rescinding or cancelling health coverage, except in cases of fraud.

Employer-provided coverage will be required to eliminate lifetime limits on essential benefits coverage and may only place “restricted” annual limits on essential benefits coverage until 2014, when annual limits are prohibited.

Effective 2011

Over-the-counter medicines will no longer be eligible for purchase with funds from Flexible Spending Accounts, Health Savings Accounts or Health Reimbursement Arrangements, unless a prescription is provided.

The penalty for use of funds from a Health Savings Account for non-qualified medical expenses will increase, doubling the additional tax on these types of withdrawals from 10 percent to 20 percent for anyone under the age of 65.

Effective 2013

A statutory cap of $2,500 will be placed on the amount of funds an employee can save in a Flexible Spending Account. The limit will be adjusted annually in accordance with the U.S. Consumer Price Index.

Effective 2014

The employer’s group health plan will be required to eliminate the pre-existing condition exclusions for adults. The plans also have to eliminate annual limits on essential benefits coverage for adults.

Employers will be required to eliminate waiting periods beyond 90 days when enrolling employees in a group health plan.

Tax Provisions

Effective 2010

Small business tax credit: Businesses with fewer than 25 employees and average wages of less than $50,000 could qualify for a tax credit of up to 35 percent of the cost of employees’ premiums.

Effective 2013

Individuals with adjusted modified gross income over $200,000, and joint filers with over $250,000, will be required to pay a Medicare surtax of 3.8 percent on investment and other passive income, including rents, interest, dividends, royalties and capital gains.

In addition, these high-income earners will have to pay a Medicare payroll tax of 2.35 percent — an increase of 0.9 percent — on the portion of their wages in excess of the above noted thresholds. (Note: These are individual mandates that affect employees; they do not employers.)

An employer’s deduction for retiree prescription drug coverage is disallowed to the extent the employer receives the Retiree Drug Subsidy for providing coverage that is as good as or better than Medicare Part D coverage.

Effective 2014

The 35 percent tax credit that goes into effect in 2010 for businesses with fewer than 25 employees and average wages of less than $50,000 increases to up to 50 percent of the cost of employees’ premiums.

Effective 2018

Excise tax on high-value health plans: A 40 percent excise tax will be applied to the excess value of a health plan above a statutory threshold. For most health plans, the threshold in the law will be established at $10,200 for individual health plans and $27,500 for family coverage. The threshold for the new excise tax will be adjusted annually for general inflation.

Also in the Patient Protection and Affordable Care Act

Wellness: The Act provides limited incentives for employers to provide corporate wellness programs to their employees. The new law permits employers to offer premium discounts of up to 30 percent and other cost-related incentives to employees who participate in employer

From Workforce Management

The landmark overhaul of the U.S. health care delivery and financing system was approved Sunday, March 21, by the House of Representatives, and Senate approval of the legislation is expected soon.

The legislation could result in as many as 32 million U.S. residents gaining coverage, chiefly through expanding Medicaid for the low-income uninsured and extending federally subsidized health insurance premiums to uninsured individuals with incomes up to 400 percent of the federal poverty level.

For the first time, employers will be subjected to taxes if they do not offer coverage to employees or if the coverage fails an affordability test. In some cases within a few months, employers will have to change the design of their plans to comply with a wide range of new requirements, such as continuing coverage to employees’ adult children.

Some benefit programs, such as flexible spending accounts, will have to be cut back; others, most notably prescription drug plans provided to Medicare-eligible retirees, will lose tax breaks.

Down the road, employers also could be affected by a new tax on costly health insurance plans if health care plan costs continue to rise. To help employers keep up with the latest developments, Workforce Management sister publication Business Insurance provides answers to frequently asked questions about the issues.

Q: Which bills did the House of Representatives approve on March 21?

A: Two measures were passed. One was the measure the Senate approved last December. The second bill, described as a reconciliation bill or a “sidecar,” includes changes to that measure.

Q: What happens next?

A: The Senate has to approve the second bill, and that action could be completed this week. President Barack Obama is expected to sign the first bill Tuesday, March 23.

Q: How would the new excise tax on health insurance premiums work?

A: Starting in 2018, a 40 percent excise tax would be imposed on health insurance premiums exceeding $10,200 for single coverage and $27,500 for family coverage. The cost thresholds triggering the tax will be slightly higher for plans covering retirees or employees in certain high-risk industries. In 2019, the thresholds would rise to match the increase in the Consumer Price Index, plus one percentage point. In 2020 and succeeding years, the thresholds will increase to match rises in the index.

Q: Who would pay the tax?

A: The tax would be paid by insurers for fully insured plans and by plan administrators for self-funded plans. Insurers and plan administrators almost certainly would try to recover that cost from employers.

Q: Would the tax apply to all health care-related coverage?

A: No, dental and vision care premiums or costs would be excluded.

Q: What is the penalty on employers that do not offer health care coverage?

A: Starting in 2014, employers with at least 50 employees would be assessed an annual penalty of $2,000 for each employee they do not offer coverage. In calculating the amount of the tax, the first 30 employees would be excluded.

Q: Is there a penalty if an employer offers coverage, but coverage is not “affordable”?

A: Yes, a penalty of $3,000 per employee per year would apply starting in 2014. Two conditions would have to be met for the penalty to be triggered: The share of the premium paid by the employee would have to exceed 9.5 percent of income and the employee would have to use federal insurance premium subsidies to purchase coverage through new state health insurance exchanges.

Q: Since 2004, employers offering retiree prescription drug coverage at least actuarially equal to Medicare Part D have been eligible for a tax break. Specifically, the government provides tax-free reimbursement of 28 percent of employers’ drug costs to retirees within a certain corridor. Does the legislation take this tax break away?

A: The legislation curbs the tax break starting in 2013. Employers still will be eligible for the subsidy, which will continue to be tax-free. But employers will not be able to take a tax deduction for retiree prescription drug expenses for amounts equal to the subsidy.

Q: What will happen to flexible spending accounts?

A: Starting in 2013, a $2,500 cap on contributions to flexible spending accounts will go into effect. In succeeding years, the cap would be increased to match the rise in the Consumer Price Index. There is no annual limit under current law, though employers typically impose limits between $4,000 and $5,000 a year.

Q: What changes affecting health care plan design would go into effect quickly?

A: Within six months after enactment of the legislation, group plans would have to extend coverage to employees’ adult children up to age 26 if the adult child is not eligible to enroll in another group plan. In addition, group plans no longer could have lifetime dollar limits and no restrictive annual limits, as defined by regulations. In 2014, waiting periods exceeding 90 days would be banned, as would annual dollar limits on benefits.

Filed by Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com