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Covering the Basics of the TeamSoft Plan and Health Care Reform

Do you have questions about health care reform? A lot of us do. This Q&A from our recent Health Care Reform meeting at M3 Insurance can help clear a few things up.

I’ve heard a lot about the health care reform law. When do the reforms become effective? The health care reform bill was signed into law in March 2010. The changes made by the health care reform law go into effect over a period of years. Some of the law’s changes are already in effect, such as the prohibition on preexisting condition exclusions for individuals under age 19. Other key changes go into effect in 2014, such as the requirement for individuals to buy health coverage or pay a penalty.

Does health care reform allow people to keep their current health coverage? Yes. Nothing in the law requires individuals to terminate coverage that they had on the date the law was passed.

Are individuals required to have health coverage? Not yet. However, in 2014, most U.S. citizens must obtain health insurance coverage or they will be subject to penalties. There are exceptions for low-income individuals and those who are unable to obtain affordable coverage.

When does free preventive care start and will it affect my plan? Effective for plan years beginning after Sept. 23, 2010, plans must provide coverage for preventive services. Recommended prevention and vaccination services will be covered without any deductibles or copayments. Seniors enrolled in Medicare will also no longer have to pay for proven preventive services. Effective for plan years beginning on or after Aug. 1, 2012, plans must provide additional preventive services for women without cost sharing, such as coverage for well woman visits, breastfeeding support and contraception. Exceptions to the contraceptive coverage requirement apply to religious employers.

Does the law affect dependent care spending accounts and health flexible spending accounts? Dependent care spending accounts are capped at $5,000 annually. Prior to 2013, health flexible spending accounts (health FSAs) had no cap (although many employers had their own caps, typically at the $5,000-$6,000 level or less). The health care reform law does not change the limit on dependent care accounts, which remains capped at $5,000. However, the law does establish an annual cap of $2,500 on employee pre-tax contributions to health FSAs. This change is effective for plan years beginning on or after Jan. 1, 2013.

Did the health care reform law eliminate COBRA? No. The health care reform law did not eliminate COBRA or change the COBRA rules.

If you are enrolled in the PPO plan and have questions about these topics, please contact