Employers should confirm with their insurers and TPAs that their group health plan provides coverage consistent with health care reform.
If an employer group health plan does not provide the coverage options required by the Affordable Care Act, the employer could be subject to an excise tax. The amount of the tax is $100 per day, for each individual for whom the failure relates. This tax penalty could be up to $36,500 per year for each plan participant. The tax penalty can apply regardless of the size of the employer.
To avoid the penalty, employer plans must be sure they
· don’t impose preexisting condition limitations;
· have a maximum waiting period of 90 days;
· comply with cost sharing limitations;
· do not impose annual or lifetime limits on essential health benefits;
· cover preventive services without cost sharing;
· offer coverage to dependents up to age 26;
· distribute a Summary of Benefits and Coverage.
Employers should review their benefit offerings to make sure they comply with health care reform.
Employers should confirm with their insurers and TPAs that their group health plan provides coverage consistent with health care reform.
