Health Plan Changes in 2012 Under the Obamacare

A lot of things are taking place in the Massachusetts healthcare over the next couple of years. Okay, here are just some of the things that would take place in the year 2012 - that is, if the world does not come to an end. If you are fully insured, a lot of this will take place automatically: translation, you will be the one paying for the compliance, while your carrier will do the work for you. From January 1st 2013, you will be the one who will be responsible for reporting the cost of your health plan. But, if you are self funded, you may be required to do some of this by yourself. The chief provisions that require attention in 2012 actually relate to the following:

Summary of Benefits & Coverage (SBC)

Sponsors of self insured health plans and insurers will be required to provide a Summary of Benefits & Coverage to all applicants and participants, this will be based on a format that was set by Health and Human Services (HHS), utilizing standardized definitions.

Advance Notice of Mid-Year Modifications

Insurance and health plans will be required to offer 60 day advance notice of modifications that will affect SBC's content.

Quality of Care Report

Insurers and health plan providers will have to submit reports to HHS annually - this way, the quality of care will be measured. By March 23rd, 2012, regulations will be required.

Comparative effectiveness Research Charges

Insurers are expected to donate 1 dollar multiplied by the figure of lives that were covered under every health plan (this include self insured health insurance plans) for policy years or plan years which ends after September 30th, 2012. In 2013, this amount will rise to 2 dollars per participant and is indexed afterward. By 2019, the fee will be phased out.

Administrative Simplification

Starting from 2012 and extending all through the year 2016, the Health and Human Services will adopt uniform standards and operating laws for the e-transactions that take place between health plans and providers that are presided over by the 1996 Act of Health Insurance and Portability and Accountability. Plans will need to confirm compliance or simply face financial consequences.

W-2 Reporting

Employers will need to include the comprehensive cost of employer-sponsored health plan, starting with the 2012 Form W-2. This may sound like a lot to take in, but you will definitely get the hang of it when the time comes.