Supreme Court Ruling & Health Care Reform Update for 2012

Attached please find the update for Health Care Reform in 2012 that includes the following topics:

• Supreme Court Ruling;
• Politics & Ongoing Issues;
• ACA Already in Effect;
• ACA Next Steps;
• 2012 - Medical Loss Ratio Rebate, Women's Preventive Services, and Summary of Benefits and Coverage (SBC) Forms.
• 2013 – FSA Contribution Limit, Additional Medicare Tax, Medical Expenses Itemized Deduction, Exchange Notices, and Comparative Effectiveness Research Plan Fees.

 

Medical Loss Ratio Rebates

The Affordable Care Act requires health insurers in the individual and small group markets (2 to 50 employees) to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group market (51+ employees), this amount is 85 percent). This is referred to as the Medical Loss Ratio (MLR) rule or the 80/20 rule. If a health insurer does not spend at least 80 percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.