Benefits Consulting Group of Florida, Inc. – Orlando, FL

Internal Revenue Service Notice 2011-28 provides interim guidance regarding the requirement to report to employees, on their annual Form W-2, the cost of their employer-sponsored group health plan coverage. This reporting requirement is required under Section 6051 (a)(14) of the Internal Revenue Code, which was added to the Code by the Patient Protection and Affordable Care Act of 2010.

This Compliance Update is limited to coverage of the guidance as it applies to health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs). However, the Notice also provides guidance on many other topics, such as which types of coverage must be included in the reported amounts, how to calculate cost of this coverage, and the method for reporting cost of coverage.

This reporting requirement was establshd to provide useful information to consumers regarding the cost of their health care coverage. This requirement does not cause otherwise excludable employer-provided health care coverage to become taxable.

The reporting requirement generally applies beginning with 2012 Forms W-2 (i.e., forms for calendar year 2012 that are provided to employees in January 2013). However, certain employers, including small employers that are required to file fewer than 250 Forms W-2 for calendar year 2011, are elgible for transition relief that delays the effective date of these requirements.

The Internal Revenue Service has announced the 2012 contribution limits for health savings accounts (HSAs) and cost-sharing amount for HSA-eligible, high-deductible health plans.
They are as follows:

Annual HSA contribution limits will be $3,100 for individual and $6,250 for family coverage. These limits have increased slighly from 2011 ($3,050 for individual and $6,150 for family).

Maximum out-of-pocket expenses (deductibles, co-payments and co-insurance) for HSA-eligible health plans will be $6,050 for individual and $12,100 for family coverage. These have also slightly increased from last year.

In order to make participants eligible for HSAs, a health plan must have deductibles of at least $1,200 for individual and $2,400 for family coverage.

Beginning September 1, members with Blue Cross Blue Shield of Florida (BCBSFL) pharmacy coverage can obtain a flu shot at no cost to the member from any in-network pharmacy which administers the Flu vaccine. Locate a participating pharmacy by going to www.bcbsfl.com, log on to MyBlueService, then from the Drugs & Pharmacy tab, click on Pharmacy Information and Resources. Listed under Find a Particpating Pharmacy, click on National Flu Vaccine Network.

The AP (9/2) reports that under the Affordable Care Act, “whenever an insurer seeks a rate hike of 10 percent or more for individual and small-employer group coverage, it now must submit the plan for either a state or federal review of whether it’s reasonable.” While the review does not include the power to prevent the hike, “any increases will be posted along with an explanation for them on the website www.healthcare.gov.” Health and Human Services Secretary Kathleen Sebelius “said in a statement Thursday that the new reviews ‘will shed a bright light on the industry’s behavior and drive market competition to lower costs.'”

The new health reform law gives a tax credit to certain small employers that provide health care coverage to their employees, effective with tax years beginning in 2010. The following questions and answers issued by the IRS provide information on the credit as it applies for 2010-2013, including information on transition relief for 2010. An enhanced version of the credit will be effective beginning in 2014. The new law, the Patient Protection and Affordable Care Act, was passed by Congress and was signed by President Obama on March 23, 2010. Read the full document here: Small Business Tax Credit (PDF)

The Healthcare business of Thomson Reuters conducted and funded a study which assessed the use and cost of health care services for 23.5 million Americans in 382 metropolitan statistical areas (MSA) in 2009.

The study involved geographic variations to help identify locations where health care costs are less, yet the quality of care and outcomes are not compromised.  Understanding where, why and how medical care costs less can provide solutions to control our nation’s health care spending.

The 5 highest-spending regions in the U.S. for people with employer-sponsored health insurance and their annual health care cost per person are:

1. Anderson, IN – $7,231
2. Punta Gorda, FL – $7,168
3. Racine, WI – $6,528
4. Naples/Marco Island, FL – $6,312
5. Ocean City, NJ – $6,128

Our summer flyer, “What’s All the Noise About”, was sent out last week, which we hope you enjoy.  Also, in our commitment to keep you aware of the ever changing health care industry, we have included a 2011 Florida Healthcare Legislative Summary.  Just phone (407)896-9600, fax (407)896-0444 or email bcg@bcgfl.com if you have any questions.  Have a happy, healthy and safe summer!!

  HHS To Stop Granting Healthcare Law Waivers.

The New York Times (6/18, A12, Pear, Subscription Publication) reported that HHS is “shutting down a program that had provided exemptions from the new healthcare law for many employers and labor unions offering bare-bones insurance coverage to workers.”

        The AP (6/18, Alonso-Zaldivar) reported that the Obama Administration Friday announced an “early end” to the healthcare waiver program. “Political considerations were ‘absolutely not’ part of the decision, said Steve Larsen, head of a section of the Health and Human Services department that oversees” Obama’s healthcare reform law. Larsen said that no “new applications for waivers will be considered after Sept. 22” but approvals or renewals “received by the deadline will be good through 2013.” Starting in 2014, the primary coverage provisions of the healthcare law “will take effect, and such waivers will no longer be needed.”

        The Hill (6/17, Pecquet, Baker) “Healthwatch” blog reported that CMS “has been updating the waiver totals every month — and every month, critics of the healthcare law have seized the fresh opportunity to argue that the healthcare law is unworkable. That cycle of bad press could have repeated itself every month for the next three years without the changes announced Friday.”

        The Wall Street Journal (6/18, Adamy, Subscription Publication) reported that 1,433 waivers had been granted as of the end of May. The Daily Caller (6/18, Boyle) says it appears “to be a last-minute move to avoid scrutiny.” Politico (6/17, Dobias) also covered the story

We’ve been advised that effective June 1, Aetna has terminated its contract with HCA, which includes Osceola Regional Medical Center and Central Florida Regional Hospital.  For anyone that is undergoing treatment at either of these facilities there is a continuation clause that is in affect.  This represents only about 1% of Aetna’s hospital admissions and most of the providers from these facilities also participate at other hospitals within the network.  Aetna is actively working towards a resolution, but it may take a number of months.

The IRS has issued the health savings account (HSA) and high deductible health plan (HDHP) limits for calendar year 2012.

Annual limit of $3,100 on deductions for an individual with self-only coverage under an HDHP.

Annual limit of $6,250 on deductions for an individual with family coverage under an HDHP.

For calendar year 2012, a “high deductible health plan” is defined under Section 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,200  for self-only coverage or $2,400 for family coverage (no change from calendar year 2011) and the annual out-of-pocket expenses (deductions, co-payments and other amounts, but not premiums) do not exceed $6,050 for self only coverage or $12,100 for family coverage.