Although the following are variable (due to the DOL failing to write many of the required regulations as of yet) the key features of PPACA to take effect in 2014 are:
1. All U.S. citizens will be mandated to purchase a minimum level of health insurance or they will receive a tax penalty (the “individual mandate”). For an individual, the tax starts at $95 a year or up to1% of income, whichever is greater. For families, the tax is capped at $285 in 2014.
2. Coverage cannot be denied by insurers due to pre-existing conditions; also the charge cannot be changed based on gender or health condition.
3. Essential Health Benefits cannot have an annual dollar limit applied to them. Also all health insurance plans must have Essential Health Benefit coverage.
4. A waiting period of more than 90 days cannot be imposed on Group health plans.
5. Insurers will be barred from dropping or reducing coverage due to an individual’s voluntary participation in a clinical trial.
6. Americans who earn less than 133% of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid.
7. Small business owners will be able to shop for health insurance using online federal and state health insurance exchanges (or “marketplaces”). These are expected to be in effect by October 2013 with coverage going into effect January 1, 2014. States must choose whether to build their own exchange or partner with the federal government. NOTE: The DOL has delayed the release of model language for the Notice of Exchanges, which will inform employees about their choices with the new exchanges.

199 Jericho TPKE, Suite 201 Floral Park, NY 11001 1(844) 579-8545