Keeping You Informed

We’ve developed this quick reference chart to help in your understanding of when various provisions of Health Reform take effect. As you can see, provisions affecting your Group Health Plan (GHP) must be included with your first contract renewal after 9/23/2010. Mandated changes for employers and health insurance carriers concerning coverage requirements and tax implications are slated for 2014.

Locally, Anthem has agreed to immediately begin allowing currently covered dependent children to continue coverage to age 26. Optima Health is studying the regulation and has indicated it will make a decision soon on how it will implement this extension of coverage. In any event, it will become effective on your first renewal following 9/23/2010.

We will continue to keep you updated as guidelines are issued by federal regulators. Please feel free to share this chart with your business associates and friends. Please call or email us with ANY questions.

Insurer and GHP Reform Insurer and GHP Reform Tax Provisions
Effective on or after 9/23/2010

  • Children covered until age 26
  • Lifetime limit restrictions
  • Annual limit restrictions
  • No pre-ex exclusion if under 19
  • Rescission prohibition
  • Standardized Benefit Summaries
  • Coverage of preventive care
  • 105(h) applicable to insured GHPEnhanced appeals process
  • Choice of PCP
  • OB/GYN services
  • Emergency services
  • High-risk pools
  • Reinsurance for pre-65 retirees
Effective 1/1/2014

  • Increase to Wellness limits (30%)
  • Cost sharing limits
  • Prohibition on all pre-ex
  • Prohibition on annual limits
  • 90 day limit on waiting periods

Employer Reform

Effective 1/1/2014

  • Employer Mandate
  • Auto-enroll if >200 employees
  • Notification of Exchange
  • Free choice vouchers
  • Annual certification to IRS

Individual Reform

Effective 1/1/2014

  • Individual Mandate

  • 011-no OTC reimbursement from FSA
  • 2011-20% ineligible HSA claim
  • 2013-3.8% investment tax
  • 2013-0.9% FICA tax increase
  • 2013-$2,500 limit on HFSA
  • 2014-7.5% threshold to 10%
  • 2018-40% "Cadillac" tax

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Advanced Benefit Strategies of Virginia, LLC


Office Location

One Columbus Center # 600
Virginia Beach, VA 23462

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