Health Care Reform Resources
The Paychex Insurance Agency gives you the knowledge and resources to take action on health care reform.
To speak with a licensed insurance representative about the right plans for your business, your employees, and yourself, call 877-393-8868, or have an agent call you. If you're a Paychex Insurance Agency client, please contact your Agency account coordinator.
Provision Timeline
Already in Effect | September 23, 2010 | January 1, 2011 | January 1, 2013 and Beyond
Provisions Already in Effect
Possible health care reform tax credits are available today for businesses with fewer than 25 employees and average annual wages of less than $50,000 that also offer health insurance.
Depending on your health plan, the "grandfather" provision may delay when certain health care reform rules take effect, or even exempt your plan from those rules.
New employer group health plans that are not "grandfathered" will no longer be able to drop individuals from coverage if they get sick, deny coverage to children under age 19 with pre-existing conditions, impose lifetime limits on essential health benefits, or discriminate in favor of highly compensated employees (HCEs).
Participants can submit FSA claims for expenses incurred by their adult dependents who will not reach age 27 by the end of the calendar year. Additionally, eligible expenses for these dependents incurred on or after March 30, 2010 are eligible for reimbursement.
Note: This guidance only applies to individuals who have not reached age 27 at any time during the calendar year, regardless of tax dependent status.
The Paychex Insurance Agency helps clients:
- Select an insurance plan if you don't currently offer health coverage.
- Obtain information needed to apply for the small business tax credit.
- Report premium amounts paid (for Paychex Insurance Agency's Insurance Payment Service [IPS] clients).
- Learn about new requirements during health plan renewal.
- Explain the changes to employees through educational resources.
- Learn more about plan non-discrimination and other health care reform provisions.
- Understand what could cause a health plan to lose its grandfathered status.
- Understand how to determine highly compensated employees (HCEs) and the value of the coverage to be taxed.
- Understand how to determine if a non-grandfathered plan violates the on-discrimination rules.
- Understand how a Simple Cafeteria Plan can be used to avoid the non-discrimination testing requirements.
- Stay up to date as laws are clarified, regulations are developed, and guidance becomes available.
Effective September 23, 2010
In order to cover the 30 percent of adults under the age of 26 who have no health insurance, employers must continue health insurance coverage until the dependents turn 26.
The Paychex Insurance Agency helps clients:
- Determine if their carrier(s) will allow dependents to remain on the policy until the plan renewal date.
- Enroll dependents not already on an employee's policy.
- Adjust deductions if there is a change in premium.
- Stay up to date as laws are clarified, regulations are developed, and guidance becomes available.
Effective January 1, 2011
Employers will be required to report the total value of all health coverage, excluding medical Flexible Spending Accounts (FSAs), on employees' W-2 forms.
The Community Living Assistance Services and Supports (CLASS) Act is intended to offset the cost of long-term care for the elderly and disabled. Funded by premiums, it will pay $50.00 or more per day to enrolled individuals to be used toward nursing home care, or to encourage individuals to stay in their own home.
Over-the-counter medicines or drugs (other than insulin) will no longer be eligible for reimbursement under a Health Reimbursement Account (HRA), Health Savings Account (HSA), or medical Flexible Spending Account (FSA) unless prescribed by a medical practitioner.
Penalties for HSAs that are used for purposes other than to pay Any otherwise un-reimbursed expenses are qualified as defined under section 213(d) of the Internal Revenue Code. Exceptions apply. will increase from 10 percent to 20 percent for distributions made after December 31, 2010.
The Paychex Insurance Agency helps clients:
- Determine the value of all health coverage provided by the Paychex Insurance Agency for their W-2s.
- Learn more about the CLASS Act and how to become a participating employer.
- Notify participating employees of the over-the-counter reimbursement changes well in advance of the effective date (for clients with FSA plans administered through Paychex, Inc.)
- Stay up to date as laws are clarified, regulations are developed, and guidance becomes available.
Effective January 1, 2013 and Beyond
Contributions will be limited to the lesser of the company maximum or a $2,500 cap per taxable year. This maximum will be adjusted annually for inflation beginning in 2014.
The Paychex Insurance Agency helps clients:
- Provide employees with resources to explain the maximum contribution limit.
- Stay up to date as laws are clarified, regulations are developed, and guidance becomes available.
Health Care Reform Updates
An essential partner to over 550,000 businesses nationwide, Paychex closely monitors legislation that affects our clients. With access to legislative and regulatory specialists in Washington, D.C. and utilizing expert, in-house sources of legal and compliance guidance, Paychex Insurance Agency will continue to provide the latest information on health care reform.
Paychex Insurance Agency is ready with the coverage you need, when you need it. To speak with a licensed insurance representative about the right plans for your business, your employees, and yourself, call 877-393-8868 or have an agent call you.
Any information provided by this website may no longer be viable subsequent to its issuance. Any information it provides is developed at the time of its issuance based upon facts and circumstances known at that time.
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