How to help your employees understand health care reform

Who is this for?

Learn how to help your employees understand health care reform.

If you’re an employer or Human Resources representative, this information will help you explain health care reform to your employees.

The federal health care reform law has already changed a lot about health care. There’s more change on the way. It can be hard to keep it all straight, let alone to explain it all to your employees.

Our employer guide to health care reform (PDF) is a great resource. It explains what’s changing and when.

You might also find our health care reform timeline helpful.

Select a topic below to learn more:

What health care reform has done so far
2014: the next milestone
What your employees need to know
Where to go for more information

What health care reform has done so far

You can tell your employees that the health care reform law has:

  • Made it easier to get insurance. High-risk pools help people with pre-existing conditions get health insurance. Insurance companies can’t deny coverage to children under age 19 because of pre-existing conditions.
  • Kept people covered. Young adults can stay on their parents’ plans until age 26. Insurance companies can’t drop your coverage over a claim. They also can’t put a lifetime limit on how much money they’ll spend on your essential benefits. 
  • Increased access to preventive services. People can get free mammograms, colonoscopies, immunizations and other services that find or prevent health problems before they become serious—and more costly. 
  • Put the focus on health. Insurance companies have to spend 85 cents out of every dollar you pay them on things directly related to your health care. If they don’t, you’ll get a refund. 
  • Helped out employers. Small businesses that pay at least 50 percent of their employees’ premiums can receive tax credits. The Early Retiree Reinsurance program reimburses employers for high-cost claims from retirees who are under age 65.

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2014: the next milestone

On Jan. 1, 2014, getting health care will be easier than ever. Here’s what you can tell your employees to expect:

  • Insurance companies will accept everyone who applies for coverage, regardless of health status.
  • Medicaid will expand to help more low-income individuals get health care. 
  • Mandates will encourage employers to provide more affordable health care plans.
  • The law will require most individuals to have at least minimal health care coverage. If they don’t, they’ll have to pay a penalty.
  • If employees choose not to enroll in the plan you offer, they’ll need to shop for a plan themselves in the exchange, an online marketplace for comparing and buying health insurance plans.

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What your employees need to know

Here’s some more information your employees might be interested in:

  • If they want to pay for over-the-counter drugs with money from a health savings account, health reimbursement account or flexible savings account, they’ll need a prescription from their doctor.
  • If they use money from their health savings account for anything other than medical expenses, they’ll have to pay a 20 percent tax on the money they spend.
  • Starting Jan. 1, 2013, they can only put $2,500 a year in their flexible spending accounts.
  • In 2013, the Medicare payroll tax rate for employees that make more than $200,000 a year will increase from 1.4 percent to 2.35 percent.
  • Starting in 2014, if you offer a wellness program for your employees, they can get up to a 30 percent discount for reaching their health goals.

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Where to go for more information

For more details about these changes, visit our Reform Alerts page.

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