Changes & Opportunities in 2014 for Small Employers under ACA


The Affordable Care Act (ACA) brings about significant healthcare reform changes, as well as opportunities for small employers in 2014. Many of the reforms affect all employers who sponsor group health plans; however, the effect of some of the reforms is limited for smaller employers. Also, small employers will benefit from changes affecting tax credits and new coverage provided through the Small Business Health Options Program.

2014 Reforms -

For plan years beginning on or after Jan. 1, 2014, certain existing reforms will be enhanced, and new reforms will apply to most plans. Annual limits will be prohibited on essential health benefits; previously, restricted limits were al- lowed. Waiting periods may not exceed 90 days. Plans may also not discriminate against a health-care provider acting within the scope of his or her license; however, this provision does not require plans or insurers to contract with “any willing provider” or prohibit varying reimbursement rates. Preexisting condition exclusions will no longer be permitted; this is true regardless of the age of the participant. Non-grandfathered plans will be required to cover costs associated with certain approved clinical trials.

Originally Published in Nashville Medical News in April, 2014.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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