With delays galore, it's easy to get confused about which provisions of the Patient Protection and Affordable Care Act actually went into effect this year and which were put off. Here's a quick and handy run-down:
1. Establishment of State Health Insurance Exchanges. Starting on January 1, 2014, each state was required to create a health insurance exchange (or HHS will do so) for use by the uninsured and small employers with 100 or fewer employees (although states may set the cap at 50 employees). The exchanges are required to offer fully insured insurance contracts that provide essential health benefits and are also required to offer three different levels of coverage (bronze, silver, gold, and platinum). Employees of small employers who offer health insurance coverage through an exchange may pay their employee premiums for such coverage on a pre-tax basis through the employer's cafeteria plan.
2. Pre-Existing Condition Exclusion Practices Eliminated. Effective January 1, 2014, pre-existing condition exclusions no longer are allowed in group health plans or individual insurance policies, not even the limited exclusions previously allowed under HIPAA. This also applies to grandfathered plans.
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