PPACA Tax Overview BenefitMall Reference Guide - (Page 13)

5.4 How will the Medicaid expansion post the U.S. Supreme Court ruling impact employers? Employers may experience different cost obligations depending on how each state adopts PPACA’s new requirements for covering the underinsured or uninsured individuals. Milliman provides some insights to this question when it wrote: The change to Medicaid expansion could also complicate matters for employers. Under PPACA, employers with over 50 employees may be subject to additional plan affordability penalties for employees under 133% FPL—unless these individuals are Medicaid eligible. If a state does not expand Medicaid, employers above 50 lives may be subject to more plan affordability penalties than they would be were their state to pursue Medicaid expansion. In this sense, a state’s decision to expand Medicaid may have cost implications for employers. More specifics will become available as each state decides how to move forward with PPACA’s Medicaid provisions. PART B: Emphasis on Prevention & Related Services 5.5 Will preventive services be offered to Medicaid and Medicare enrollees? One of the more popular provisions of PPACA concerns the preventive care services benefit. This provision provides coverage for preventive services and applies to those covered by private health benefit plans as well as government health insurance programs. Both Medicaid and Medicare programs must now provide beneficiaries with preventive services with no cost sharing, deductibles or copays. Services such as an annual wellness visit, screenings for various illnesses, and flu shots are covered under the benefit. 5.6 What are some of the additional benefits that Medicare will be offering? Here are some examples of prevention and wellness benefits that will be offered to Medicare enrollees: • Initial preventive physical examination • Annual wellness visit • Cancer screenings • Cardiovascular disease screening • Diabetes screening and self-management training • Glaucoma screening • Human immunodeficiency virus (HIV) screening • Immunizations • Medical nutrition therapy (for beneficiaries with diabetes or renal disease) • Tobacco-use cessation counseling • Screening for depression in adults • Intensive behavioral therapy for obesity 5.7 What are some of the additional benefits that Medicaid will offer? Medicaid also now provides the following services: • Benchmark Benefit Plans, including mental health services and prescription drugs • Family Planning – States have the option to begin providing medical assistance for family planning services and supplies • Hospice Care for Children – Children enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) are now assured hospice care • Preventive and Obesity-Related Services – States can choose to cover specified obesity-related services at no cost to adult Medicaid enrollees • Tobacco Cessation, including counseling and pharmacotherapy Other services will be offered as well. Some customization will be likely at the state level since Medicaid is a state/federal program. 5.8 How will employers be impacted by the general expansion of preventive health care services? Generally speaking, premium increases will be experienced both in the private and public sectors as these new services are covered with little or no costsharing requirements. Some actuaries say this will reduce the overall costs to the health care system. Others disagree. In the short term, employers will pay more into the health care system through premium increases and/or through increased taxes/penalties. 13

Table of Contents for the Digital Edition of PPACA Tax Overview BenefitMall Reference Guide

PPACA Tax Overview BenefitMall Reference Guide
Table of Contents
Individual Mandate & Tax Implications
Premium Subsidies
Employer Requirements & Tax Implications
PART A: Small Employer Tax Credits
PART B: Large Employer Tax Penalties
PART C: Employer W-2 Reporting Requirements
PART D: Employer Deductions for Retiree Drug Coverage
Additional PPACA Tax Provisions Impacting Employers & Employees
PART A: The Unearned Income Medicare Contribution Tax
PART B: Excise Tax on Comprehensive, High-Cost Health Insurance Plans
PART C: Assessing the Impact of PPACA on HSAs, MSAs, FSAs, & HRAs
Medicaid & Medicare Changes & the Impact on Employers
PART A: The Expanding Medicaid Program
PART B: Emphasis on Prevention & Related Services
PART C: Medicare Part D Updates
PART D: Putting the Coverage Puzzle Together

PPACA Tax Overview BenefitMall Reference Guide

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