2011

• All employers must include on W2s the aggregate cost of employer‐sponsored health benefits, for informational purposes. If an employee receives health insurance coverage under multiple plans, the employer must disclose the aggregate value of all such health coverage, but exclude all contributions to HSAs and Archer MSAs and salary‐reduction contributions to FSAs. Applies to benefits provided during taxable years after December 31, 2010.

• The tax on distributions from a Health Savings Account that are not used for qualified medical expenses increases from 10% to 20%.

• OTC drugs will no longer be reimbursable under HSAs, medical FSAS, HRAs and Archer MSAs unless they are prescribed by a doctor.

• Small employers (less than 100 lives) will be allowed to adopt new “simple cafeteria plans.”

• All employers would be required to enroll employees in a new national public long‐term care program, unless the employee opted out.

• All business owners will be subject to new expanded federal income tax requirements on payments of fixed or determinable income or compensation.

• The Department of Labor will begin annual studies on self‐insured plans using data collected from Form 5500.

 2012

• All group plans and group and individual health insurers (including self‐insured plans) will have to provide a summary of benefits and a coverage explanation that meets specified criteria to all enrollees when they apply for coverage, when they enroll or reenroll in coverage, when the policy is delivered and id any material modification is made to the terms of their coverage. The summary and explanation will require substantially more information than current summary plan descriptions and can be provided electronically or in written form. It must be no more than four pages in length with print no smaller than 12‐point font written in a culturally linguistically appropriate manner. There is a $1,000‐per‐enrollee fine for willful failure to provide the information.

• All group plans (including self‐insured plans) and all individual and group carriers will have to annually submit reports to the HHS secretary on whether or not the benefits provided under their plans meet criteria to be established by HHS on improving health outcomes, preventing hospital readmissions, improving patient safety and reducing medical errors, including wellness and health promotion activities. This report also must be provided to all plan participants during the annual open enrollment period and HHS will make the reports publicly available through the Internet. The secretary of HHS can also create and impose fines for noncompliance by employers and plans.

2013

• New federal premium tax on fully insured and self‐insured group health plans to fund comparative effectiveness research program begins. It imposes an annual fee on private insurance plans equal to two dollars for each individual covered.

• FSA contributions for medical expenses will be limited to $2500 per year, with the cap annually indexed for inflation.

• The Medicare payroll tax increase of 0.9% on self‐employed individuals and employees with respect to earnings and wages received during the year above $200,000 for individuals and above $250,000 for joint filers will go into effect. The income eligibility levels for the tax are not indexed for inflation. The new tax does not change the employer’s tax obligations, but self‐employed individuals are not permitted to deduct any portion of the additional tax. In addition, there will be a new 3.8% Medicare contribution on certain unearned income from individuals with AGI over $200,000 ($250,000 for joint filers).

• For those who itemize their federal income taxes, the threshold for deducting unreimbursed medical expenses will increase from 7.5% of AGI to 10% of AGI. The increase would be waived for those ages 65 and older through 2016.

• All employers must provide notice to their employees informing them of the existence of the state‐based exchanges.