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Health Care Reform County Compliance

The table below contains a listing of the PPACA provisions and applicable County’s compliance efforts. The Patient Protection and Affordable Care Act (PPACA) also known as Health Care Reform was signed into law on March 23, 2010, and included numerous provisions that impacted County health benefits. We encourage you to visit this page frequently to obtain the most current information on the County’s Compliance with Health Care Reform.

Plan Year Implemented Provision Provision Description County Compliance Required Implementation Date
2014 Employer Pay or Play Penalty Effective 2015, employers with 50 or more full-time employees may incur “pay or play” penalties if they offer no coverage or coverage that is unaffordable or fails to provide minimum value AND one or more full-time employees receive subsidized coverage through an exchange. Provision will be implemented and communication regarding compliance will be forthcoming. Coming Soon
Waiting Periods Limited to 90 Days Waiting periods longer than 90 days prohibited. No action required on County’s part as the County’s current plan benefits do not have waiting periods. N/A
2013 Notices of Exchanges and Subsidies Employers are to provide notices regarding insurance exchanges and subsidies by October 1, 2013. Communication forthcoming. September 2013
Summary of Benefits and Coverage (SBC) Requires all group health plans and insurers of fully insured plans for distributing SBCs to participants and beneficiaries. County notified active employees’ via-postmaster e-mail and first class mail. Electronic SBC’s hosted on EBSD internet and intranet sites and available in hard copy upon request. COBRA participants notified of SBC via Open Enrollment Notification Letter. May 20, 2013
2012 Women’s Preventive Care Services Women’s preventive care including contraceptives must be provided with no cost sharing. County included women’s preventive care services with no copayments and plan prescription formularies were updated accordingly. July 28, 2012
$2,500 Limit on Health FSA Salary Reductions Cafeteria plans must limit each employee’s annual salary reduction contributions to a health FSA to no more than $2,500. County limited FSA salary reductions contributions to $2,500 maximum beginning in the 2012-13 FSA plan year. July 28, 2012
2010 and 2011 Coverage for Adult Children Plans are required to extend the coverage of dependents to age 26. County extended dependent coverage to age 26 effective July 31, 2010. July 30, 2011
Prohibition of Annual or Lifetime Dollar Limits Restricted annual and lifetime limits on essential health benefits. Limits were revised or eliminated altogether. 2011
Prohibition of Preexisting Condition Exclusions Group health plans cannot exclude enrollees under age 19 based on pre-existing conditions. No action required on County’s part as existing County sponsored health plans do not contain a preexisting conditions clause. N/A

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Employee Benefits & Services Division
157 West Fifth Street, First Floor | San Bernardino CA 92415-0440
Phone: (909) 387-5787 • Toll Free: (888) 743-1474 • Fax: (909) 387-5566

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