California Restaurant Association

• Change in tax treatment for over-age dependent coverage
• Accounting impact of change in Medicare retiree drug subsidy tax treatment
• Early retiree medical reinsurance
• Medicare prescription drug “donut hole” beneficiary rebate
• Break time/private room for nursing moms

• Extension of coverage for children to 26 (grandfathered plans may limit to children without access to other employer coverage, other than parent’s coverage)*
• No lifetime dollar limits*
• Restricted annual dollar limits, phased amounts until 2014*
• No pre-existing condition limitations for enrollees up to age 19*
• No rescissions*
• No health FSA/HRA/HSA reimbursement for non-prescribed drugs
• Increased penalties for non-qualified HSA distributions
• Additional standards for new or “non-grandfathered” health plans, including mandatory preventive care in network with no cost-sharing (nondiscrimination provisions for insured plans have been delayed)
• Voluntary long-term care “CLASS” program slated to start (implementation TBD)
• Pharmaceutical manufacturers’ fees start
• Medicare, Medicare Advantage benefit and payment reform
• Insurers subject to medical loss ratio rules

_{* Applies to all plans, including “grandfathered” plans, effective for plan years beginning on or after   Sept. 23, 2010 (Jan. 1, 2011, for calendar year plans).
** Applies to all plans, including grandfathered plans, effective for plan years beginning on or after Jan. 1, 2014.}

• Employers must distribute uniform benefit summaries to participants
• Employers must provide 60-day advance notice of material modifications
• Group health plan fees begin

• $2,500 health FSA contribution cap (indexed)
• Form W-2 reporting for 2012 health coverage
• Medical device manufacturers’ fees start
• Higher Medicare payroll tax on wages exceeding $200,000/ individual; $250,000/couples
• New tax on net investment income for taxpayers with incomes exceeding $200,000/ individual; $250,000/couples
• Change in Medicare retiree drug subsidy tax treatment takes effect

• Health insurance exchanges
• Individual coverage mandate
• Financial assistance for exchange coverage of low-income individuals
• Medicaid expansion
• HIPAA wellness limit increases
• Shared responsibility penalties
• Free-choice vouchers
• Additional reporting and disclosure
• Auto enrollment of full-time employees (effective TBD)
• Extension of coverage for children to age 26, regardless of other coverage**
• No annual dollar limits**
• No pre-existing condition limits**
• No waiting period over 90 days**
• Additional new standards for new or “non-grandfathered” health plans, including limited cost-sharing
• Health insurance industry fees begin

_{** Applies to all plans, including grandfathered plans, effective for plan years beginning on or after Jan. 1, 2014.}

• Excise tax on “high cost” or Cadillac plans