Health Care Reform

About Health Care Reform


On March 23, 2010, the Patient Protection and Affordable Care Act (aka as PPACA or ACA) was approved by Congress, and President Obama signed it into law 6 months later, on September 23, 2010.

Requirements


The following are some of the requirements that Maricopa County either already had in place prior to PPACA or changes that resulted due to the implementation of PPACA.
  • Limit reimbursements from an Flexible Savings Account, Health Reimbursement Account, or Health Savings Account to prescribed drugs or insulin (no over-the-counter drugs except with prescription).
  • Provide adequate break times and private lactation rooms/area for nursing mothers.
  • Cover dependent children up to age 26.
  • Lift lifetime limits on essential health benefits.
  • Remove restricted annual dollar limits.
  • Remove pre-existing condition exclusion for children up to age 19.
  • Eliminate rescissions on coverage for a member due to medical condition.
  • Offer preventive care and medical screenings at zero cost share.
  • Establish and provide notice of appeals process for denials of coverage and claims.
  • Provide 60-day advanced notice to employees on Material Modifications to plans or coverage.
  • Cap the limit on contributions to a Health Care Flexible Spending Account to $2,500.
  • Report the value of benefits on W2 forms (for calendar year 2012).
  • Increase the Medicare tax for employees whose wages exceed $200,000 (individual) and $250,000 (couples).
  • Make available Uniform Summary of Benefits and Coverage to employees.
  • Offer certain women's preventive services and medications at zero cost share.
  • Notify employees about the public health insurance exchanges (aka Marketplaces) - Scheduled for October 1, 2013.

Resources


Contact Information


Contact the new Health Insurance Marketplace by calling 800-318-2596 or visiting the Federal Healthcare website.

IRS Form 1095-C


The Patient Protection and Affordable Care Act of 2010 (PPACA or ACA) requires certain employers to offer health insurance coverage to full-time employees and their dependents. The IRS form used to confirm an offer of coverage and enrollment in healthcare benefits is Form 1095-C.

During the first week in February 2016, all benefits-eligible employees were sent a Form 1095-C indicating that they were offered health insurance coverage through Maricopa County for calendar year 2015. The form confirmed enrollment in coverage, along with the months of coverage. Any dependent covered under an employee's healthcare insurance benefits through the County was listed on the form.

While the information provided on Form 1095-C may assist employees in preparing their 2015 tax return, the form was not required for the 2015 tax year. As was the case for the 2014 tax year, when preparing their individual tax return, taxpayers may use other information about their health insurance in order to confirm that they had minimum essential coverage for 2015. For purposes of maintaining proper documentation, employees should retain a copy of Form 1095-C for their records.