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Health care law revamps benefits funding


How the Patient Protection and Affordable Care Act affects the funding of health care benefits:


• Creation of a $5 billion federal fund to partially reimburse employers and other early retiree health care plan sponsors for claims incurred by retirees and their dependents.


• Elimination of health care plans' lifetime dollar limits.

• Extension of group health care plan coverage to employees' adult children up to age 26.

• Non-prescription drug costs no longer reimbursable through flexible spending accounts.


• Maximum contribution to health care flexible spending accounts capped at $2,500 per enrollee. Future increases linked to annual rise in the consumer price index.

• Employer tax deduction for prescription drug coverage provided to Medicare-eligible retirees ended for amounts equal to federal subsidy to employers whose drug plans are at least equal to Medicare Part D.


• Imposes an annual $2,000 penalty on employers with 50+ employees for each full-timer not offered coverage.

• $3,000 penalty on employers with 50+ employees for each full-time employee whose premium contribution exceeds 9.5% of income and receives subsidized coverage through state insurance exchanges.

• Maximum waiting period before new full-time employees can receive coverage limited to 90 days.

• Annual dollar limits on health care expenses eliminated.

• Federal premium subsidies provided to full-time employees with adjusted gross incomes of up to 400% of the federal level who are not eligible for affordable employer-provided health care coverage.


• Forty percent excise tax imposed on health insurance premiums exceeding $10,200 for single coverage and $27,500 for family coverage. Cost thresholds slightly higher for plans covering retirees or employees in certain high-risk industries. In 2019, thresholds rise to match the increase in the consumer price index, plus one percentage point. In 2020 and succeeding years, thresholds match percentage rises in the index.