Healthcare Reform Information

The recently enacted health care reform act—consisting of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010—is a vast undertaking, with far reaching consequences.

At its core, the legislation imposes a diverse range of requirements on individuals, employers, health insurance carriers and health care provides for the purposes of expanding coverage, controlling spiraling health care costs, and increasing the quality of medical outcomes.

BCG Advisors is committed to guiding our clients through every step of this complicated transition. This objective is in accordance with our mission to consistently invest in our Firm to deliver the highest, most professional level of service in the industry. We will continue to update this site as more details are released.

  • Implementation Timeline

    (National Association of Health Underwriters)

  • NAHU Timeline Updated


  • Small Business Healthcare Tax Credit

  • New Employer Form W-2 Health Insurance Reporting Requirements
    (according to NAHU who sites its sources)

    The Patient Protection and Affordable Care Act (PPACA) adds a new reporting requirement aimed at improving health care transparency and cost awareness by requiring employers to report the value of employees’ health benefits on Form W-2s.

    For taxable years beginning after December 31, 2010, employers will be required to calculate and report the aggregate cost of applicable employer-sponsored health insurance coverage on employees' Form W-2s. This new reporting requirement applies for employees' tax years beginning after December 31, 2010. However, because employees are entitled to request their Form W-2 early if they terminate employment during the year, payroll systems need to be updated for this change by January 2011.

    Therefore, while most W-2s for tax year 2011 will be issued in January 2012, W-2s reflecting the new health insurance information must be available no later than February 1, 2011, in the event that a terminating employee requests one.

  • Dependent Coverage for Children Under Age 26

    Adult children who become eligible to enroll in a group health plan because of this new coverage requirement must be provided written notice of their enrollment rights by the first day of the first plan year beginning on or after September 23, 2010 - January 1, 2011 for calendar year plans. This notice may be provided with a plan’s enrollment materials, provided that the notice is “prominent”. However, plans and insurers that provide the required notice at least 30 days in advance of the first day of the first plan year before this requirement takes effect can avoid having to administer retroactive enrollment. Those eligible for this enrollment opportunity must be treated as special enrollees, i.e., they must be given the right to enroll in all of the benefit packages available to similarly situated individuals upon initial enrollment.

    Model Notice
    Frequently Asked Questions
    Fact Sheet

  • Lifetime Limits

    Group health plans and health insurance issuers are prohibited from imposing a lifetime limit on the dollar value of “essential health benefits.” Individuals who had reached a lifetime limit under a group health plan, and who are otherwise still eligible for coverage under the plan, must be provided with written notice that the lifetime limit no longer applies. Individuals who are no longer enrolled in the plan must be provided notice of their enrollment rights by the first day of the first plan year beginning on or after September 23, 2010 – * January 1, 2011* for calendar year plans. Similar to the adult child coverage notice, this notice may be provided to an individual with a plan’s enrollment materials, provided that the notice is “prominent” and the individual is still receiving plan communications.
    Model Notice

  • Patient Protection

    Group health plans and health insurance issuers with a network of providers must (1) permit a participant to choose a primary care provider including a pediatrician when the plan or issuer requires designation of a primary care provider, and (2) permit a participant to obtain obstetrical or gynecological care without prior authorization. Notice of these rights must be provided to plan participants when participants are provided with a summary plan description (or other similar description of benefits under the plan) by the first day of the first plan year on or after September 23, 2010 – January 1, 2011 for calendar year plans.
    Model Notice