10 Health Plan Changes Taking Effect in the New Year

Whether it be inflation adjustments, new laws, or tweaks to existing regulations, each new year brings changes to health plans and other benefits.

Here is a summary of 10 health plan changes taking effect in 2019: 

  1. There will be no penalty under federal law if you don’t have health insurance. The Tax Cuts and Jobs Act made the cost for not having health insurance $0 starting in 2019.
  2. The maximum out-of-pocket (OOP) allowed under health insurance plans will increase to $7,900 for single coverage and $15,800 for family coverage. Please note that the maximum OOP allowed under an HSA-qualified plan is lower. Those OOP limits will be $6,750 for single coverage and $13,500 for family coverage.
  3. The maximum contribution an employee can make to an FSA will increase to \$2,700, unless their employer sets a lower limit.
  4. Patient-Centered Outcomes Research Institute (PCORI) fees will rise to $2.45 per covered life for most health plans. Click here for more details.
  5. Standardized plan options on the Health Insurance Marketplace will disappear. Standardized plans were available in 2017 and 2018. These plans were offered by different insurance carriers and included the same deductibles, copays and out-of-pocket expenses to make comparing plans easier. The Department of Health and Human Services (HHS) will not be encouraging standardized plans anymore.
  6. Transitional health plans (sometimes called grandmothered plans) can continue to be renewed up until October 1, 2019 so long as they end by December 31, 2019. This is subject to state regulatory approval and an insurance carrier’s willingness to continue offering these plans. Click here for more details.
  7. The affordability percentage under the Employer Mandate will rise to 9.86% in 2019. Click here for more details.
  8. Employers and insurance carriers will have additional time to provide employees with copies of Form 1095-B and/or 1095-C. The due date was originally January 31st, but it has been extended to March 4th. Reporting to the IRS has remain unchanged. If filing manually, forms must be submitted to the IRS by February 28th. If filing electronically, forms must be submitted to the IRS by April 1st.
  9. New HRA rules are expected to get finalized and will open the door for more employers to reimburse individual health insurance plans on a tax-free basis. The new rules aren’t expected to become effective until 2020, but we should have a better idea on how the new rules will work next year.
  10. The Affordable Care Act (ACA) imposes a tax on health insurance companies, but the tax has been suspended for 2019 which will help to keep health insurance premiums a little lower. If the tax were in place, health insurance premiums would likely be 2-3% more expensive.

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