Get access to the exclusive HR Resources you need to succeed in 2018.
Sign up for free email newsletters and get more SHRM content delivered to your inbox.
Is your employee handbook keeping up with the changing world of work? With SHRM's Employee Handbook Builder get peace of mind that your handbook is up-to-date.
Build competencies, establish credibility and advance your career—while earning PDCs—at SHRM Seminars in 14 cities across the U.S. this fall.
Gain the skills you need to rise to the next level in your career. Jon us at SHRM's Leadership Development Forum, October 2-3 in Boston.
Members may download one copy of our sample forms and templates for your personal use within your organization. Please note that all such forms and policies should be reviewed by your legal counsel for compliance with applicable law, and should be modified to suit your organization’s culture, industry, and practices. Neither members nor non-members may reproduce such samples in any other way (e.g., to republish in a book or use for a commercial purpose) without SHRM’s permission. To request permission for specific items, click on the “reuse permissions” button on the page where you find the item.
In 2012, 58 percent of U.S. employers that offered health care coverage had at least one plan that was grandfathered (or exempt from specific health care reform requirements such as fully covered preventative care). In contrast, an examination of 2013 plans reveals that, on average, less than 20 percent were grandfathered.
This finding may be due to employers' need to provide competitive health plans, according to findings from the fourth annual Medical Plan Trends Report from benefits-management firm HighRoads and CEB, a member-based advisory company.
The Patient Protection and Affordable Care Act requires nongrandfathered plans to provide coverage without a co-payment for services such as Pap smears, routine mammograms and colorectal cancer screenings under generally accepted medical guidelines (for instance, a colorectal cancer screening once every five years for men over age 50).
While grandfathered plans
can charge enrollees a co-pay for “well woman” visits to an OB/GYN, only 16 percent of all surveyed plans actually did so. Similarly, just 10 percent of all plans required co-pays for adult immunizations, Pap smears, mammograms or colorectal cancer screenings.
These findings suggest that many grandfathered plans are moving toward providing coverage levels required of nongrandfathered plans, and that "fewer plans than expected will retain their grandfathered status," according to the report.
'Cadillac Tax' Risks
The so-called Cadillac tax on high-value plans is scheduled to take effect in 2018. This 40 percent nondeductible excise tax will be levied against employers that pay more than $10,200 for individual coverage and $27,500 for family coverage.
Nearly one in five plans still have no deductibles, and 55 percent of plans charge a co-pay of $20 or less for a primary care physician visit, the study found, which suggests they are likely to trigger the Cadillac tax.
"Organizations must take a careful look at their plans and redesign them to mitigate the tax while protecting the employment value proposition," the report advised. "Changes such as increasing prescription drug costs," which has a relatively limited effect on employee perceived value, "could help avoid the tax entirely while protecting the employment value proposition."
is an online editor/manager for SHRM.
SHRM Online Health Care Reform Resource Page
Keep up with the latest news. Sign up for SHRM’s free
Compensation & Benefits e-newsletter
You have successfully saved this page as a bookmark.
Please confirm that you want to proceed with deleting bookmark.
You have successfully removed bookmark.
Please log in as a SHRM member before saving bookmarks.
Please sign in as a SHRM member before saving bookmarks.
Please purchase a SHRM membership before saving bookmarks.
An error has occurred
Recommended for you
Get recognized as an HR expert. Earn your SHRM-CP and SHRM-SCP certification, and set yourself apart.
SHRM’s HR Vendor Directory contains over 10,000 companies