1. Roundtable Discussion – 9/9/2010

2. Reform today & near future  Mandatory reforms – examples impacting now:  Accommodate breast-feeding mothers on-site – must provide a private place other than restroom <50 employees may have exemption  Required mandates (preventive care, dependent age limits, exclusion of lifetime limits) increasing rates by around 4% for current/next renewal

3. Reforms for 2011  Value of benefits to be reported on W-2s  No pre-tax reimbursements from HSA, FSA or HRA for over-the-counter Rx without prescription  Tax increase for non-qualified HSA withdrawals moves from 10% to 20%  Automatic enrollment in assisted living programs (CLASS Act); employees may opt out

4. To Grandfather or not to Grandfather  Not grandfathered:  Non-discrimination testing  Preventative care benefits @ 100%  New claims appeal processes  Adult children (to age 26) with access to other coverage  All Plans regardless of grandfathered status:  Eliminate pre-ex for children under 19  Eliminate lifetime and annual maximums  Eliminate rescissions (except for fraud)  Adult children (to age 26) without access to other coverage

5. 2014 – The big year  Health Insurance Exchanges come on line  Requirement to offer coverage (50 or more employees)  Penalties range from $2,000 to $3,000 per employee if no coverage offered or deemed “unaffordable”  Waiting period cannot be more than 90 days  Treasury reporting; enrollment, premiums, number of full time EE’s each month