Refresher on topics from 2010

1. Michael M. Fuselier, CPA, CITP, RN, FACHE Health Systems Leader www.MichaelFuselier.com What Does Health Care Reform Mean for You? Updated as of November 2010

2. Michael M. Fuselier, CPA, CITP, RN, FACHE Health Systems Leader www.MichaelFuselier.com Michael is a seasoned healthcare executive with over eighteen years’ experience in the industry. As a financial, clinical and information technology professional, he brings a wealth of diverse perspectives to the teams and organizations he is fortunate to lead. He has proven success managing hospitals, outpatient surgical clinics, group medical practices, pharmacies, retail health ventures and more. Michael can be reached at michael@michaelfuselier.com.

4. Importance of being prepared and informed

5. Overview of key provisions, rules and requirements, and what they mean to you

6. 2010 to 2014 effective dates

7. Q&A3 2010 American Institute of CPAs

9. Health Care and Education Reconciliation Act of 2010

10. Legislation’s impact − substantial and long term 4 2010 American Institute of CPAs

12. Lifetime limits and serious illness

13. Pre-existing condition exclusion

14. Dependent care coverage

15. Medicare taxes

16. Itemized deduction threshold for unreimbursed medical expenses

17. Mandatory insurance coverage

18. Premium assistance credit

19. Adoption credit

20. Adoption assistance program exclusion

21. Health FSAs, HSAs, HRAs and Archer MSAs

22. Indoor tanning services5 2010 American Institute of CPAs

24. Pre-existing conditions no longer excluded beginning 2014

25. Pool dissolves in 20146 2010 American Institute of CPAs

27. No policy cancellations for serious illness allowed

28. Effective: September 23, 20107 2010 American Institute of CPAs

29. Pre-Existing Condition Exclusion Plans may not exclude children due to pre-existing conditions Effective: September 23, 2010 8 2010 American Institute of CPAs

30. Dependent Care Coverage Employer-provided accident or health plans Reimbursements excluded from taxable income for dependents up to age 27 (effective March 30, 2010) Continued coverage for adult child until age 26 (effective September 23, 2010) 9 2010 American Institute of CPAs

31. Medicare Taxes 0.9% increase depending on wages and filing status 2.35% Medicare tax rate 3.8% tax on investment income or modified adjusted gross income (MAGI) over the above limits depending on filing status Effective: 2013 10 2010 American Institute of CPAs

33. Age-based exception – remains at 7.5% if individual/individual’s spouse has turned 65 before close of tax year (to expire after 2016)

34. Effective: 2013 11 2010 American Institute of CPAs

36. Penalties for non-compliance based on fixed amount or percentage of income over filing thresholds

37. Nocriminal penalties, or IRS liens or seizures12 2010 American Institute of CPAs

39. Incarcerated individuals

40. Members of Native American Indian tribes

41. Individuals not legally present in US

42. Individuals claiming religious conscience exemption

43. Effective: 201413 2010 American Institute of CPAs

45. Treasury payment directly to insurer

46. Income-based eligibility

47. Inflation adjustment

48. Effective: Years ending after December 31, 201314

49. Adoption Credit Maximum $13,170 credit per eligible child Applies to both non-special-needs and special-needs adoptions Refundable credit Inflation adjustment for new dollar limit and credit phase-out Effective: 2010 15 Caution: Credit reverts to $6,000 and available for special-needs children only after December 31, 2011 2010 American Institute of CPAs

50. Adoption Assistance Program Exclusion Maximum $13,170 per eligible child exclusion for employer-provided adoption assistance programs Inflation adjustment for new dollar limit and income limitations of exclusion Effective: 2010 16 Caution: Income exclusion goes away after 2011. 2010 American Institute of CPAs

52. No over-the-counter drug purchases from health FSAs, HSAs, HRAs or Archer MSAs(effective 2011)

53. Health FSA contribution limit of $2,500 (effective 2013)17 2010 American Institute of CPAs

55. Tax collection at time of payment

56. Effective: July 1, 2010 18 2010 American Institute of CPAs

58. New proposals, adjustments and other changes

59. Professional guidance

60. www.360financialliteracy.org19 2010 American Institute of CPAs