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7 <br />Fully Insured <br />Fully Insured <br />Implementation <br />Provision <br />(Small Group) <br />(Large Group) <br />ASO <br />Individual <br />Date ** <br />PRCORI — Fee for comparative effectiveness <br />research agency for fiscal year 2013, which <br />technically begins October 1, 2012 <br />Required - health <br />Required - health plan <br />Required — employer <br />Federal FY 2013 <br />IRS Form 720 — Quarterly Federal Excise Tax Return <br />plan will take <br />will take <br />responsible for <br />(applies to plan years <br />care of it on <br />care of it on <br />determining amount and <br />ending 10/1/2012 and <br />$1 1St Year, $2 2nd Year until 2019 <br />employers' behalf <br />employers' behalf <br />paying of fee ($1 then $2) <br />Required <br />later) * ** <br />Employee notification of exchanges, premium <br />subsidies and free choice vouchers <br />Required <br />Required <br />Required <br />N/A <br />Deferred <br />State /Federal /Private Based Exchanges <br />January 1, 2014 <br />North Carolina will not work with the federal government in setting up a health <br />insurance exchange. "There has been a lack of preparation within state <br />government during the past year to build necessary and reliable systems to <br />North Carolina <br />implement a state exchange," Gov. Pat McCrory said in a statement. <br />January 1, 2014 <br />30% incentive cap for wellness programs <br />Required <br />Required <br />Required <br />N/A <br />January 1, 2014 <br />Large groups required to auto - enroll employees <br />Required - dependent <br />Required - dependent <br />into health benefits (200+ employees) <br />N/A <br />on size of organization <br />on size of organization <br />N/A <br />January 1, 2014 <br />Small group redefined as 1— 100 (state may defer <br />Required - dependent <br />until 2016) <br />Required <br />N/A <br />on size of organization <br />N/A <br />January 1, 2014 <br />Ensure that annual cost - sharing for essential health <br />benefits doesn't exceed the maximum out -of- <br />pocket limits for a high - deductible health plan <br />(HDHP), as defined by Internal Revenue Code (these <br />limits are adjusted for inflation annually) <br />Required <br />N/A <br />N/A <br />Required <br />January 1, 2014 <br />New fee on fully insured coverage <br />Required <br />Required <br />Not applicable <br />Required <br />January 1, 2014 <br />90 -day limit on waiting periods for coverage <br />Required <br />Required <br />Required <br />Required <br />January 1, 2014 <br />Coverage of routine patient costs for clinical trials of <br />life- threatening diseases* <br />Required <br />Required <br />Required <br />Required <br />January 1, 2014 <br />Definition of Full Time Employees is 30 Hours of <br />more <br />Required <br />Required <br />Required <br />Required <br />January 1, 2014 <br />Transitional Reinsurance Fee - 2014 - 2016 <br />Required <br />Required <br />Required <br />Required <br />January 1, 2014 <br />** Some dates may change based on additional guidance /requirements from HHS, these are intended to be general implementation timeframes. <br />* ** Best understanding subject to publication of regulations. <br />7 <br />