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5500 Preparer's Manual for 2012 Plan Years

5500 Preparer's Manual for 2012 Plan Years
The premier resource in the field of Form 5500 preparation, 5500 Preparer's Manual will help you handle the required annual Form 5500 filings for both pension benefits and welfare benefit plans.

CCH® BENEFITS — 04/26/11

Insureds In ACA Health Insurance Exchanges May Face Disparate Cost-Sharing

from Spencer’s Benefits Reports: Beginning in 2014, individuals covered in health insurance exchanges provided under the Patient Protection and Affordable Care Act (ACA) could face substantially varied cost-sharing structures across plans in the same tier, a study for the Kaiser Family Foundation (KFF) revealed.

The ACA provides for state-based health insurance exchanges to offer plans in four coverage levels based on actuarial value. Those four levels, and their required actuarial values, are as follows:

The plans face maximum out-of-pocket limits based on health savings account (HSA)-qualified high deductible health plans (HDHPs). Yet, the cost-sharing structure in these plans could still vary among plans, for example with a higher deductible paired with a lower coinsurance percentage.

Applying the same parameters KFF provided to make their separate calculations, the Actuarial Research Corporation, Aon Hewitt, and Towers Watson estimated potential cost-sharing for insureds in the exchanges. Based on the study, KFF reached the following conclusions:

According to KFF, this analysis “allows people to come to their own judgments about key questions regarding the appropriateness of the coverage provided for in the ACA, such as the following:

With substantial variation in the exchanges’ actual coverage, “the exchanges could play an important role in helping consumers understand their choices by, for example, providing online tools to estimate their out-of-pocket costs,” the KFF analysis concluded.

For a copy of the report, Focus in Health Reform: What the Actuarial Values in the Affordable Care Act Mean, visit

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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