At the start of the materials, participants should identify the following topics for study:

* Structural provisions of PPAC
* Individual mandates for health coverage and penalties
* Premium assistance credits and subsidies
* Business provisions of PPAC
* Taxes, fees and credits related to PPAC
* Timetable for the enactment of PPAC

1. Summarize the structural provisions of the Patient Protection and Affordable Care Act (PPAC) as they relate to essential health benefits and levels of coverage and explain how the responsibility requirement to maintain minimum essential coverage under PPAC impacts individuals and who would be exempt from these requirements;
2. Explain how the provisions of PPAC affect individuals by:
a. Distinguishing between the types of premium assistance subsidies and credits available to individuals; and
b. Outlining the tax consequences of PPAC for individuals as relates to itemized deductions, the hospital insurance tax, withdrawal penalties from HSAs, and loan repayment tax relief for health professionals.

3. Explain how the provisions of PPAC affect businesses by:

a. Describing the requirements informing employer mandates and the resulting penalties associated with failure to provide adequate coverage;
b. Identifying the various fees and taxes imposed under PPAC and the credits and subsidies available to help small businesses pay for health insurance; and
c. Prioritizing the application of the major provisions of PPAC for affected taxpayers by summarizing the implementation timetable.

Chapter 1 - Selected Tax & Other Provisions of the 2010 Health Care Act

Introduction

Structural Provisions

Existing Insurance

Grandfathered Plans

Medicaid

Medicare

American Health Benefit Exchanges

Qualified Health Plan

Essential Health Benefits

Catastrophic-Only Plan

Insurance Cooperatives

State Flexibility

Changes to Public Programs

Medicare

Medicare Advantage (Part C)

Medicare Prescription Drug Plan (Part D)

Linking Payment to Quality Outcomes in Medicare

Development of New Patient Care Models

Medicaid Expansion

Children’s Health Insurance Program (CHIP)

Simplifying Enrollment

Dual Eligible Coverage and Payment Coordination

Individual Provisions

Individual Mandate & Penalties - §5000A

Penalty Exemptions

Grandfathered Plans Exception

Refundable Premium Assistance Tax Credit - §36B

Mechanics

Failure to Pay Remaining Premium  

Eligibility & Federal Poverty Level (FPL)

Initial Income Base 

Income Defined 

Sliding Scale Credit

Adjustments 

Exclusions 

Adult Dependents - §§162(l)(1) & 105(b)

Itemized Deduction for Medical Expenses - §213(a)

Medicare Prescription Drug “Donut Hole” Rebate 

Hospital Insurance (HI) Tax 

Increased Percentage - §164(f)

Expanded to Investment Income - §1411 

HSAs & Archer MSAs - §220 

Drugs & Medications 

Increased Withdrawal Penalty 

Health Professionals Loan Repayment Tax Relief - §108(f)(4)

Disclosure of Tax Return Information - §6103 

Business Provisions 

Employer Mandate 

50 or More Employees:  Penalty for Inadequate Coverage - §4980H  

200+ Employees – Automatic Enrollment & Notice 

Employer Reporting of Coverage - §6056 

Insurer Reporting Requirements - §6055 

Summary of Benefits 

Small Business Health Insurance Expense Tax Credit - §45R  

Tax on High-Cost Employer Plans - §4980I 

Fees on Insured & Self-Insured Health Plans - §4375 

Inclusion of Health Coverage on W-2 - §6051 

Cafeteria Plans - §125 

Eligible Benefit - §125(f)

FSAs -§125(i) thru (k)

Simple Cafeteria Plans for Small Businesses - §125(j) thru (l)

No Deduction for Medicare Part D Expenses - §139A  

Excise Tax on Tanning Services - §5000B  

Annual Fee on Health Insurance Providers 

Remuneration Paid by Health Insurance Providers - §163(m)(6)

Excise Tax on Medical Devices - §4191 

Pharmaceutical Manufacturer & Importer Annual Fee 

Therapeutic Discovery Project Credit - §48D  

Free Choice Vouchers - §§139A, 162(a), & 6056,

Miscellaneous Provisions 

Adoption Tax Credit & Assistance - §§23 & 137 

Form 1099 for Payments to Corporations - §6041(h)

Clarification of the Economic Substance Doctrine - §7701(o)

Corporate Estimated Taxes.

Time Table of Selected Provisions 

2010 

2011 

2012 

2013 

2014 

2017 

2018 

Glossary