Much of the new health care law remains a moving target, with regulations yet to be written, but one thing is certain:
Employers will have more paperwork to deal with, attorneys from Foulston Siefkin said at a workshop earlier this week.
Many of the 70 human resources and benefits representatives at the workshop were like Lee Meyer, human resources manager for Child Start: She said the session was the fifth she's been to this year as she tries to figure out what the changes will mean.
"I'm signing up for all of them," she said.
Changes begin going into effect in not much more than a month, but the details even for some of them haven't been finalized, attorney Jay Rector said.
Though politicians promised "you can keep what you have," it will be difficult for most employers to keep grandfathered status, and the benefits that come with it, for their health plans, Rector said.
In fact, 70 percent expect to lose their grandfathered status immediately, and 90 percent expect to lose it by 2014, when the final parts of health care reform legislation become effective.
Rector and colleagues Doug Hanisch and Jason Lacey said grandfathered plans will be exempt from some health care law requirements, but even small changes to a health plan can jeopardize the status.
The three spent most of the workshop on "the 2700s," or the market changes to the Public Health Service Act.
Among their points:
* Companies with federally qualified wellness programs will still be allowed to have insurance surcharges based on health status factors. That means smokers still can be required to pay more than nonsmokers, for example.
* Health insurance plans must include coverage of "essential health benefits," but those have yet to be determined.
* If coverage for dependents is offered, it must be available until a child turns 26 — but employers don't have to offer coverage for dependents. The age 26 requirement does not apply to dental coverage.
* Lifetime or annual limits on the dollar value of benefits can't be imposed on essential health benefits. But limits can be set on services that aren't deemed essential.
The regulations, the attorneys said, have a bit of a hodgepodge effect, with some applying to group plans, some to individuals, some to insurance companies and some to employer health plans.
"You will have winners and losers," Rector said, depending on individual cases.
One thing did seem certain at the workshop.
When Rector asked how many people thought the health care law would be repealed, not a single hand went up.