2011 Healthcare Preview -- It's Uhhh-gly

If you're excited about healthcare reform, you might want to slow down a little. Because in the short term, there's going to be a lot of confusion as to how to implement it -- or how to keep your small health plan from being subject to healthcare reform's rules.

For starters, a new study from PriceWaterhouseCoopers foundpremiums will likely go up 9 percentnext year, on top oflast year's 15 percent hike.

So that is not going to help business owners or their staffs for the next few years, until all the pieces of reform -- especially the state-run healthcare exchanges -- are up and running.

Looming even larger than premium hikes is the coming issue of what your plan must cover under healthcare reform -- and whether your plan will have to conform to the law. Tax attorney Barbara Weltman recently discussed the issue of the difficulties ingetting your plan "grandfathered" out of healthcare reform-- namely, retaining the ability to keep you plan the way it is and not have to comply with the expanded coverage you might well need to offer workers if your plan falls under the reform bill. It appears to be a complicated mess.

There's a fact sheet on thefederal portal for healthcare reform, and it's miles long. But to give you a quick overview, grandfathered plans have to watch their step, because there are many ways these plans can find themselves disqualified for grandfather status and subject to the new law.

Some of the ways your plan can lose its grandfathered status:

• Cutting or reducing benefits
• 提高cosurance or co-pay charges
• Raising deductibles
• Lowering employer contributions
• Changing insurance companies

In other words, your plan may be somewhat frozen in time for the next three years if you want to keep it from having to add coverage, expand limits and make other changes to comply with healthcare reform. Which could be tough -- when premiums go up, companies usually look for places to cut to keep rates affordable.

Basically, it's going to be a lot easier for companies looking to start offering healthcare to navigate the next few years than it will be for small businesses that already have a plan. As tax attorney Barbara Weltman recently wrote,don't make any changesto your plan without getting expert help.