Well, the ink is dry on our nations most sweeping piece of Health Care legislation to come out of Washington since Social Security and now it's time for the experts to figure out what it all means. There's only one problem, the folks in Congress who voted for it aren't quite sure what's in the over 2,500 page mammoth bill but there are some significant changes as a result of passage that we can outline here. With that in mind, we won't know the true extent to which this law with alter the way we do business for months to come. The things that no one is in disagreement about in this Bill is that it's riddled with new mandates, taxes, penalties, compliance requirements, price fixes, Medicare cuts, Medicaid expansion and administrative burdens that will forever change the face of business.
There are various time-lines and important benchmarks set forth in this legislation that can lend to a great deal of confusion. So, with that said, let's look at some FAQ's:
- Will employers and individuals see premiums increase as a result of health care reform?
In compliance with the guidelines and requirements of the new health care law required by September 23, 2010, insurance carriers will modify policyholder benefits accordingly. With these adjustments to policy benefits, it is probable that an increase in premium costs will occur. Beginning in 2014, premium prices cannot be based on a customer’s gender or health status. Until then, current premium pricing will apply.
- Are there annual or lifetime maximums on coverage under the new law?
Effective September 23, 2010, there are no lifetime maximum limits on coverage. In addition, there will be no annual limits on group plans. For individual plans, annual limits may be allowed based on what Health and Human Services deems reasonable. This information is not yet available.
- When are employees able to have their dependents covered until they are 26?
Effective September 23, 2010, the law states that customers will be able to have dependent coverage for their married AND unmarried children up to the age of 26. The requirement is applicable even if the child is not a tax dependent. The law does not specifically include spouses of married children. There is no requirement to cover children of covered dependent children (i.e., grandchildren).
- Under the new law, do pre‐existing conditions no longer matter?
Effective September 23, 2010, insurance companies cannot limit coverage for children on individual or group policies with pre‐existing medical conditions. For adults with individual policies, this provision goes into effect in 2014.
- Under health care reform, what happens to rescission?
Effective September 23, 2010, rescissions will occur only in cases of customer fraud or intentional misrepresentation.
- Is it true that anyone who applies for coverage will be issued coverage?
Under the Guarantee Issue provision, effective in 2014, anyone who applies for coverage must be issued coverage.
- How will this new law affect MSAs/HSAs?
At this point, the only change we are aware of is the tax penalty increase from 10 percent to 20 percent for “non‐qualified” expense withdrawals.
If you would like to find out more about how Health Care Reform effects you and your business email me at bknauss@employeemployersolutions.com or visit my website at www.employeemployersolutions.com Thanks
