Posted July 22, 2010:  This segment is for EMPLOYERS who either already have a group policy in place, or are considering a group health insurance plan.  The bottom line is that after September 23, 2010, all employees, managers, and owners must be treated equally when it comes to the type of health insurance plans offered, the percentage of premiums covered for employees, and the percentage of premiums covered for all dependents (if the employer elects to cover dependents... which he/she does not have to do).  It's really just that black and white.  For more complete details in a printable PDF, please click here.

Posted July 20, 2010:  The pieces of this Health Reform are finally starting to fall into place.  The magic date to remember is September 23, 2010.  This is the date in which many of these new changes begin to take effect.  They are:

• The age for the definition of dependents is age 26.  This is for both family plans and group plans.
• Dependents under the age of 19 (not age 26) can no longer have pre-existing conditions excluded, and can no longer be denied coverage.
• Preventative services can no longer be a "cost-sharing" service.  In other words, these services will be free.
• Lastly...  The High Risk Pool has been created for those who have been denied medical insurance for at least 6 months.  This "pool" allows individuals to apply, and be accepted, regardless of any pre-existing conditions.  Proof of denied medical insurance must be present when applying.

For complete details, including some items that I DID NOT highlight, please click here.

Two other points to take note:  First, as I see it now, it appears that most of these new regulations DO NOT apply to plans that are already in force (or grandfathered plans).  You must apply for a new plan if these new regulations will benefit you.  Secondly, we still DO NOT know the premiums of these plans.  My guess is that they're going up, but we're still in wait-and-see mode.

Any questions, please don't hesitate to give me a call.

Posted May 01, 2010:  In keeping up with the constant changes that are coming with the new health reform legislation, I've included a "timeline" of what parts of the legislation is supposed begin, and the impact it may have on you (or your business).
 

Highlights include:

• The HHS (U.S. Health and Human Services) is going to have quite a bit of power.  They are going to be working with all the States and insurance carriers to determine rates and rate filings.  This is scheduled to happen on an annual basis.
• Starting Jan. 1st of this year, employers with less than 25 employees, and average wages of $40,000 will be eligible for a tax credit for a percentage of the employer's share of premium contributions.  However, it has yet to be determined how this is going to be implemented.
• By October 1st of this year, insurance carriers will be prohibited from issuing plans with "lifetime benefit limits."
• This definition of dependent will be extended until age 26.
• By January 1st, 2011, pre-existing exclusions will be prohibited for children under 19 years of age.  However, premiums will probably be increased to accept a pre-existing condition.

It also appears that January 1st, 2014 is going to be the year to keep an eye on...  Many of the "major" changes are to be in full effect by this time.  They include:

• The health insurance exchange should be in full force.  This is the nationwide pool of health plans (from different carriers) that will be available to everyone.   This is separate from the "high risk pool" that is also going to be available to those with pre-existing conditions.
• No one will be declined coverage, or will have pre-existing conditions waived.  All policies will be guaranteed.  Applicants will have an option to purchase coverage from a "high risk pool," which is separate from the insurance exchange.
• Insurance carriers will be restricted from certain rating factors.  For example, carriers will be limited in using "age" as major rating factor.
• Individual responsibilities and Employer responsibilities will be established.  This includes penalties for not offering, or not purchasing, health insurance.

I personally believe that this timeline is wishful thinking for the programs that are supposed to be implemented this year.  There's just too much information, and too many changes to coordinate such a large overhaul in a short amount of time.  However, by January 1st, 2014, I think most of these plans/changes/updates will be in full force.

Like before, I'm trying to keep pace with all the changes, and will try to bring you new information as I receive it.

Best Regards,

Jed Maslowski
Lead Consultant
MAZ Insurance LLC