Thursday, July 15, 2010

Healthcare Reform: Are you ready for September?

It’s been a little while since we’ve talked about healthcare reform, but that doesn’t mean that the changes are coming any slower. In fact, there’s a lot happening in September. Here’s a list of changes effective September 23rd, 2010 for all new plan years starting on or after that date. I picked the topics that I believe will impact business owners the most, but this is by no means an exhaustive list:

• Young adults that are covered by your plan as dependents must be offered coverage until they reach age 26 (unless covered by an employer of their own).
• Plans must include preventive care services such as mammograms and colonoscopies for free. Co-pays, deductibles, and co-insurance are not allowed.
• Insurance companies cannot rescind coverage for someone who is ill due to a technicality or application error.
• There is a new external review process for individuals to appeal insurance company decisions.
• Lifetime benefit maximums have been eliminated
• Annual limits on essential services have been eliminated
• Pre-existing condition clauses have been eliminated for all children under the age of 19.

Those are the key changes for September and there are some additional changes that will take effect on January 1st, 2011. Those changes include:

• Large employer plans will be eligible for rebates if medical claim costs are less than 85% of the insurance costs.
• Small employer and individual plans are eligible for rebates if medical claim costs are less than 80% of the insurance costs.

The rebates are designed to limit the profit and administrative expense amounts available to insurance companies.

If you have not yet reviewed your plan for changes, I would strongly encourage you to do so soon. Additional information is available on the web at:

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