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National Health Care Reform
All health plans – whether or not they are grandfathered plans – must provide certain benefits to their customers for plan years starting on or after September 23, 2010 including:
- No lifetime limits on coverage for all plans;
- No rescissions of coverage when people get sick and have previously made an unintentional mistake on their application;
- Extension of parents’ coverage to young adults under 26 years old;
- No coverage exclusions for children with pre-existing conditions;
- No “restricted” annual limits (e.g., annual dollar-amount limits on coverage below standards to be set in future regulations).
Click Here to read more.
June 11, 2010 - Early Retiree Temporary Reinsurance Program Update
As a result of the Patient Protection and Affordable Care Act of 2010 (PPACA), the U.S. Department of Health and Human Services (HHS) will establish a temporary reinsurance program to assist employment-based plans with the costs of providing health benefits to early retirees and their dependents.
HHS will reimburse 80 percent of the claims between $15,000 and $90,000 and will adjust these numbers annually based on the medical care component of the Consumer Price Index (CPI). There is currently $5 billion appropriated for the program. When the program funds are expended, the program is expected to cease.
If an employer determines that completing an application is in their best interest, they will first be required to file an application with the HHS Secretary and be certified for participation in the program.
A draft application has been posted to the Office of Management and Budget website at www.reginfo.gov. HHS is expected to post the final application on their website, www.hhs.gov/ociio. Because HHS may stop accepting applications if funds under the program are exhausted, and because it is not yet known when HHS may have the final application process in place, we encourage you to
continue to check the HHS website for updates and the final application.
Application Requirements
According to the regulations, an application will require you to include the following:
- The projected amount of reimbursement to be received for the first two plan-year cycles with specific amounts for each plan year.
- An attestation that policies and procedures are in place to detect and reduce fraud, waste, and abuse.
- A description of the procedures or programs the employer has in place with the potential to generate cost savings with respect to chronic and high-cost conditions.
- An assurance that the sponsor has a written agreement with its health insurance issuer or group health plan to provide the HHS Secretary with information and data necessary to verify compliance with the program requirements, including access to individually identifiable health information subject to the HIPAA Privacy Rule.
- A summary of how the employer will use reimbursed amounts to maintain its level of contribution to the plan and to reduce costs to the plan (e.g., using funds to lower participant deductibles, co-insurance, or copayments in future years).
Longfellow Hosted HCR Webinar Focusing on 2010 & 2011
The recently passed National Health Care Reform Acts have several provisions that take effect immediately, while others begin with the first renewal date or plan year beginning on or after September 23, 2010. These provisions will impact the open enrollment and renewal processes for 2010 and 2011. This webinar will focus on these provisions and what employers need to be doing now in preparation as well as what they should be incorporating into the renewal planning process.
To learn more about the webinar, download the slide deck, or watch a recorded playback, click here.
Longfellow HCR Webinar - April 2010
On April 13th and 14th Longfellow Benefits hosted a free webinar on National Health Care Reform. Our presenter was Pat Haraden, SVP of Employee Benefits Services at Longfellow Benefits. The webinar focused on employer and employee impact, provided a summary of the legislation and the provisions, went through a detailed timeline of the effective date of each provision, and reviewed each provision in detail to the extent we are able at this time. The webinar closed with planning strategies for employers.
To learn more about the webinar, download the slide deck, or watch a recorded playback click here.
March 23, 2010 President Obama signs the National Health Care Reconciliation Bill into law.
National Health Care Reform Update - March 22, 2010
As of Monday, March 22, 2010 the Senate version of the national health care reform bill has passed both houses and has been sent to the President for his signature. He is expected to sign the bill shortly. The Senate must now vote on the House proposed changes. If the Senate approves the House changes without any further amendments, these changes would then become law. If there are amendments or other changes in the Sentate, it must go back to the House for final approval. It is also possible that there will be opposition bills and appeals filed within the next couple of days to oppose the bill and possibly delay it's passing.
Longfellow is tracking the progress of the health care reform bill closely and will keep you informed of developments. Upon finalization of a bill should it occur, Longfellow will hold a webinar to review the provisions of the bill and how it impacts employers and employees.
Health Care Reform Proposals - February 2010
This report is based on the two major healthcare reform bills that have been passed by Congress. The Senate Bill, the Patient Protection and Affordable Care Act (H.R. 35901) was passed on December 24, 2009. The House Bill, the Affordable Health Care for America Act (H.R. 3962) was passed on November 7, 2009. Additionally, a Manager.s Amendment to the Senate Bill was introduced on December 19, 2009 and passed on December 21, 2009. Read more
This interactive side-by-side compares the leading comprehensive reform proposals by the President and members of Congress across a number of key characteristics and plan components.
Side-by-Side Comparison of Major Health Care Reform Proposals - Kaiser Family Foundation
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