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HCR Update: Preventive, OAD, and NonDiscrimination

Oct 05, 2010

Health Care Reform Update


October 1, 2010



 

Get the scoop on our updated list of preventive health care services

We've created a helpful flier detailing the new preventive health care services we are offering. Based on the health care reform law and guidelines related to the law prepared by the Blue Cross and Blue Shield Association and America's Health Insurance Plans, we expanded our list of services. 

Print copies of this flier will be available soon. Watch for a future announcement on how to obtain printed copies.

 

Keeping it simple -raising the life insurance dependent age limit to 26 

Health care reform does not apply to life insurance, but we want to make it easier for customers to do business with us across all of our products. So, we've raised the life insurance dependent age limit to 26 to match the health care reform health insurance requirement. This change goes into effect for new groups and existing groups on October 1, 2010.

Current customers will receive a letter and FAQ explaining this change.

 Employers will get a member notice to give to their employees with dependent life coverage.

This change does not affect dependent life rates.

Just like the health care reform law requirements for dependent health coverage, our dependent life coverage will now extend to the end of the month of the child's 26th birthday. Plus, the dependent does not need to be a full-time student to qualify.

Groups can opt out of this change by notifying us.

 We will hold a special enrollment period from October 1 to November 1, 2010, for members with dependent children who are older than 19, but younger than 26. This is not an open enrollment period.

Some states have extended the dependent health benefit coverage past the age of 26 (see table below). Our coverage will match these state mandates.   

State

Dependent age limit for health insurance coverage

Florida

30

Illinois

30

Nebraska

30

New Jersey

31

New York

29

Ohio

28

Wisconsin

27

If you have any questions about this change to our dependent age limit for life insurance, contact your group life account representative.


Get the facts on the health care reform nondiscrimination provision 

The health care reform law notes that, effective September 23, 2010, plans may not discriminate in favor of highly compensated employees. This means that group health plans cannot base eligibility, or the level of benefits, on an employee's wage. 

Check out the details of this provision in our new fact sheet.

Special notes 

Groups will be responsible for following this section of the law because health insurance companies are not privy to employee compensation figures.  

This part of the law does not apply to grandfathered plans, which are plans that were in effect when the law was passed on March 23, 2010, and have had no changes made to the benefits or the benefit plan. 

Health care reform does not prohibit companies from offering plans such as executive medical plans, but it could have tax implications for the employees in those plans. We may continue to offer such plans, but it's possible that the tax implications could reduce the attractiveness of these plans.

 


Getting to the bottom of your health care costs       

Did you know: One out of every five Americans visits the emergency room?

According to a May 2010 National Center for Health Statistics (NCHC) report, Emergency Department Visitors and Visits: Who Used the Emergency Room in 2007, 20% of Americans visited an emergency room at least once in 2007, the latest year for which the NCHC has data. Since 1996, the NCHC reports that demand for emergency services in the United States has been steadily rising while the number of emergency departments across the country has decreased.

This content is provided solely for informational purposes: it is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.

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