ADDITIONAL HEALTH CARE REFORM PROVISIONS KICK
On Sept. 23, the next round of provisions in the Patient Protection and Affordable Care Act (PPACA) will begin to go into effect. Many of these provisions provide new or expanded options and consumer protections for health insurance coverage. These benefits could mean significant changes to your policy options during open enrollment or when renewing your individual health policy. The National Association of Insurance Commissioners (NAIC) provides the following highlights of these PPACA provisions to help you navigate the coverages and options you may soon see on your health insurance renewal.
The changes beginning Sept. 23 include expanded coverage and new consumer protections. If they are not spelled out in the documentation you receive from your insurance provider or employer, talk with your employer’s plan administrator or your health insurance company about how these protections will apply to your coverage and what new options you may have.
If you have health insurance coverage through an employer, these new
benefits and protections will be added to your policy at the next policy
renewal after Sept. 23. If you purchased an individual health insurance
policy on your own, the effective date is a bit more complicated. If your
insurer has specified a "policy year" for your coverage, the new
provisions will become effective on that date. Otherwise, the new benefits
and protections will be added on the date when annual deductibles and
annual limits reset each year. If your policy does not have an annual
deductible or annual limit, these changes will become effective on
You may be hearing a lot about what are referred to as “grandfathered plans.” These are health plans in which either a group or an individual was enrolled in prior to March 23, 2010, when President Obama signed the PPACA into law. Grandfathered plans are exempt from most changes required by the PPACA. However, if the plan significantly reduces benefits or increases deductibles, copayments, and/or an employee‘s share of premium contributions, it will lose its grandfathered status and its exemptions. This could make a difference in what provision you see at renewal time.
Consumer Protection Changes
You can get more information about all of these changes from your state insurance department. Go to http://map.naic.org for contact details.
You can also find more information about the PPACA and how it will affect you today and in the future on the NAIC website. Go to the special health reform section at http://www.naic.org/index_health_reform_section.htm. Here you’ll find the latest information on the state insurance departments’ work on the PPACA implementation; an FAQ for consumers, employers and seniors on the health care reform; timelines for implementation and much more.
Confused about health insurance and what is available to you and your family? Get smart about insurance with the help of the NAIC’s Insure U consumer education program. Go to www.insureuonline.org for tips and information about health insurance options.
About the NAIC
Formed in 1871, the National Association of Insurance Commissioners
(NAIC) is a voluntary organization of the chief insurance regulatory
officials of the 50 states, the District of Columbia and five U.S.
territories. The NAIC has three offices: Executive Office, Washington,
D.C.; Central Office, Kansas City, Mo.; and Securities Valuation Office,
New York City. The NAIC serves the needs of consumers and the industry,
with an overriding objective of supporting state insurance regulators as
they protect consumers and maintain the financial stability of the
insurance marketplace. For more consumer information, visit insureUonline.org.
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