Summary of Benefits and Coverage under the Affordable Care Act
Posts Tagged Barak Obama
If you like your health care plan, tough luck – if you’re on a Medicare prescription drug plan:
More than 3 million seniors may have to switch their Medicare prescription plan next year, even if they’re perfectly happy with it, thanks to an attempt by the government to simplify their lives.
The policy change could turn into a hassle for seniors who hadn’t intended to switch plans during Medicare’s open enrollment season this fall.
And it risks undercutting President Barack Obama’s promise that people who like their health care plans can keep them….”As a result of this policy, there are going to be fewer plans offered in 2011,” said Bonnie Washington, a senior analyst with Avalere Health, which produced the study.
If you like your health care plan, better luck next time – if you’re a college student:
Along comes word that the bill “could make it impossible for colleges and universities to continue to offer student health plans.” That’s how the American Council on Education and a dozen other higher-ed lobbies put it in a recent letter to the Obama Administration, warning that the insurance coverage they offer may get junked by ObamaCare’s decrees.
Between 4.5 million to 5.5 million students annually are insured by short-term plans sponsored by their schools, which are tailored to upperclassman who have aged out of their parents’ coverage or to international and graduate students. These plans are very low cost because the benefits are designed for generally healthy young people and often organized around campus health services and academic medical centers.
All of which means these plans aren’t likely to qualify under ObamaCare’s “minimal essential coverage” rules that mandate rich benefit packages, even if colleges have the flexibility to make exceptions for special needs. And given that insurance must now be sold anytime to everyone, colleges may be required to continue to cover students after they’ve graduated-leaving this type of coverage unaffordable.
If you like your health care plan, cross your fingers and hope you’ll like your new one better – if your employer sponsored plan doesn’t meet the law’s strict grandfathering requirements:
While many U.S. companies initially hoped they could preserve much of their existing group health plans under the new grandfather provision, a new survey by Hewitt Associates, a global human resources consulting and outsourcing company, shows that almost all now believe they will not. Ninety percent of companies said they anticipate losing grandfathered status by 2014, with the majority expecting to do so in the next two years.
Under the “grandfather” provision of the U.S. Patient Protection and Affordable Care Act, companies can maintain many of their current health care coverage provisions and are required to make fewer changes to plan documents and administrative procedures in order to comply with the new law. Companies can lose their grandfather status if they take certain steps such as reducing benefits, significantly raising co-payment charges, significantly raising deductibles or changing insurance carriers.
According to Hewitt’s survey of 466 companies–representing 6.9 million employees–most companies expect to lose grandfather status because of health plan design changes (72 percent) and/or changes to company subsidy levels (39 percent).
None of this is exactly surprising—at least if you’ve been paying attention. Any health system overhaul as sweeping as the PPACA was bound to upset existing coverage arrangements, especially given the dominance of insurance in American health care. But given how disastrous the possibility of forced plan changes proved to HillaryCare in the 90s, the law’s supporters couldn’t admit that. So President Obama and congressional leadership and the progressive activist class had to promise, repeatedly, that no one would have to change plans if they didn’t want to.
Please watch this… some insight on what is going on in Healthcare.
[UnitedHealthCare] will launch a national direct-mail campaign in early April to support Generations of Wellness®, a program created to serve the health needs of African-American small businesses and families. This campaign is directed to African-American small-business owners and companies with large percentages of African-American employees.
The Generations of Wellness direct-mail piece above provides recipients with resources on how they can reduce their health care costs by directing them to a toll-free number and Web site address. Prospects have the option of receiving a complementary guide to Health care management solutions for business or Product Portfolio (California only).
As a reminder, interested parties can also access health-tip fliers, family health history tree, a physician directory, a health care glossary and many other helpful tools via uhcgenerations.com.
Contact your Consultants at Catalist Health for more information.
One of the goals of health care reform is to make coverage more affordable, but the proposed annual $6.7 billion health insurance premium tax will have the opposite effect by increasing costs for families and employers across the country. The new health insurance premium tax will:
Increase premiums for families and small businesses: CBO has stated that new taxes on health plans will result in “higher premiums for private coverage.” These taxes would increase costs for families and employers at a time when they are already struggling with rising health care costs.
Cause immediate disruption for policyholders: While broader reforms will not begin until 2014, the new health insurance premium tax would go into effect in 2010 – after contracts have been negotiated and after individuals have enrolled in their plan for next year. Imposing new taxes next year that cannot be supported by current premium levels will cause significant disruption and higher costs for policyholders, and could impede the ability of health plans to meet promised benefits.
Create an unsustainable burden on health plans: Health plans will be required to pay a $6.7 billion tax beginning next year for the next 10 years, in addition to “stabilization‟ fees of $25 billion in 2013, 2014, and 2015. According to Fortune magazine‟s analysis of the companies listed under “Insurance and Managed Care‟, earnings in 2008 totaled $8.61 billion with a profit margin of 2.2% — ranking the industry 35th on the Fortune list.
The new tax is non-deductible and is layered on top of existing state and federal taxes paid by health insurance plans, including: premium taxes, assessments to support high risk pools, state and federal income taxes, employment taxes, sales and use taxes, and property taxes.
Put benefits at risk for families and employers: The new health insurance premium tax is assessed based on market share and is not tax deductible. As shown in this chart, the new tax will disproportionately impact health plans with the lowest net income, and for some health plans, could result in an effective tax rate of more than 100 percent. This would put at risk the reserves health plans are required by law to keep on hand to pay out benefits for families and businesses.