Brought to you be the General Insurance Services, Inc.
Over the past few weeks, the agencies responsible for implementation of the health care reform law - the Departments of Health and Human Services, Labor and the Treasury - issued proposed regulations regarding a number of health care reform provisions. The proposals address topics including the definition of essential health benefits, the actuarial value of health plans, employer-based wellness programs and insurance market reforms such as guaranteed availability and renewability, premium rating and cost-sharing limits. Although these rules are proposed, not final, they indicate the direction the agencies are taking. We thought you might find some of the items we’ve posted to our web site to be of interest:
Proposed Rules on Workplace Wellness Programs
The Affordable Care Act (ACA) includes provisions to encourage appropriately designed, consumer-protective wellness programs in group health coverage. Effective for plan years beginning on or after Jan. 1, 2014, ACA essentially codifies the existing HIPAA nondiscrimination requirements for health-contingent wellness programs, while also increasing the maximum reward that can be offered under these programs. Rest of article...
Proposed Rule on Essential Health Benefits, Actuarial Value and Accreditation Standards
Beginning in 2014, the Affordable Care Act (ACA) requires certain plans to offer a comprehensive package of items and services that meets certain actuarial value requirements, known as an essential health benefits (EHB) package. This requirement applies to non-grandfathered plans in the individual and small group markets. Additionally, ACA requires issuers offering coverage in a state insurance exchange (Exchange) to be accredited and imposes requirements for accreditation. Rest of article...
Proposed Rule on Health Insurance Reforms and Rate Review
The Affordable Care Act (ACA) includes provisions that prohibit discrimination by health plans against people with pre-existing conditions and provide certain protections for consumers. Effective for plan years beginning on or after Jan. 1, 2014, ACA extends guaranteed issue protections for individuals and employers, prohibits the use of health and other factors to set premium rates, limits age rating and prohibits insurers from dividing up insurance pools. Rest of article...
Proposed Rules on Health Insurance Reforms and Wellness Programs
On Nov. 20, 2012, federal agencies responsible for health care reform released advance copies of three proposed rules implementing provisions of the Affordable Care Act (ACA). The proposed regulations relate to:
Health insurance market reforms and rate review;
Essential health benefits, actuarial value and accreditation; and
Employer-based wellness programs.
These proposed rules provide details on ACA provisions that prohibit discrimination by health plans against people with pre-existing conditions, enable consumers to compare health plan options, and help employers promote and encourage employee wellness. It is important to note that these rules are in the proposed stage, and will not go into effect until final regulations are issued. Rest of article...
Craig Menne, JD, CIC
General Insurance Services, Inc
cmenne@genins.com
Office: 219-510-6210
Earl R. McLain, CLU, ChFC
General Insurance Services, Inc
emclain@genins.com
Office:219-369-0209