The uninsured are among the biggest winners of the new healthcare reform law, which mandates coverage for as many as 32 million people who are currently uninsured, either because health plans consider them too sick to insure or because they cannot afford to pay rising premiums.
The approach to insuring the uninsured will be incremental.
Consumers will have more opportunities to take control of their health insurance choices when the Department of Health and Human Services goes live on July 1 with a website where individuals can identify affordable health insurance coverage options in their home states. This will help consumers choose the plan that is best for them.
Beginning within six months of March 23 (when President Barack Obama signed the legislation into law), health plans will be prohibited from denying coverage to children based on pre-existing conditions. Starting in 2014, all pre-existing condition exclusions will be prohibited. Consumers who are currently uninsured because of a pre-existing condition will be able to purchase affordable insurance through a temporary, subsidized high-risk pool. This program will cease in 2014 when consumers will be able to purchase insurance through state-based health exchanges if their employer does not provide coverage or they earn too much to qualify for Medicaid.
Tax credits aimed at helping subsidize health insurance premiums will apply to individuals earning less than $44,000 and families earning less than $88,000.
Also beginning in 2014, individuals with an income below 133 percent of the poverty level (about $29,327 in 2009 for a family of four) will be eligible for Medicaid.
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Filed under insurance by on Jan 17th, 2011. Comment. 
Beginning in 2014, small businesses can apply for grant money to implement comprehensive workplace wellness programs through a $200 billion, five-year federal program designed to address underlying poor health habits and promote disease prevention through:
Smoking cessation, Stress management, Weight loss, Reduced intake of fatty, high-calorie foods; and,Other ways of healthier livingGrant money can be used to set up employee screenings and assessments; mechanisms to encourage employee participation; initiatives to change unhealthy behaviors and lifestyle choices with counseling, seminars and online programs; and workplace environment policies that encourage healthier lifestyles.
Employers will be able to offer increased incentives to employees for participation in a wellness program like lunchtime walking or smoking cessation groups, or for meeting certain health-status targets. Premium discounts of up to 30 percent of the cost of coverage will also be available. Existing wellness regulations max out at 20 percent of the total premium.
In addition, a national public education plan will focus on the importance of community and worksite wellness and health-promotion programs. And companies of any size will have access to government web portals, call centers and other tools to increase employee participation; develop standardized measures of a program’s impact on employee health and healthcare expenditures; and create evaluation tools to measure changes in productivity, absenteeism, changes in employees’ health status, and medical costs incurred over the course of a specified time period.
Filed under insurance by on Jan 13th, 2011. Comment.
As a result of the new healthcare reform law, the health insurance industry must now comply with a number of new requirements that will affect nearly every American. Those include:
By September 2010, health plans cannot deny coverage to children based on pre-existing conditions. Beginning in 2014, all pre-existing condition exclusions will be prohibited.
By September 2010, all health plans must permit children to stay on family policies until age 26, unless the adult child (married or unmarried) has an offer of coverage through his or her employer. Beginning in 2014, parents can keep children up to age 26 on their plan, even if dependents have access to employer-based coverage.
In September 2010, insurers will be prohibited from placing lifetime limits on what they will pay for your medical care, and they can only apply restricted annual benefit limits.
Insurers will no longer be able to arbitrarily cancel your insurance policy when you get sick.
By September 2010, health plans must provide coverage for preventive services. Recommended prevention and vaccination services will be covered without any deductibles or co-payments.
Starting in plan year 2011, insurance companies must disclose requested premium increases publicly. If the rate increase is found to be unreasonable, the insurer may be prohibited from competing for business in the new state-based exchange system that begins in 2014.
Beginning on Jan. 1, 2011, health plans will be required to spend most of their premium dollars on consumer care – rather than on profits and overhead – and rebate any excessive overhead to enrollees.
Filed under insurance by on Jan 6th, 2011. Comment.