Friday, April 8th, 2011

Good Neighbor Insurance (www.gnazhealth.com and www.gninsurance.com) is continuing to update our clients on the new health insurance laws that were signed into law in the spring of 2010.   There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

PPACA = Patient Protection and Affordable Care Act 

ONE YEAR LATER

One year ago, March 23, 2010, the President signed the Patient Protection and Affordable Care Act (now being referred to by many as Affordable Care Act).  We’ve seen some plan changes, some eligibility changes, and some provision delayed.  We still have lawsuits pending and a lot of confusion.  We’ve seen a new congress take office and new legislation introduced.  But, until either the lawsuits are settled or the legislation passed (and signed), we still have PPACA.

 This update is meant to give you information on some of the current happenings surrounding the law.

AUTO ENROLLMENT

PPACA requires employers to automatically enroll employees in medical coverage beginning no later than January 1, 2014.  This effective date may be moved to an earlier date by pending regulations.  Prior to finalizing the proposed regulations on automatic enrollment, the Department of Labor is hosting a forum where employers can share their views on how the DOL should draft the regulations.  This forum will be held in Washington, DC on April 8, 2011.  Employers and their representatives may submit written comments prior to the date of the forum.  A link to the DOL press release is below. 

 RATE REVIEW

Mid-March, CMS introduced a new disclosure form for health insurance carriers that must be completed when the carrier is proposing a rate increase of greater than 10%.  This program is to begin July 2011.

 WELLNESS GRANTS FOR SMALL EMPLOYERS

Beginning this year, grants are available for small employers to provide their employees access to new workplace wellness programs.

Eligible employers include:

    -    less than 100 employees working 25 or more hours per week, AND

    -    did not have a workplace wellness program as of March 23, 2010

The program must include:

    -    Health awareness initiatives

    -    Efforts to maximize employee engagement

    -    Initiatives to change unhealthy behaviors and lifestyle choices

    -    Supportive environment efforts

Eligible employers must submit an application of HHS that includes a proposal for the program.  Grants will be available until the budgeted amount ($200 million) runs out.

REFORMS IMPACT

 19 – States where parents can no longer buy child-only insurance policies as a result of the law

30 – States suing to block the law from taking effect, or requesting waivers from its requirements

1,270 – New bureaucrats requested by the Internal Revenue Service to implement the law this year

$2,100 – Increase in individual insurance premiums due to Reform, according to the Congressional Budget Office

$2,500 – Premium reduction promised by candidate Obama “by the end of my first term as President”

6,578 – Pages of new regulations issued implementing Reform through March 14, 2011

800,000 – Reduction in the American labor force due to Reform provisions that “will effectively increase marginal tax rates, which will also discourage work,” according to the CBO

2,624,720 – Total individuals in 1,040 plans granted waivers thus far exempting them from the law’s insurance mandates; nearly half of whom participate in union plans

7,400,000 – Reduction in Medicare Advantage enrollment as a result of Reform, resulting in a loss of choice for seniors and millions of beneficiaries losing their current health plan

$118,000,000,000 – New costs imposed on states to implement Reform-budgetary costs that will lead to reduced services for other state programs like education or to higher state taxes

$310,800,000,000 – Projected increase in health costs due to Reform, according to the independent Medicare actuary, who called its promise of lower costs “false, more so than true”

$552,200,000,000 – Amount of higher taxes Americans will pay if Reform remains in place

$1,390,000,000,000 -Federal spending on new entitlements during fiscal years 2012-2021 according to the CBO, a 48% increase from an earlier estimate

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, www.overseashealthinsurance.com/trip-protection.asp, information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.