Health Care Reform Briefing

• What Employers Really Need To Know & When
  Health reform provisions beginning Sept 23:
  Key provisions under the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act:
• No discrimination against children with pre-existing conditions: Prohibits all employer plans and new plans in the individual market from denying coverage to children with pre-existing conditions.
• No rescissions: Bans all health plans from dropping people from coverage when they get sick.
• No lifetime limits on coverage: Prohibits all health plans from placing lifetime caps on coverage.
• Tightly regulates annual limits on coverage: Tightly restricts the use of annual limits by all employer plans and new plans in the individual market, to ensure access to needed care.
• Free preventive care under new plans: Requires new private plans to cover preventive services with no cost sharing in network and with preventive services being exempt from deductibles.
• New, independent appeals process for new plans: Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions.
• No discrimination based on salary: Prohibits new employer health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees.
• Extending coverage for young people up to the 26th birthday through parents’ insurance: Requires plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice regardless of marital status.