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While the Health Care Reform Act has been passed, there is still a lot that is unknown about how it will be implemented, what the actual rules are, plans, and more. As we find out solid answers and information, we will share what we believe is factual and useful vs. rumor and conjecture.

When does it all start?

Some of the provisions take effect immediately, some in September 2010, and others spread out all the way until 2014.

Here’s what we have today and coming in the next few months that you need to know about:

Health Plan Changes

Plans will have to make changes in benefits, including “well care” benefits, to stay eligible for tax deductions and credits. You can “freeze” or “grandfather” a plan but no benefit changes, additions, or deletions may occur.

Changes are currently scheduled to begin in your “plan year” which begins six months after enactment of the law (plan renewals on or after September 23rd, 2010).

1. Insurance companies will be prohibited from canceling coverage except in cases of fraud.
2. Lifetime benefit limits will be abolished.
3. Plans must allow coverage for dependents up to age 26. Here’s what we know so far about the current rules:
   • We do not know what happens yet to those who became ineligible, dropped, and under the new rules would be eligible and want to re-enroll.
   • Dependent does not have to be a student and can even be married.
   • They cannot be eligible for another employer plan (via work or spouse).
   • For grandfathered group plans, this applies only to dependents that do not have another source of employer-sponsored coverage (until 2014).
   • NOTE: June is a typical time many dependents drop off plans, and the new provision does not take effect until September. To bridge this gap, some carriers are allowing or contemplating allowing dependents to remain on before September. Contact us if you have a dependent and we’ll check the latest information for you.
4. Small businesses that develop wellness initiatives will be eligible for grants for up to five years.
5. Plans will be required to cover preventive care at no cost.
6. The limit for employer sponsored adoptions increases to $13,170 and the tax credit has been extended through 2011.

Will you be forced to carry insurance?

If you do not have insurance through your employer, or individually, in 2014 you will be required to carry insurance, join a state insurance exchange, or a Medicare program. If you do not, fines will be imposed.

The official White House statement says: You will have access to new insurance choices in the same insurance marketplace where all members of Congress will buy their insurance, receive tax credits to help you afford coverage if needed, and get protections from insurance company abuses like denying you coverage based on pre-existing conditions.

Since most of this does not take effect until 2014, right now there is a lot here that remains unknown or needs clarification. Watch for more to come.

Will you be forced to cover your employees?

There is a lot of debate here. Currently what we know for sure is starting in 2014, the legislation requires employers with more than 50 employees to offer affordable coverage to their workers or face a tax of $2,000 per full-time worker. There are significant tax breaks available to companies under 50 employees to encourage coverage. See our article on Health Care Reform Tax Saving, and watch for more to come as we find out more.

As always, please contact us with questions or for more information. We'd also be happy to provide you with a health insurance quote.