Posted: 06.21.2010
Health Care Reform - Are You Ready?

With the passage of the Patient Protection and Affordable Care Act, a massive overhaul of the health care system will take place. There are still many questions surrounding how the regulations detailed in the bill will be implemented. Below is a brief highlight of some of the most impactful provisions of the bill. This summary is not all inclusive.

These privisions apply to the design of the new fully insured & self funded health plans:

• Lifetime Limits / Annual Limits - Lifetime & Annual limits will be prohibited on certain health benefits.
• Dependant Children - Plans must allow dependent children, married or unmarried, to be eligible until age 26.
• Pre-Existing Condition Exclusions - Exclusions of pre-existing conditions will be prohibited effective as of the first day of the first plan year beginning on or after January 1, 2014 (earlier for children under age 19).
• Preventive Services Coverage - Plans must offer first dollar coverage with respect to certain preventive care services.

These provisions are not specific to medical plan design:

• Medical Loss Ratio Reporting / Premium Rebates - Health Insurers must publicly report the percentage of total premium revenue spent on claims activities vs. non-claims costs. Beginning in 2011, if more than 15% (large groups) or 20% (small groups) of the premium collected is expended on non-claims costs, insurers will be required to provide a premium rebate.
• Small Employer Tax Credit - Starting in 2010, small employers (with no more than 25 full time employees with average annual wages of less than $50,000) who provide health care coverage to their workers will be eligible for a tax credit.

Brown & Brown of Detroit's goal is to assist all of our clients in understanding these complex reform regulations. To keep you up to date on this legislation, Brown & Brown is providing client reviews, periodic email alerts, posting informative documents to our internet site at www.bbdetroit.com and hosting an educational employer seminar on health care reform. For more information, please contact your Brown & Brown insurance representative at 586.977.6300.

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