Health Insurance Reform Immediate Actions

While the majority of health insurance reform provisions go into effect in 2014, there are a number of provisions that take effect in 2010. Here’s an overview of the provisions that become effective this year:

Immediately at enactment

  • Grandfathering – Plans and individuals that “renew” their coverage are exempt from any provisions of the law. These “grandfathered plans” must comply, however, with the following provisions of the law: extend dependent coverage through age 26, prohibit rescissions, eliminate waiting periods greater than 90 days, and eliminate pre-existing condition exclusions for children
  • Small employer tax credits – provides premium subsidies for small groups with 25 or fewer employees and average salaries of $40K or less

Less than six months

  • High-risk pool program – establish a temporary national high-risk pool for individuals with pre-existing medical conditions. (effective 90 days post enactment through January 1, 2014)
  • Temporary reinsurance for employer retirees – Creates a temporary reinsurance for employers providing health insurance coverage to retirees over 55 who are not eligible for Medicare (effective 90 days post enactment through January 1, 2014)

Six months plus

  • No lifetime limits – Eliminates all lifetime limits on the dollar value of coverage (effective six months post enactment)
  • Restrictions on rescissions – Prohibits insurers from rescinding coverage except in the cases of fraud (effective six months post enactment)
  • No pre-existing conditions for children – Eliminate pre-existing condition exclusions for children under 19 (effective six months post enactment)
  • Dependent age 26 – Extends dependent coverage to age 26 (effective six months post enactment)
  • Preventive care with no cost sharing – Eliminates cost-sharing for certain preventive services (effective January 1, 2011)
  • Appeals process – Individuals  have access to an  internal and external appeals process to appeal decisions by their health insurance plan.

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