Thursday, September 23, 2010

Early health reform provisions go into effect

Today, September 23, 2010, marks the effective date that some of the earliest provisions of the Patient Protection and Affordable Care Act (PPACA) will go into effect with the start of your new plan year. For example, if your plan renews on January 1st, these provisions will not be effective until January 1st, 2011.

As a reminder, below are the major changes that go into effect:
• Dependent coverage for eligible dependents extended up to age 26
• Restrictions of rescissions other than for fraud or intentional misrepresentation of an important fact on applications
• No pre-existing condition exclusion for children under age 19
• No lifetime dollar limits on health benefits and restricted annual dollar limits
• Ban on discrimination in favor of highly compensated workers*
• Preventive services with no cost-sharing*
• New requirements for internal claims and appeals and external review processes for all health plans and health insurance carriers*
• Right to designate a primary care provider and access to emergency services, pediatricians and OB/GYNs*

*not applicable to grandfathered health plans

These changes are being implemented by your insurance carrier to ensure requirements of the law are met. Remember, the provisions go into effect at the start of your new plan year.

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