Can I Get Health Coverage for a Child with a Pre-Existing Condition?
There’s good news for children with pre-existing conditions who are below the age of 19. Under the Affordable Care Act passed in 2010, they can’t be denied coverage under group plans and most individual family or child-only policies. This applies even if your child has a potentially life-threatening medical condition like asthma or diabetes. This rule applies to all […]
What is an Accountable Care Organization (ACO) and What Will it do?
An accountable care organization (ACO) is a new health care delivery model envisioned by theAffordable Care Act (ACA) in which a group of doctors, hospitals and other health care providers work together to coordinate care for people enrolled in Original Medicare. Many Medicare beneficiaries have several chronic conditions and see several different doctors. As often as not, the doctors don’t […]
Are Employers Required by the Affordable Care Act to Purchase Group Insurance for Their Employees?
Yes, the Affordable Care Act requires large employers to provide coverage to full-time employees or pay a penalty. This provision, called the “play or pay” rule, goes into effect Jan. 1, 2014. Small employers – those with fewer than 50 employees – are exempt from the coverage requirement and penalty. As a side note, be aware that the […]
The Repeal of Health Care Reform
The house is going to vote on repealing the health care reform. Most news outlet are stating this is a symbolic gesture. I think its a lot more than that. The healthcare reform bill is a huge gamble with 1/6th of the economy. The health care reform bill has done nothing to address the cost […]
States Alliance for Balanced Insurance Regulation
A new group, the States Alliance for Balanced Insurance Regulation, will represent small and midsize insurance-related businesses in the looming battle over the role of federal regulators. With health care reform we have seen the Office of Consumer Information and Insurance Oversight created by the Federal Goverment and SABIR is being created to in protecting […]
Indiana Individual Health Plan Black Out On Sept. 23rd 2010
With Sept. 23rd right around the corner health plans are ordered by law to cover certain aspect of reform. There is real uncertainty in the carrier market. We have already seen an exodus of stand alone children policies being offered. The only carrier offer standalone children’s plan is Anthem. There is a chance that they too […]
Health Reform Repeal
Rep. Wally Herger (R-Calif.) filed a discharge petition Tuesday that would get rid of the Democrats’ health care reform and replace it with a Republican alternative. His push follows Rep. Steve King’s (R-Iowa) petition to simply repeal the reform without replacing it with new legislation. King’s petition currently has 170 supporters, while Herger’s got 28 […]
Legislation Introduced to Repeal FSA and HSA Limitations
As the health care reform becomes more and more clear we are starting to see the debate to repeal certain aspects. This recent legislation to repeal makes a lot of sense. The entire purpose of the Health Savings Accounts and Flexible Spending Accounts is to make consumers more engaged in their health care spending. With […]
New Consumer Protections Go Into Affect Sept. 23rd
New Consumer Protections Start This Fall The new Patients’ Bill of Rights regulations detail a set of protections that apply to health coverage starting on or after September 23, 2010. They are: No Pre-Existing Condition Exclusions for Children Under Age 19. The new regulations will prohibit insurance plans from denying coverage to children based on pre-existing […]
Interim Final Rules on New Appeals Process
Under the Patient Protection and Affordable Care Act, a non-grandfathered group health plan must adopt an improved internal claims and appeal process and follow minimum requirements for external review. On July 23, 2010, interim final regulations were issued implementing these requirements (the Interim Final Rule). The appeals process rules are effective for plan years beginning […]
