Health Care Reform

The purpose of providing the following information is to help our clients or future clients find answers to some of the many questions in regards to the health care reform. Please know that MLJ Insurance Services does not intend for this to be a complete and comprehensive resource search engine for Health Care Reform topics. We recommend that for complete information you visit the pages we have provided links for in the Resources section at the bottom of this page.

  

 

Child-only coverage (Update 5/2011)- On April 29, 2011, a new bill was signed into law in Colorado that affects existing child-only policies. The Governor’s signing of SB11-128 supersedes the DOI emergency regulation that had established the previous child-only open enrollment periods. Please disregard any information provided by this agency sent prior to this notice regarding the July 2011 open enrollment as it is no longer valid. Effective Immediately:
  • NO child-only open enrollment during July 2011.
  • The next open enrollment will be in August 2011 with an effective date of October 1st.
  • The open enrollment period shall be followed by a thirty (30) day waiting period for the child-only plan to take effect.
  • A carrier may cancel coverage for a dependent in the individual market in the parent subscriber cancels his or her individual coverage. The carrier shall allow the dependent to apply for a child-only plan during the next open enrollment period with no surcharge.
  • A carrier may deny coverage to an applicant for enrollment in a child-only plan if other creditable coverage is available.
  • Unless there is a change in legislation, starting in 2012 January and July open enrollment periods thereafter.

For more details and to view the bill click here.

IRS Announces That Breast Pumps and Lactation Supplies Will Qualify as Medical Care Expenses- The IRS has concluded that breast pumps and supplies that assist lactation will qualify as medical care expenses under Code Section 213(d) because they are for the purpose of affecting a structure or function of the body of the lactating woman. Therefore, these items will qualify for tax-free reimbursement from a health FSA or HRA, or for a tax-free distribution from an HSA. The announcement indicates that the IRS will revise Publication 502 (Medical and Dental Expenses) to include this new information.

 

Child-only coverage- The state of Colorado has established open enrollment periods during the month of January and July 2011 for applicant under the age of 19 who are seeking individual health coverage. A child under the age of 19 may apply for coverage on his or her own plan only during the enrollment period. The exceptions to the open enrollment rules include the following qualifying events:
  • Birth or adoption
  • Marriage or dissolution of marriage
  • Loss of employer-sponsored insurance
  • Loss of eligibility under the Colorado Medical Assistance Act or Children’s Basic Health Plan
  • Entry of a valid court order mandating that a child be covered
  • Loss of other existing coverage for any reason other than fraud, misrepresentation, or failure to pay premium

The application must be submitted with in 30 days of qualifying event. Effective date will be determined based on application submission date. For more details on each insurance company click here.

 

Small Business Tax Credit Calculator- Anthem has made available a Tax Credit Calculator to help qualifying employers receive up to a 35% tax credit on health insurance. This Tax Calculator has been developed by Anthem in partnership with tax advisor H&R Block. Determining eligibility and the amount of the potential credit is quick and easy.

 

Health Care Reform Timeline- This timeline will provide you with a snapshot of the various aspects that the health care reform will be implementing and the dates for the key provisions of the reform. Download here.

 

Regulations on Preventative Care Services- The Departments of Health and Human Services, Labor, and the Treasury issued new regulations requiring private health plans to cover evidence-based preventive services and to eliminate cost-sharing for preventive care.  For new health policies beginning on or after September 23, 2010,1 preventive services that have strong scientific evidence of their health benefits must be covered and plans can no longer charge a patient a copayment, co-insurance or deductible for these services when they are delivered by a network provider. 

 ~Full article posted on HealthCare

~Chicago Tribune Article shows that emphasis on Preventative Care no guarantee of use of benefits.

  

Grandfathered Plans- The Department of Labor’s Employee Benefits Security Administration has released the following information related to grandfathered health plans under the Affordable Care Act.

~ Fact sheet on grandfathered plans

~ NAIC Guidance On Essential Points – Grandfathering of Health Insurance Coverage

 

 Resources Page-  Click Here

 
 
 
 
 
 
 

 

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