My quest for information appears to be a very long one as I attempt to read the Affordable Care Act in its entirety. I do this on an especially cold dreary Sunday morning. Leaves are dropping off the trees here faster than honeybees gather in a field of lavender flowers. Thankfully we didn't get the three feet of snow South Dakota did yesterday.
Onto the task...
A friend of ours posted this article today and I think it's worthy of reposting in this blog. PolitiFact has demystified some continuing rumors swirling around the Obamacare. Check it out.
http://www.tampabay.com/news/politics/national/politifact-the-top-15-myths-about-obamacare/2144026
Now back to the Affordable Care Act discussion. Here is the link to the first post if you want to catch up.
http://managingforward.blogspot.com/2013/10/healthcare-act-simplified-oh-yeah.html
Sec 1101 This section is very long. It discusses creating a temporary high risk pool for the uninsured and how it is funded. If an employer is found to have persuaded a high risk employee to not participate in the employer provided insurance, the employer may have to reimburse the state 65% of the premiums for the state coverage of that individual. In other words, all you employees need to have coverage, not just a select few.
Sec 1102 Temporary reimbursements to employers will be made for keeping early retirees (not eligible for medicare) on their insurance plans. This ends January 2014.
Sec 1104 Health plans will need to be able to prove compliance by 2015 and ensure their proprietary operating systems meet the intent of this law. This section sets operating and reporting standards for the industry.
Sec 2704 A health plan may not impose pre-existing condition exclusion.
Sec 2701 May not impose unfair health insurance premiums.
Sec 2702 Insurance companies must accept every employer and individual that applies for coverage.
Sec 2703 Guaranteed renewability. Insurance plans "may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
‘‘(1) Health status.
‘‘(2) Medical condition (including both physical and mental illnesses).
‘‘(3) Claims experience.
‘‘(4) Receipt of health care.
‘‘(5) Medical history.
‘‘(6) Genetic information.
‘‘(7) Evidence of insurability (including conditions arising
out of acts of domestic violence). ‘‘(8) Disability.
‘‘(9) Any other health status-related factor determined appropriate by the Secretary."
Sec 2705 Any conditions set for a rebate on a premium or lower premium needs to be offered to all.
Participation in wellness programs can result in a discounted premium however an individuals health status cannot be a requirement for that discount. The wellness program will be designed to promote health or reduce disease. The wellness program cannot set unreasonable standards to be attained.
Sec 2706 The insurance companies can contract with health care providers and may set quality and performance measures.
Sec 2707 Comprehensive health insurance will minimally include what is defined in the Affordable Care Act. Insurance companies may provide more but must at minimum include what is required by the law.
Sec 2708 An insurer cannot impose more than a 90 day waiting period before an individual can use the health insurance coverage.
Sec 1251 Everyone maintains the right to continue their current health insurance coverage.
Sec 1252 In a given state, all new standards and reforms will apply evenly to all health plans.
Stay tuned to my next blog and have a great Sunday!
"By perseverance the snail reached the ark" or in this case the turtle! Charles Spurgeon
‘‘(2) Medical condition (including both physical and mental illnesses).
‘‘(3) Claims experience.
‘‘(4) Receipt of health care.
‘‘(5) Medical history.
‘‘(6) Genetic information.
‘‘(7) Evidence of insurability (including conditions arising
out of acts of domestic violence). ‘‘(8) Disability.
‘‘(9) Any other health status-related factor determined appropriate by the Secretary."
Sec 2705 Any conditions set for a rebate on a premium or lower premium needs to be offered to all.
Participation in wellness programs can result in a discounted premium however an individuals health status cannot be a requirement for that discount. The wellness program will be designed to promote health or reduce disease. The wellness program cannot set unreasonable standards to be attained.
Sec 2706 The insurance companies can contract with health care providers and may set quality and performance measures.
Sec 2707 Comprehensive health insurance will minimally include what is defined in the Affordable Care Act. Insurance companies may provide more but must at minimum include what is required by the law.
Sec 2708 An insurer cannot impose more than a 90 day waiting period before an individual can use the health insurance coverage.
Sec 1251 Everyone maintains the right to continue their current health insurance coverage.
Sec 1252 In a given state, all new standards and reforms will apply evenly to all health plans.
Stay tuned to my next blog and have a great Sunday!
"By perseverance the snail reached the ark" or in this case the turtle! Charles Spurgeon
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