Archive for the ‘requirements’ Category

Premium changes

The legislation instructs state exchanges to require insurance carriers seeking certification as qualified health plans to submit a justification for any premium increase prior to implementation of the increase. The exchange is then required to take the information into consideration when determining...
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Penalty for use of Health Savings Account Funds for withdrawal goes from 10 to 20

Penalty for use of Health Savings Account Funds for withdrawal goes from 10 to 20% Source: NAHU
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Deduction limitation on taxable year remuneration to certain jobs

$500,000 deduction limitation on taxable year remuneration to officers, employees, directors, and service providers of covered health insurance providers. Source: Kaiser Family Foundation
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Tobacco Cessation for Pregnant Women

Require coverage of tobacco cessation programs for pregnant women under Medicaid free of cost-sharing. Effective October 1, 2010. Source: The Common Wealth Fund
July 9th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, requirements | Read More

Annual Review of Premium Increases

In 2010, effective immeadiately, the HHS secretary and states will establish a process for annual review of unreasonable premium increases. Health insurers will be required to submit to the secretary and the relevant state a justification for an unreasonable increase prior to implementation of the increase....
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Limits on Share of Private Premiums Insurers Spend on Non-Medical Costs

New limits will be set for the percent of premiums that insurers can spend on non-medical costs. Beginning in 2010, health plans are required to report the proportion of premiums spent on items other than medical care. Beginning in 2011, health plans in the large group market that spend less than 85...
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Prohibition Against Rescissions

Group health plans or insurance companies providing group or individual market coverage are prohibited from rescinding coverage once an enrolled is covered under a plan, except in the case of an individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation...
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Prohibition on Preexisting Condition Exclusions for children

 Insurers are prohibited from excluding coverage of preexisting conditions for children in the individual market, effective six months after enactment. Source: The Common Wealth Fund
July 9th, 2010 | National Health Care Reform Legislation, Uncategorized, insurance, requirements | Read More

States required to create “Exchanges”

Requires each state to create an Exchange to facilitate the sale of qualified benefit plans to individuals, including the federally administered multi-state plans and non-profit co-operative plans. A catastrophic only policy would be available for those 30 and younger. In addition the states must create...
July 7th, 2010 | National Health Care Reform Legislation, Uncategorized, new programs, requirements | Read More

Changes requiring states to offer more assistance to Medicaid

Requires states to offer premium assistance and Medicaid wrap-around benefits to Medicaid beneficiaries who are offered employer-sponsored coverage if cost-effective to do so, under terms outlined already in current law. Source:NAHU
July 6th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, Uncategorized, requirements | Read More

Mandates healthcare purchase

Requires all American citizens and legal residents to purchase qualified health insurance coverage. Exceptions are provided for religious objectors, individuals not lawfully present and incarcerated, those who cannot afford coverage, taxpayers with income under 100 percent of poverty, members of Indian...
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Small group coverage redefined

Redefines small group coverage as 1-100 employees. States may also elect to reduce this number to 50 for plan years prior to January 1, 2016. Source: NAHU
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Waiting periods limited

Waiting periods in excess of 90 days are prohibited for all plans, including grandfathered plans. Source: NAHU
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Employers with 50+ employees must offer coverage

An employer does not have to offer coverage, but if they do not offer qualified coverage and employ more than 50 full-time equivalent employees (with an exception for seasonal workers) and one or more employees receives a premium assistance tax credit to buy coverage through an exchange, the employer...
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Employers must provide free choice vouchers

An employer that provides and contributes to health coverage for employees must provide free choice vouchers to each employee who is required to contribute between 8% and 9.8% of the employee’s household income toward the cost of coverage, if such employee’s household income is less than 400% of...
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More

Health plans required to provide coverage documentation

Health plans, including self-insured employer plans and public programs, must also provide coverage documentation to both covered individuals and the IRS. Source: NAHU
July 6th, 2010 | National Health Care Reform Legislation, Uncategorized, requirements | Read More
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