Although many of the provisions of health care reform remain uncertain, and others don’t go into effect until as late as 2018, employers need to begin planning now to ensure they are aware of all deadlines and can take steps to meet them.
“Health care reform will have a significant impact on employers, their health plans and related administration, both in the short term and for years to come,” says John Boss III, Executive Vice President and Health & Benefits Practice Leader at Aon Risk Services. “Much of the plan hasn’t been finalized, making it difficult for employers to make final decisions on certain issues. But employers need to understand the many changes that the health care reform law makes to their employee benefits program so they can begin to take the proper steps to comply.”
Smart Business spoke with Boss about how the coming changes may impact your benefits plan and the steps you can take to ease the transition.
What are some key changes in health care that employers should be aware of?
A major change is that health plans that provide for coverage of adult children will have to permit continued coverage of those children until age 26 if they are not eligible for other employer-sponsored health coverage. Employers will have to establish a process to add them to the plan with plan years beginning on or after Sept. 23, 2010. The full-time student requirements will no longer apply, and the law does not exclude married children. In addition, employers with more than 200 employees must establish procedures to automatically enroll employees into health insurance plans and provide opt-out rights. Automatic enrollment applies only to new hires, and waiting periods for new enrollees cannot exceed 90 days. Currently enrolled employees would remain enrolled unless they opt out.
Also, health plans may no longer impose lifetime maximums on the dollar value of benefits, effective for plan years beginning on Sept. 23, 2010, or later. Annual limits on the dollar value of benefits will also be prohibited beginning in 2014, subject to approval of the Secretary of Health and Human Services. Lifetime limits also cannot be imposed on the overall plan benefits.
Finally, plans must provide certain preventive care without participant cost-sharing requirements and may not impose pre-existing conditions exclusions for plan years beginning on or after Jan. 1, 2014.
There are many other changes to the way health care plans will be administered, but final guidance remains to be issued on them.
