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Date: 01/04/2020
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HCR Blog Launch

I'm very pleased to be launching our new blog to facilitate the exchange of info, ideas and opinions focused on a new era in health care and health insurance with dramatic change being fueled by Patient Protection and Affordable Care Act Health Care Reform, PPACA. Thank you for visiting and your comments are always welcomed and encouraged!
We can now see the tip of the iceberg as the initial changes begin to take effect. We spend a good bit of time reminding people that the big changes come in 2014. For the most part officials in the current administration are downplaying the cost and projections of cost associated with reform. I have to say I agree with statements made by industry leaders that when you add benefits into health plans, the cost of coverage goes up. Near-term provisions to accommodate immediate regulations are being estimated to cost an additional 1.5%. All the initiatives appear to be well intended, but it appears to us that we're going to pay more, one way or another, to increase access to care and enhance benefits. Please don't misunderstand me, I want more benefits, more quality and I want to pay less for it too! However, I feel we are expanding the health care system without addressing systemic cost issues. In other words, we are doing too much too quickly and I believe we will pay dearly for it.
We have been working diligently for years to help employers and their employees manage the rising cost of health insurance. We were very much in favor of improving the health care and insurance systems to benefit our country's ability to have access to affordable health care. Unfortunately, the affordability initiatives appear to be missing from the overall health care reform effort. Our nation is now divided on the new rules and regulations that were supposed to be designed to help us have access to affordable care. My clients want to know why cost containment is not part of the results we see so far. What we do have for all plans with plan years effective on or after September 23, 2010, at an additional cost above medical inflation is the following benefit and eligibility enhancements, estimated to be about 1.5%:

  • No lifetime dollar limits
  • No annual dollar limits, except as permitted by HHS
  • No pre-existing condition exclusions for anyone under age 19
  • Dependents can be covered to age 26, regardless of marital status, tax dependent status, student status and whether or not they reside with or get financial support from parents

Grandfathered plans are not required to comply with the following and therefore can choose to avoid increased benefits cost as long as grandfathered status is maintained:

  • First dollar coverage of preventive care benefits
  • Provide coverage to adult dependents age 18-26 who have access to their own employer sponsored coverage
  • Prohibitions of discrimination in favor of highly compensated individuals in group plans (IRC Section 105 (h)), this was previously applied only to self-funded plans


Welcome to the complexities of health care reform!