Prepare for Health-Care Changes

Several key provisions of the health-care reform law will go into effect this year.

March 11, 2011

Several key provisions of the health-care reform law will go into effect this year, affecting both employers and private insurers, says Brad Pricer, senior manager of employee benefits product management for CUNA Mutual Group, Madison, Wis.

Among the provisions slated for 2011 are:

  • Raised premiums for higher-income Medicare beneficiaries;
  • Subsidies and drug discounts to help close the Medicare Coverage gap;
  • Grants to help states launch the Health Insurance Exchanges; and
  • The establishment of national minimum medical loss ratios for health plans.

This will require health plans to report the proportion of premium dollars spent on medical services, Pricer explains, and provide rebates to consumers if the share of the premium spent on medical services is less than a federally mandated standard.

On Jan. 19, the House voted to repeal health-care reform legislation, although the Senate didn’t follow suit.

Republicans, however, could try to dismantle this law using other means.

Other changes involve the Children’s Health Insurance Program (CHIP) Reauthorization Act, Pricer adds.

This specifies that employers must provide annual notification to employees that they may qualify for premium assistance if their state provides premium assistance subsidies for Medicaid or CHIP plans.

Employers that fail to issue these notices are subject to penalties of up to $100 per day, per employee.