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Rules kicking in for new healthcare plans

September 22, 2010

New healthcare plans starting Thursday, Sept. 23, will be subject to several new requirements under federal healthcare reform, according to www.healthcare.gov.

Those requirements include:
-A prohibition against lifetime limits on most benefits.
-New restrictions on annual limits.
-Adult children up to age 26 will be able to remain on their parents' insurance plan.
-Certain preventive healthcare services such as mammograms and colonoscopies must be provided without charging a deductible, co-pay or coinsurance.
-A prohibition on insurance companies from rescinding coverage. This practice involved insurers search for errors or mistakes on customer applications and then using that information to deny coverage once a customer became ill.
-An appeals process for insurance company decisions on claims that can include an external review process.
-A prohibition against denying coverage for children under age 19 based on pre-existing conditions (new plans and existing group plans).

Annual limits on coverage will be phased out in 2014, but starting Thursday, plans will not be able to have an annual limit of lower than $750,000. The annual limit rises to $1.25 million a year from now and to $2 million two years from now.

For the requirement to cover adult children up to age 26, there is an exception for grandfathered group plans until 2014 that coverage does not have to be offered if the young adult is eligible for group coverage outside of their parents' plan.

For a timeline on healthcare reform regulations from www.healthcare.gov, click here.

Could healthcare costs add to employer expenses? A survey by the National Business Group on Health found employers are budgeting more for healthcare costs in 2011 than in 2010.

Employers were budgeting, on average, for a 7.0% increase in healthcare costs for 2010 and an average increase of 8.9% for 2011, according to a survey of 70 employers released in August by the National Business Group on Health.

The National Business Group on Health is a nonprofit organization that represents large employers' perspective on national health policy issues and its members are primarily Fortune 500 companies.

To go to the survey, click here.