Today marks a new beginning for many plans as they enter their new plan years. September 23, 2010 has been engrained in the mind of plans and TPAs alike as coverage that starts today (or any day after which plan coverage renews) will have to comply with the new healthcare reform changes.

A brief outline of a few of the changes includes:

(1) Lifetime or annual coverage limits;

(2) Extension of dependent coverage;

(3) Coverage rescission prohibited;

(4) Coverage for preventive health services mandates;

(5) Patient protections mandates;

(6) Appeals process mandates;

(7) Cost ratio requirements; and

(8) Pre-existing condition exclusion prohibitions.

Some plans (i.e. grandfathered plans) will be exempt from certain requirements. For example, grandfathered plans are exempt from the preventive services, patient protections, and claim appeals mandates.

With the intention of improving coverage quality, changes will continually go into effect with some of the biggest provisions taking effect in 2014. Until then, and over the next few years, the laws will develop and hopefully clarifications will be issued.

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This entry was posted by Adam V. Russo on Thursday, September 23rd, 2010 at 3:55 pm and is filed under Health Care Legislation, News. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.