Wednesday, April 7, 2010

9 big changes to look for from Health Reform

Many folks have been asking, "What has changed now that Obama has signed the bill"?  Well to be honest, not much... so far.  We just had a conference last Thursday on what we, as agents can expect to see change now, this year, and 4 years to come.  Here is a list of what to expect in chronological order.

1.  National risk-pool will be created 90 days from enactment- this is the pool that is created that will add to the state level risk pools already in place.  It allows people who can not attain insurance, a pool to enroll into and gain coverage.  This should be a temporary fix for now that will allow more to get insurance until the major changes in 2013 or 2014 take place.

October 1, 2010
2.  Prohibits lifetime benefits limits- you will see all health insurance carriers prohibited from using lifetime benefits limits.  Most carriers rarely see this limit reached but some carriers who are not able to negotiate rates with doctors and hospitals and issue guaranteed policies will be affected.

3.  Dependant coverage up to age 26 is mandated- Coverage for dependents is extended to help young  people to retain their parents coverage.  Although it is not free, this will help those young dependents who have not yet attained health coverage from employers.

4.  Internet portal to facilitate consumer and small employer shopping- I find this addition very interesting because this levels the playing field for all the insurance companies.  I don't know how efficiently this will be implemented by October, but this will make a big difference.

5.  Pre-existing condition exclusions for dependant children (under 19 years of age) are prohibited- Anyone older than 19 will have to wait until 2014.  So those policies issued with riders or exclusions on children 19 or under will be cleared as of October.

As you can see most of these changes will only affect the insurance companies.  The changes you see here actually help the client, you, more than anything.

January 1 2014

6.  Health insurance exchange is established- this give individuals, families and small employers a chance to shop the competition as well as give them a public health option.

7.  Policies will be guarantee issue- no more denying coverage.  Again this is great for the client but bad for the company.  In the long run it will raise prices.

8.  Now we see Pre-existing conditions exclusions prohibited- for all ages.  Again I don't like the idea of what will happen to prices.

9.  Multi-state qualified health plans are created and offered through the Exchange- I like this change because it reaches across state boundaries.  This should have been done a long time ago.  This creates competition for insurance companies which means better prices for clients.  We will also see the government mandate that health plans develop and file new health rates.

And there you have it.  These are the most profound changes but the whole health insurance industry as a whole has been turned on its head.  This wasn't health care reform, it was health insurance reform.  The issues with the hospital services is not well addressed in this bill.  I don't know why the insurance companies were made out to be villains, other than they believed they have monopolistic traits.  Anyhow we see many major changes coming all that I have mentioned to this point may be reordered in the timeline.

Remember, we the agents may not have all the answers, but we do have the tools to find them.

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