What the new Federal Healthcare bill means to you

Individual and Family policies and Medicare

There is a great deal of confusion surrounding the Health Care Reform Bill of 2010. There is still a great deal to be sorted out. However, there are several changes that are definitely going into effect. For the purposes of this article we will outline the elements that will assuredly change.

  1. Guaranteed coverage for people with pre-existing conditions. Effective July 1, 2010
  2. Plans are prohibited from putting lifetime limits on medical coverage. Insurance companies will be barred from putting caps on your treatment if you get ill. Effective September 23, 2010.
  3. Insurance companies cannot cancel policies if you get sick. Effective September 23, 2010.
  4. Children with preexisting conditions cannot be denied coverage. Effective September 23, 2010.
  5. Dependent children up to age 26 can stay on parents plan. Effective September 23, 2010.
  6. New policies must cover immunizations, screenings and other forms of preventative care for free. Effective, September 23, 2010.
  7. The Federal Government will rebate $250 for Medicare patients who spent enough on drugs to reach the doughnut hole.2010
  8. Insurance companies must offer a client rebates if they spend less than 80-85% of their premium income on medical costs. 2011
  9. Drug manufacturers must give 50% discounts on brand name drugs to Medicare patients who reach the doughnut hole. 2011
  10. You must have health insurance. If you do not have health insurance you will face a penalty. This rule takes effect 2014. For 2014 the penalty will be $95 or 1% of income whichever is greater, The Internal Revenue Service will be charged with policing the policy. If you are getting health insurance through your employer there are no changes.
  11. Medicaid to be expanded to help people who cannot afford insurance. Effective 2014. Households with income up to 133 percent of the federal poverty level, or about $29,327 for a family of four would be eligible.
  12. If you lose your job you would automatically qualify to participate in one of the State exchanges. 2014
  13. No waiting time for qualifying for a policy if you have a preexisting condition
  14. People who do not get insurance from their employers will have the option of using insurance exchanges in 2014. People with incomes of more than 133 percent of the poverty level but less than 400 percent (that's $29,327 to $88,200 for a family of four) would be eligible for premium subsidies through the exchanges.
  15. Medicare prescription "doughnut hole" will be eliminated by 2020.

If you have any other questions about the effects of the Health Care Bill feel free to call Murray Insurance or contact us by email.

Group Health or Insurance for Businesses

  1. 2010-2014 Business tax credits- Businesses with 10 or fewer full-time-equivalent employees earning less than $25,000 a year on average will be eligible for a tax credit of 35% of health insurance costs. (Companies with between 11 and 25 workers and an average wage of up to $50,000 are eligible for partial credits.)
  2. 2010- Employer provided insurance for retirees ages 55-64. The government will set aside $5 billion to help sustain coverage of this group. Program ends in 2014 when guaranteed insurance begins.
  3. 2014-Insurers will no longer be able to set rates or exclude coverage based on pre-existing conditions, and can vary premiums only by geographic location, age, and tobacco use.
  4. 2010- Insurers will no longer be able to have lifetime limits on coverage and on "rescission" (canceling policies already issued) except in cases of fraud.
  5. 2014-Businesses with more than 50 employees will be required to either offer healthcare coverage or pay a penalty of $750 a year per full-time worker. The coverage offered will also have to meet minimum benefits -- covering both a specific set of services and 60% of employee health costs overall -- or else employers will face additional penalties.
  6. 2014-Plans costing more than $10,200 a year (also known as "Cadillac Plans") for individuals or $27,500 for family coverage (not counting dental and vision plans) will be subject to a 40% tax on the portion of the cost that exceeds the limit. Though the tax would actually be paid by insurers, it's expected that it would be passed along to plan holders in the form of higher premiums.
  7. 2014- States will have to set up Small Business Health Options Programs, or "SHOP Exchanges," where small businesses will be able to pool together to buy insurance. ("Small businesses" are defined as those with no more than 100 employees, though states have the option of limiting pools to companies with 50 or fewer employees through 2016; companies that grow beyond the size limit will also be grandfathered in.)

If you have any other questions about the effects of the Health Care Bill on your business,feel free to call Murray Insurance or contact us by email.