Limited medical plans

September 24, 2010

Employers that offer their employees limited medical plans are impacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, since they are considered group health insurance plans.

Q. I won't be able to afford the new premiums on the limited medical plan that I offer my employees. Is there anything I can do with all the recent changes affecting these plans?

A: Employers that offer their employees limited medical plans are impacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, since they are considered group health insurance plans. The limited medical plans will have to meet the legislative requirements that took effect September 23, such as eliminating the annual and lifetime limit on benefits to employees, forcing many carriers to increase premiums.

There may be a brief reprieve, however, for practices that offer their employees limited medical plans. The Department of Health and Human Services (HHS) released additional guidance on the waiver process on September 3. HHS will give the insurance carriers the ability to apply for a 1-year waiver from the annual limits if they can demonstrate why the implementation of regulations "would result in a significant decrease in access to benefits for those currently covered by such plans or policies, or significant increase in premiums paid by those covered by such plans or policies, along with any supporting documentation." These waivers will apply to the upcoming plan year and the carriers will have to resubmit applications for subsequent years. You may be able to find a carrier that has applied for a waiver.

Answer provided by Bonnie Hauck Evelyn, CBIZ Employee Services, Boca Raton, Florida. Send your practice management questions to medec@advanstar.com

x