The Road to Reform

The Road to Reform
From United Health Care


At UnitedHealthcare, our goal is to help people live healthier lives

How? Providing innovative and affordable choices in the health benefit plans we offer. Focusing on the quality of service we deliver. And, making health benefit plans easy to
understand and simple to administer. The Patient Protection and Affordable Care Act of 2010 (the Act) brings significant and sweeping changes to how Americans access and pay for health care. And while change is good, it can be challenging. We are navigating these changes together. Changes in federal law are just one way to move toward a more modern health care delivery system. UnitedHealthcare is at the forefront of improving access to quality care, containing costs, using technology to increase transparency, and changing the way the system pays for care. We understand that when physicians, insurance companies, employers, consumers and government bring their best ideas to the table, we can help improve access to quality and affordable care.

The Big Picture

The Act is being rolled out in phases between 2010-2019. Generally, the provisions fall into one of these areas:

  • Standards for minimum health benefit plan offerings
  • State-based Health Benefit Exchanges
  • Mandates for employers and individuals to provide or purchase health care coverage
  • Subsidies to individuals to purchase coverage
  • Requirements that insurance companies spend a certain percentage of premium dollars on patient care
  • Insurance market reforms
  • Expanded appeal rights for patients
  • Expanded Medicaid eligibility
  • Changes to Medicare reimbursement The Road to Reform


Keeping Your Grandfathered Plan

If you decided to “grandfather” your health benefit plan, some of the health reform changes won’t apply. Grandfathering a plan means that you decided to keep the plan that you had in effect on March 23, 2010, with only minimal changes. Going forward, only approved changes can be or will be made to a grandfathered plan. However, there are a few changes that apply to all plans
whether or not you have a grandfathered plan.

Remember, employers will need to stay on top of any reporting obligations that may be required to maintain grandfathered status. In general, plan changes that can cause loss of grandfathered status include: eliminating certain benefits, increasing coinsurance, increasing fixed dollar cost-sharing (copays, deductibles and out-of-pocket limits) beyond allowed amounts, and the plan sponsor’s decrease in its contributions toward the cost of coverage by more than 5 percent. So if you have chosen to maintain grandfathered status, keep in touch with your broker or account representative to be aware of any changes that could affect that status.

Click to read full article

One comment

  1. Was originally investigating this actual stuff through the use of google when i stumbled with your web-site. A large amount brilliant articles on right here. Unquestionably just one for my favs. Lance

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>