From The Segal Company:

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. On March 30, 2010, the President signed into law the Health Care and Education Reconciliation Act, which contains a package of significant amendments to the PPACA.

The centerpieces of health care reform - the individual mandate, subsidies, Health Insurance Exchanges and the employer free rider penalty - are all effective in 2014. However, important changes to plan benefit design rules, certain tax rules and the Medicare program are effective either in the near future or over the next four years.

The Segal Company has put together a Bulletin that contains a brief summary
of the PPACA's key provisions as amended by the HCERA. To read Segal’s Bulletin online, click here . You can download a PDF version by clicking here.

Dependent Coverage
The new health care reform law contains a provision requiring group health plans that provide dependent coverage for children to continue to make such coverage available for an adult child until the child turns 26 years of age.This requirement applies to group health plans in existence when the law was enacted.

Additionally, a separate new tax code provision allows a group health plan to provide health coverage on a tax-free basis to any child of the plan participant through the end of the calendar year in which the child turns 26.

To learn more about the implications of these new provisions, click here.

The House of Representatives’ vote to pass a Senate version of health care reform will lead to a dramatic change for many Americans, even some union members covered by one of the funds in New England.

The following information is provided by The Segal Company, a consulting company that works with benefit funds throughout the country, including carpenter union funds in New England. For even more information, visit this page.

Significant portions of the bill will not take effect right away—and some may still be modified—but there are some important changes that will benefit members and go into effect within the next year, such as:

• No lifetime benefit limits and only limited annual benefit limits
• Coverage for dependent children up to age 26, as long as they do not have access to other employer-sponsored health coverage (the reconciliation bill also assures that this coverage can be provided on a tax-free basis)
• No preexisting conditions for children under age 19
• No rescission of health coverage, except in cases of fraud (primarily an individual insurance policy issue)

Other items that are immediately effective include a Medicare Part D provision that provides that beneficiaries who are in a Prescription Drug Plan and who reach the doughnut hole in 2010 would receive a one-time $250 rebate, as well as a reinsurance program for pre-Medicare retirees (discussed below)

Additional reforms would be effective for plan years beginning on or after January 1, 2014, including a ban on waiting periods over 90 days.

In 2011, Health Flexible Spending Arrangements, Health Reimbursement Arrangements, and Health Savings Accounts can only reimburse participants for over-the-counter drugs with a prescription written by their health care provider.

From the Hill...

Organized labor is flexing its muscle in Senate negotiations over healthcare reform and winning important concessions from Senate Majority Leader Harry Reid (D-Nev.).

Reid has not given labor unions everything. But he has done enough to keep them from turning completely against the bill: including a version of the government-run health insurance program; raising the taxable level on high-cost insurance plans; and increasing the penalty for those companies that fail to provide health insurance to employees.

Keeping labor unions, a reliable Democratic-base group, on his side is an important accomplishment for Reid as he heads into a multi-week floor debate on the party’s biggest legislative priority. If unions were provoked to oppose the bill’s central provisions, it could tear apart the Senate Democratic Conference, pitting liberals against centrists.

Labor unions have put heavy pressure on Reid and other Senate Democrats to move away from the more centrist Senate Finance Committee bill and move closer to legislation approved by the Senate Health, Education, Labor and Pensions (HELP) Committee.