By Bryan C. Keathley 10/29/2010
The overwhelming sum of opinions and information about healthcare reform has everyone asking “how is this going to affect me?” or as an employer, “how is this going to affect my employee benefits cost?” This buzz is creating a struggle in all of us. Do we need to act now – what don’t I know that maybe I should know?
Our advice: There is no reason to panic or make significant changes to your current insurance situation because everything will be in a state of flux until the main changes take effect in 2014. There is no need to try to read all the details in the proposed plans because significant changes are likely. However, here are three main reasons that you need to be aware of now as to why new employer group plans and new individual health plans are becoming more expensive. Here are three Heathcare Reform mandates and their affect on insurance costs –
1. Unlimited Coverage means unlimited liability – Starting Oct. 1, all new policies must provide unlimited lifetime benefits (they were typically limited to five million dollars) so insurance companies cannot measure their risk and must raise prices to cover this unlimited liability.
2. No waiting periods for pre-existing conditions for children 19 and under plus any dependent child can be added to an employer’s group policy up to the age of 26. There is an abundance of uninsured children in TX because it cost so much to add them to an employee’s group coverage. Consequently, insurance companies are very concerned that employees will wait until their children have expensive medical needs due to a severe accident, maternity or a newly contracted disease and then add them to the group plans without the previous waiting periods. Hence –
3. 100% of preventative procedure costs must be covered without co-pays or deductibles. The insurance companies used to be able to make a list of what was deemed preventative procedures and price their policies accordingly. Now the government is in the process of creating a list of procedures they want to be covered 100%. (google USPSTF to see how vague the government is on this list) Some believe that insurance companies are concerned that doctors will take advantage of this situation and order extra “preventative” tests and the public will gladly take these additional tests since there is no cost