Since the ACA mandates health insurance coverage for smaller businesses, it’s important for these employers to consider and evaluate the predicted effects of this landmark legislation. This brief summary of some major provisions of healthcare reform programs is brought to you by Sackett & Associates Insurance Services, serving Sonoma County, California for over 30 years. Here are some more important changes.
- Small groups must receive “essential health benefits.”
- All health insurance plans (except catastrophic coverage) must cover at least 60 percent of “average” healthcare costs.
- Caps on out-of-pocket expenses, including co-pays and deductibles, apply to all new healthcare plans.
- Eligibility waiting periods, often up to six months or longer, have a maximum of 60 days in California.
- All healthcare providers must include all of their licensed services. Providers cannot exclude some services if they are licensed to offer them.