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Federal Health Care Reform Update,  9/23/10

The following key provisions of the Affordable Care Act become law today, and take effect at a group health plan's next renewal.  For the State Health Plan ("Plan"), these provisions will go into effect on the renewal date of July 1, 2011:

  • Plans can no longer require pre-existing condition waiting periods for children under age 19.
  • Plans must allow adult dependent children up to age 26 – who are not eligible for employer-sponsored health benefits -- to remain on the Plan, regardless of student or marital status.
  • Only new plans must provide coverage of preventive care without copayments. (Note: This does not apply to existing group plans.)

The State Health Plan is currently in compliance with the following provisions that go into effect today, September 23, 2010:

  • Plans are not allowed to drop sick and/or costly customers due to technical mistakes on applications.
  • Plans cannot have lifetime limits on essential benefits.
  • Plans must make available an external appeals process.
  • Plans must not require prior authorization for emergency services.

For more information on the Affordable Care Act, visit www.HealthCare.gov.

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