Delicious! U.S. Unveils Letters Insurers Must Send About Health Plans
http://www.nytimes.com/2013/11/22/us/politics/us-unveils-letters-insurers-must-send-about-health-plans.html?_r=0
WASHINGTON — President Obama said last week that the Affordable Care Act would not stop Americans from keeping their health insurance plans, even if those plans did not meet minimum standards set by the health care law. But he did not promise to say nice things about them. On Thursday, the federal government unveiled
sample letters that insurance companies will be required to send to anyone seeking to renew one of those policies.
The letters are blunt, declaring that the insurance that is about to be renewed “will NOT provide all of the rights and protections of the health care law.” Renewal letters sent by insurance companies will have to list all the deficiencies in the policy. The letters, among other things, will have to warn that policies might not:
¶Meet standards for premiums, allowing companies to charge more based on factors like gender or a pre-existing condition.
¶Guarantee the policy’s renewal.
¶Prevent discrimination based on a customer’s health status.
¶Cover essential health benefits or limit annual out-of-pocket spending.
The letters must also make it clear that consumers can still voluntarily switch to a plan offered by the new federal or state insurance marketplaces. “The Marketplace allows you to choose a private plan that fits your budget and health care needs,” the letters will have to say. “You may also qualify for tax credits or other financial assistance to help you afford health insurance coverage through the Marketplace.”
This is beautiful. From a sample letter ....
http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/standard-notice-bulletin-11-21-2013.pdf
Dear Policyholder,
...
If you choose to renew your current policy, it will NOT provide all of the rights and protections of the health care law. These include one or more of the following new protections of the Public Health Service Act (PHS Act) that were added by the health care law and that take effect for coverage beginning in 2014. As a result, your coverage:
• May not meet standards for fair health insurance premiums, so it can charge more based on factors such as gender or a pre-existing condition, and it doesn’t have to comply with rules limiting the ability to charge older people more than younger people (section 2701).
• May not meet standards for guaranteed availability, so it can exclude customers based on factors such as a pre-existing condition (section 2702).
• May not meet standards for guaranteed renewability (section 2703).
• May not meet standards related to pre-existing conditions for adults, so it can exclude coverage for treatment of an adult’s pre-existing condition (section 2704).
• May not meet standards related to discrimination based on health status (section 2705).
• May not meet standards for non-discrimination in providers (section 2706).
• May not cover essential health benefits or limit annual out-of-pocket spending, so it may not cover benefits like prescription drugs.
= new reply since forum marked as read
.html][IMG]
[/IMG][/URL]
