Ritter Insurance Marketing, Craig Ritter

New Health Care Reform Provisions Going into Effect on January 1st

There are a number of provisions from the PPACA law (Health Care Reform) that will go into effect on January 1st:

  • Mandated Minimum Loss Ratios – Insurance companies will need to prove that they spend at least 80% of premiums (for Individual Health and Small Group Health Insurance) on “activities that improve care”.  NAIC has issued guidance for insurance companies on what this means, but, for the most part, these amounts are limited to payment for claims on the policy.
  • Changes to Medicare – Adds preventative benefit and 50% discount on certain Brand Name drugs in the Doughnut Hole and a 7% discount on Generic drugs in the Doughnut Hole.

The full story is covered by Insurance Broadcasting here.

Posted by filed under All, News .

  • Dan

    Thanks for the info Craig. Is there not another provision stating that “Children, up to age 26 no matter if in school or not” may be placed back on parents Health Insurance Policy? Provided that employer of said child does not offer Health Insurance?

    • Don

      Hi Dan – I can clarify that provision for you. This provision of the Affordable Care Act you are referring to was effective on September 23rd of this year. This is how the law affects you and your dependents: The health care reform law allows you to keep your children on your health plan until they turn 26 years old regardless of their student status, marital status, whether they live with their parents, or are claimed as a dependent on their parents’ tax return, as long as the dependent is not eligible to enroll in other employer provided coverage. “Children” includes natural children, legally adopted children, stepchildren, and children who are dependent on you during the waiting period before adoption. Unfortunately, grandchildren are not eligible. If the state you live in provides a higher maximum dependent age, then that requirement will continue to apply.


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