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The big picture
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HEALTH CARE REFORM | WHAT TO EXPECT
Colorado Healthcare Associated Risk Management Annual MeetingSeptember 20, 2013
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HEALTH CARE REFORM | WHAT TO EXPECT
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On March 23, 2010, the Affordable Care Act was signed into federal law.
It’s the most significant change to our nation’s health care system since Medicare was enacted in 1965.
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HEALTH CARE REFORM | WHAT TO EXPECT
Primary purpose of legislation
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HEALTH CARE REFORM | WHAT TO EXPECT
Changes already enacted
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Expanded, no-cost preventive care
No annual or lifetime limits on essential health benefits
Kids can stay on their parents’ plan until they turn 26
Children with pre-existing conditions are covered
Grandfathered plans are exempt from many ACA requirements. As a result, people enrolled in grandfathered plans may not have coverage that reflects the changes listed above.
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Delayed — Employer shared responsibility penalty
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General updatesHEALTH CARE REFORM | WHAT TO EXPECT
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Employer exchange notice
New employees — Employers must provide the exchange notice to each new employee within 14 days of start date.
Existing employees — Employers must provide the exchange notice by October 1, 2013.
Exchange notices located at the Department of Labor website: dol.gov/ebsa/pdf/FLSAwithplans.pdf dol.gov/ebsa/pdf/FLSAwithoutplans.pdf
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Key datesHEALTH CARE REFORM | WHAT TO EXPECT
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HEALTH CARE REFORM | WHAT TO EXPECT
Top 3 things you should know
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Coverage is guaranteed for people, even if they have pre-existing conditions
Most people must buy coverage
Federal financial assistance is available
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HEALTH CARE REFORM | WHAT TO EXPECT
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Known as guaranteed availability Can’t be denied based on medical condition No medical exam required Preventive care included at no cost*
* Grandfathered plans for individuals (those that were in effect on or before March 23, 2010) may not include all preventive services at no cost.
Coverage is guaranteed1
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HEALTH CARE REFORM | WHAT TO EXPECT
Coverage options
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Most people must buy coverage2
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HEALTH CARE REFORM | WHAT TO EXPECT
Enrolling through the individual marketplace
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Most people must buy coverage2
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HEALTH CARE REFORM | WHAT TO EXPECT
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You have help in the marketplace
Most people must buy coverage2
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Individual exchanges
Behind the scenes:
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* If consumer is eligible for subsidies
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HEALTH CARE REFORM | WHAT TO EXPECT
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Available federal financial assistance helps lower-income families afford health care coverage
Financial assistance through the marketplace3
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Connect for Health Colorado (connectforhealthCO.com)
Let’s take a look…
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Health plans participating in the SHOP
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HEALTH CARE REFORM | WHAT TO EXPECT
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HEALTH CARE REFORM | WHAT TO EXPECT
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HEALTH CARE REFORM | WHAT TO EXPECT
Supporting members and our communities
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