Health Insurance for Autism Spectrum Disorders in Nebraska

Size: px
Start display at page:

Download "Health Insurance for Autism Spectrum Disorders in Nebraska"

Transcription

1 Health Insurance for Autism Spectrum Disorders in Nebraska What Parents and Service Providers Need to Know about the Nebraska Autism Insurance Law Mike Wasmer Director, State Government Affairs Autism Speaks September 25, 2014

2 Thank You! Senator Colby Coash Parents and providers Autism Action Partnership Autism Center of Nebraska Autism Family Network Autism Society of Nebraska American Communications Group UNMC/Munroe-Meyer Institute

3 Goals Review details of LB 254 Gain a basic understanding of health insurance plan types Understand how coverage for autism is affected by plan type - State regulated - Self funded - Medicaid - Tricare - NE Marketplace plans

4

5 but, am I covered??

6 Who is covered by LB 254? state law can only mandate coverage for fully insured health plans approximately 30% of health plans in the U.S. are fully insured State mandates cannot help all policyholders

7 Sources of Health Insurance Coverage in the U.S. (age 0-18) uninsured 9% TRICARE 2% self-funded 31% Medicaid 32% individual 4% fully insured large group 17% fully insured small group 5%

8 State Regulated Karen Dan LB 254

9 Plans affected by LB 254 fully insured large group market - large 51 employees - grandfathered (purchased before March 23, 2010) fully insured small group market - small = 2-50 employees - grandfathered (purchased before March 23, 2010) individual plans

10 Covered Services Diagnosis Pharmacy Care Psychiatric Care Psychological Care Applied Behavior Analysis (ABA) and other behavioral health treatments Speech, Occupational and Physical Therapy

11 Terms of Coverage limited to individuals under age 21 Behavioral health treatments - e.g., ABA - up to 25 hours/week no cap on other services

12 ABA provider qualifications LB 254 requires coverage for ABA for individuals with autism when provided or supervised, either in person or by telehealth, - by a behavior analyst certified by a national certifying organization - or a licensed psychologist if the services performed are within the boundaries of the psychologist's competency. proposed Medicaid guidance??

13

14 Self Funded Health Benefit Plans and Autism What can I do if my health insurance plan is not impacted by LB 254?

15 Self Funded (ERISA) not impacted by LB 254 but we can help! LB 254

16 Fully Insured Plans consumer employer group insurance contract medical provider

17 Individual Plans consumer individual insurance plan medical provider

18 Self-Funded Plans self = the employer third party administrator (TPA) or ASO consumer employer medical provider

19 How can you tell? Homer Simpson Homer Simpson employer-sponsored fully insured vs employer-sponsored self-funded

20 How can you tell? May not be clear from your insurance card Many employers who self-fund health benefit plans use an insurance company as a third party administrator (TPA) or administrative services only (ASO) Read the Summary Plan Description Contact your HR department U.S. Department of Labor, Employee Benefits Security Administration:

21 An online interactive application Is an individual eligible for coverage for the treatment autism under their existing plan? Short series of questions Options and Advocacy Resources

22 Why Plan Type is Important Self funded health benefit plans are federally regulated - ERISA establishes baseline benefits - exempt from state laws - currently there is no federal requirement to cover treatment for autism - file complaints with U.S. Department of Labor Fully insured and individual plans are state regulated - 37 states have enacted legislation that requires coverage for treatment of autism that includes ABA - State law may exempt some plan types - file complaints with State Department of Insurance

23 ABA and Self Funded Health Benefit Plans Although ABA for autism is not currently required to be covered under ERISA, it is not precluded from being covered An employer can request that the benefit be added 36% of large companies (>500 employees) cover ABA for autism

24

25 Autism Speaks website: advocacy/insurance

26 Request a meeting Head of Human Resources Company Executive Autism Speaks representative will join you if requested

27

28 The NE Marketplace and Autism LB 254 How has the Affordable Care Act impacted the autism community in Nebraska?

29 Impact of ACA on the Autism Community Prevents exclusion of preexisting conditions Children can enroll on their parents policy until age 26 Coverage for preventative services such as ASD screening without cost-sharing (e.g co-pays, deductibles) Changes to appeals process

30 Marketplace = Exchange Exchanges are virtual marketplaces designed to provide qualified individuals and small businesses with access to insurers qualified health plans. Qualified health plans (QHPs) as described in the ACA are health plans that are subject to a specified list of requirements including essential health benefits

31 What are the EHBs? Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance abuse services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventative and wellness services and chronic disease management Pediatric services, including oral and vision care

32

33 Benchmark Plans The specific services within each EHB category were not detailed by HHS States are permitted to select a single benchmark plan that will define the EHB package for that state Must provide coverage for each of the 10 categories of essential health benefits. States must supplement the benchmark plan if each EHB category is not represented

34 ABA and Benchmark Plan Selection States could select from among 10 benchmark options identified by HHS - one of 3 largest small group plans in the state - one of 3 largest SEHPs - one of 3 largest FEHB - largest non-medicaid HMO in the state If a state did not choose, the default plan was the largest small group plan in the state Only states with an existing autism insurance law had a benchmark option that included coverage for ABA

35 States with autism insurance laws (37)

36 States with ABA in their EHB package (25 + D.C.) essential essential **

37 Impact of the ACA in these states Access to ABA for individuals who were previously uninsured Families with health insurance but whose plans do not cover ABA (e.g., a self funded plan) are buying child only policies" through the Marketplace and getting coverage for ABA

38 Will there be another chance to change our EHB package? Per early HHS bulletins, the EHB process will be re-evaluated for plan year 2016 Please watch for action alerts on this issue

39

40 Contact Information Autism Speaks State Government Affairs Michael Wasmer, DVM, DACVIM Director

41 About Autism Speaks Autism Speaks Autism Speaks is the world s leading autism science and advocacy organization. It is dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. Autism Speaks was founded in February 2005 by Suzanne and Bob Wright, the grandparents of a child with autism. Mr. Wright is the former vice chairman of General Electric and chief executive officer of NBC and NBC Universal. Since its inception, Autism Speaks has committed more than $500 million to its mission, the majority in science and medical research. Each year Walk Now for Autism Speaks events are held in more than 100 cities across North America. On the global front, Autism Speaks has established partnerships in more than 40 countries on five continents to foster international research, services and awareness. To learn more about Autism Speaks, please visit

KANSAS AUTISM INSURANCE UPDATE. What does the new autism insurance law mean for my family?

KANSAS AUTISM INSURANCE UPDATE. What does the new autism insurance law mean for my family? KANSAS AUTISM INSURANCE UPDATE What does the new autism insurance law mean for my family? September 19, 2014 Details of HB 2744 New coverage and its impact on existing coverage for state employees Mike

More information

Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session. August 16, 2012

Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session. August 16, 2012 Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session August 16, 2012 TODAY'S AGENDA Section 1: Review of Health Insurance Exchanges Section 2: Overview of Essential

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST AFFORDABLE CARE ACT SMALL EMPLOYER Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform

More information

Preventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals. Section 6 BENEFITS

Preventive Services. Essential Health Benefits. Exceptions. The Affordable Care Act: A Working Guide for MCH Professionals. Section 6 BENEFITS The Affordable Care Act: A Working Guide for MCH Professionals Section 6 BENEFITS In addition to expanding access to affordable health coverage options, the Affordable Care Act (ACA) makes several changes

More information

Federal Health Reform FAQs

Federal Health Reform FAQs Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.

More information

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS The Affordable Care Act: A Working Guide for MCH Professionals Module 2 GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS Overview A fundamental first step in accessing health care in the United States is having

More information

Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms

Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms Kaitlyn Kenney Director of Policy & Research and National Health Reform Coordinator Board of Directors Meeting October

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information

Essential Health Benefits Discussion

Essential Health Benefits Discussion APPENDIX E National Conference of Insurance Legislators July 16, 2015 Essential Health Benefits Discussion Christopher S. Sears (317) 236-5891 sears@icemiller.com 1 Overview Affordable Care Act requires,

More information

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform. WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals

More information

ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO)

ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) Introduction and background: Summarizes the essential benefit package

More information

Health Care Reform Update

Health Care Reform Update Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in

More information

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014 vhealth insurance exchanges Health Insurance Marketplace What to expect in 2014 What to expect in 2014 The basics of exchanges As part of the Affordable Care Act (ACA or health care reform law), starting

More information

Kansas Legislator Briefing Book 2015

Kansas Legislator Briefing Book 2015 K a n s a s L e g i s l a t i v e R e s e a r c h D e p a r t m e n t Kansas Legislator Briefing Book 2015 J-1 Kansas Health Insurance Mandates J-2 Payday Loan Regulation J-3 Uninsured Motorists Financial

More information

ESSENTIAL HEALTH BENEFITS

ESSENTIAL HEALTH BENEFITS on ESSENTIAL HEALTH BENEFITS Fact sheet This fact sheet reflects the final rule of Standards Related to Essential Health Benefits published by the Department of Health and Human Services on February 20,

More information

State Roles in Implementing Health Insurance Exchanges

State Roles in Implementing Health Insurance Exchanges State Roles in Implementing Health Insurance Exchanges By Alex Azarian August 2012 Principal Policy Analyst The Affordable Care Act (ACA) requires states to establish competitive insurance marketplaces,

More information

Essential Health Benefits. Christy Tinnes Groom Law Group American Benefits Council February 1, 2012

Essential Health Benefits. Christy Tinnes Groom Law Group American Benefits Council February 1, 2012 Essential Health Benefits Christy Tinnes Groom Law Group American Benefits Council February 1, 2012 1 Why are Essential Health Benefits Important? Insured plans in individual & small group market & plans

More information

The Vermont Health Benefit Exchange: An Update for Small Business Owners

The Vermont Health Benefit Exchange: An Update for Small Business Owners The Vermont Health Benefit Exchange: An Update for Small Business Owners Today s Presentation Health Reform Goals Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like?

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER AFFORDABLE CARE ACT Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Provisions take effect on staggered dates

More information

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE Laurus Strategies Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE The Affordable Care Act (ACA) requires non grandfathered health insurance plans in the individual and

More information

HEALTH INSURANCE MARKETPLACES FACT SHEET

HEALTH INSURANCE MARKETPLACES FACT SHEET HEALTH INSURANCE MARKETPLACES FACT SHEET INFORMED ON REFORM Overview A Health Insurance Marketplace, also known as a Health Insurance Exchange, is available in every state as a public option for individuals

More information

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, together commonly referred to as the

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, together commonly referred to as the The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, together commonly referred to as the Affordable Care Act (ACA), requires that health insurance

More information

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist www.thinkhr.com 877-225-1101 Employer Health ThinkHR grants the reader non-exclusive, non-transferable, and limited permission to use this document. The reader may not sell or otherwise use this document

More information

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Health Policy Essentials: Private Health Insurance Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Briefing Agenda What is the purpose of private health insurance (PHI)? How is PHI

More information

The Vermont Health Benefit Exchange: An Update

The Vermont Health Benefit Exchange: An Update The Vermont Health Benefit Exchange: An Update Today s Discussion Health Reform Goals & Timeline Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like? Plan Design Enrollment

More information

Health insurance Marketplace. What to expect in 2014

Health insurance Marketplace. What to expect in 2014 Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning

More information

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association Tobacco Cessation and the Affordable Care Act Jennifer Singleterry Director, National Health Policy American Lung Association Background on ACA Acronyms ACA = Affordable Care Act (healthcare reform) HHS

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health

More information

Idaho Health Care Council Forum 10/30/2012

Idaho Health Care Council Forum 10/30/2012 Key Issues in Meeting Requirements of Essential Health Benefits Idaho Health Care Council Forum October 30, 2012 Tom Donovan, Deputy Director, Idaho Dept. of Insurance 1 SEC. 2707 COMPREHENSIVE HEALTH

More information

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable

More information

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law.

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people

More information

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers?

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers? The Patient Protection and Affordable Care Act (ACA) includes provisions that will have significant implications for individuals, families and employers in 2014. These provisions include: The creation

More information

Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits

Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits Dr. LaShawn A. McIver, MD, MPH National Director, Public Policy & Strategic Alliances American Diabetes Association O Presentation

More information

MISSOURI. 2. When did the law requiring insurance companies to cover services for children with autism spectrum disorder go into effect?

MISSOURI. 2. When did the law requiring insurance companies to cover services for children with autism spectrum disorder go into effect? MISSOURI FREQUENTLY ASKED QUESTIONS ABOUT THE AUTISM INSURANCE REFORM LAW 1. Generally speaking, what does the Missouri law do? The law requires all group health plans to cover the diagnosis and treatment

More information

Why the Affordable Care Act Matters for Women: Health Insurance 101

Why the Affordable Care Act Matters for Women: Health Insurance 101 Why the Affordable Care Act Matters for Women: Health Insurance 101 APRIL 2014 Women are the health care decision makers in our country they make approximately 80 percent of the health care decisions in

More information

Healthcare Reform Preparedness for Small Businesses

Healthcare Reform Preparedness for Small Businesses Healthcare Reform Preparedness for Small Businesses Blue KC on Wheels Community awareness initiative Health screenings Wellness information Seminars on healthcare reform, health insurance and wellness

More information

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010.

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The Affordable Care Act President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The ACA was enacted to: v Increase quality and affordability of health insurance v Lower the uninsured

More information

Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin

Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin The Washington State Health Care Authority (HCA) is pleased to submit comments

More information

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget.

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. March 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

Update. Director of Policy and National Health Care Reform Coordinator. Roni Mansur Chief Operating Officer. Board of Directors Meeting March 8, 2012

Update. Director of Policy and National Health Care Reform Coordinator. Roni Mansur Chief Operating Officer. Board of Directors Meeting March 8, 2012 National Health Care Reform Update Kaitlyn Kenney Director of Policy and National Health Care Reform Coordinator Roni Mansur Chief Operating Officer Board of Directors Meeting March 8, 2012 Agenda Update

More information

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers This page provides answers to frequently asked questions (FAQ) regarding The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010

More information

CBIZ Health Reform Bulletin

CBIZ Health Reform Bulletin Subject: Year-end Wrap Up Date: December 21, 2011 As the Affordable Care Act (ACA) is approaching its second birthday, it is appropriate to reflect on where we have come and what we can anticipate in the

More information

Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth

Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth National Technical Assistance Center for Children s Mental Health, Georgetown University What We Are Talking About Today Exchanges

More information

The Impact of Health Care Reform on Community Health Centers in Colorado. Kristen Pieper Policy Manager Colorado Community Health Network

The Impact of Health Care Reform on Community Health Centers in Colorado. Kristen Pieper Policy Manager Colorado Community Health Network The Impact of Health Care Reform on Community Health Centers in Colorado Kristen Pieper Policy Manager Colorado Community Health Network Presentation Topics Background information on CCHN, Colorado CHCs,

More information

Health Insurance Marketplace 101

Health Insurance Marketplace 101 Health Insurance Marketplace 101 The Marketplace is open! Find health care options that meet your needs and fit your budget. The Health Care Law In March 2010, President Obama signed the Affordable Care

More information

Review of Market Rules for the Commercial Market

Review of Market Rules for the Commercial Market Review of Market Rules for the Commercial Market What Makes up the Commercial Market? Individual Market Through MNSure and from carriers directly ( Off-Exchange ) Small Group Market Through MNSure s SHOP

More information

The Affordable Care Act: What Does it Mean for Individuals and Families?

The Affordable Care Act: What Does it Mean for Individuals and Families? The Affordable Care Act: What Does it Mean for Individuals and Families? FIRM Team Fact Sheet 13-04 Available at http://www.firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan

More information

Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director

Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director National Healthcare Reform State of Michigan Regulatory Reform Autism Mandate Direct Pay Initiative Medical Policy:

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

Insurance Issues Affecting Folks with Disabilities

Insurance Issues Affecting Folks with Disabilities Insurance Issues Affecting Folks with Disabilities Illinois Department of Insurance By Jim Norris, Outreach Officer **AND** Illinois Attorney General s Office By Ray Threlkeld, Esq., Health Care Bureau

More information

Mississippi Insurance Department. 1001 Woolfolk State Office Building 501 North West Street Jackson, Mississippi 39201

Mississippi Insurance Department. 1001 Woolfolk State Office Building 501 North West Street Jackson, Mississippi 39201 Mississippi Insurance Department 1001 Woolfolk State Office Building 501 North West Street Jackson, Mississippi 39201 1 What is an Exchange? Essentially, an Exchange is a marketplace for major medical

More information

FLORIDA: Frequently Asked Questions About the Autism Insurance Reform Law. What does the Florida Autism Legislation (Senate Bill Number 2654) do?

FLORIDA: Frequently Asked Questions About the Autism Insurance Reform Law. What does the Florida Autism Legislation (Senate Bill Number 2654) do? FLORIDA: Frequently Asked Questions About the Autism Insurance Reform Law What does the Florida Autism Legislation (Senate Bill Number 2654) do? There are three major components of the Florida Autism Legislation,

More information

(3) The commercial HMO with the largest insured commercial, non-medicaid enrollment in the state (hereafter referred to as Commercial HMO ) and

(3) The commercial HMO with the largest insured commercial, non-medicaid enrollment in the state (hereafter referred to as Commercial HMO ) and DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Center for Medicaid and CHIP Services SMDL # 12-003

More information

5Want to know more about the health

5Want to know more about the health www. WHAT S INSIDE STEPS TO UNDERSTANDING OBAMACARE Introduction 4 Step 1 Does your current health insurance plan need to change? 6 Step 2 How will you pay for health insurance in 2014? 10 Step 3 What

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 Introduction to the Marketplace The Health Insurance Marketplace (or Exchange) Place for individuals and small employers to directly compare private health insurance

More information

OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS

OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS Brief Prepared by MATTHEW COKE Senior Research Attorney LEGISLATIVE

More information

Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013

Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013 Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013 1 New Hampshire Insurance Department Presentation Overview What s New in 2014 Key Questions for Individuals

More information

HHealth HEALTH INSURANCE EXCHANGE FAQs

HHealth HEALTH INSURANCE EXCHANGE FAQs HHealth HEALTH INSURANCE EXCHANGE FAQs Page 1 TABLE OF CONTENTS Introduction... 3 Background... 3 Health Insurance Exchange FAQs... 4 What is the Patient Protection and Affordable Care Act (PPACA)?...

More information

Section 2: INDIVIDUALS WHO CURRENTLY HAVE

Section 2: INDIVIDUALS WHO CURRENTLY HAVE Section 2: INDIVIDUALS WHO CURRENTLY HAVE COVERAGE OR AN OFFER OF COVERAGE FROM THEIR EMPLOYER Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage whether through

More information

HEALTH INSURANCE EXCHANGE FAQS

HEALTH INSURANCE EXCHANGE FAQS HEALTH INSURANCE EXCHANGE FAQS 0 TABLE OF CONTENTS INTRODUCTION... 1 BACKGROUND... 1 HEALTH INSURANCE EXCHANGE FAQS... 1 1 INTRODUCTION IN EARLY 2010, CONGRESS PASSED THE PATIENT PROTECTION AND AFFORDABLE

More information

The Affordable Care Act in New Hampshire

The Affordable Care Act in New Hampshire The State of New Hampshire Insurance Department 21 South Fruit Street, Suite 14 Concord, NH 03301 (603) 271-2261 Fax (603) 271-1406 TDD Access: Relay NH 1-800-735-2964 The Affordable Care Act in New Hampshire

More information

Affordable Care Act FAQs

Affordable Care Act FAQs Note: This material is not intended to serve as legal advice and only constitutes Delta Dental s opinion on the subject matter contained herein based on its own review of available guidance. Delta Dental

More information

Maximizing Coverage Under the New Jersey Autism & Other Developmental Disabilities Insurance Mandate: A Guide for Parents and Professionals

Maximizing Coverage Under the New Jersey Autism & Other Developmental Disabilities Insurance Mandate: A Guide for Parents and Professionals Maximizing Coverage Under the New Jersey Autism & Other Developmental Disabilities Insurance Mandate: A Guide for Parents and Professionals About Autism New Jersey Autism New Jersey is the state s leading

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

Presented by South Dakota Community Action Partnership

Presented by South Dakota Community Action Partnership Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for

More information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information DISCLAIMER 2 This information is being provided in an effort to alert you to changes required by the

More information

Fact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules

Fact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules Fact Sheet Health Reform Changes Insurance Rules The Affordable Care Act (ACA) will greatly increase the availability of health insurance and broadly impact the delivery of health care in America. This

More information

Health Insurance Marketplace Basics

Health Insurance Marketplace Basics Health Insurance Marketplace Basics Amanda Ptashkin, JD Outreach and Advocacy Director aptashkin@healthyfuturega.org 404-890-5804 WHY SHOULD I GET COVERAGE? Access to the health care system Financial protection

More information

CHILDREN S HEALTH INSURANCE. Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance

CHILDREN S HEALTH INSURANCE. Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance United States Government Accountability Office Report to the Chairman, Subcommittee on Health Care, Committee on Finance, U.S. Senate November 2013 CHILDREN S HEALTH INSURANCE Information on Coverage of

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER

THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER Overview Affordable Care Act, aka Obamacare Goals Affordable Insurance Coverage

More information

The Health Insurance Marketplace 101. July 2013

The Health Insurance Marketplace 101. July 2013 The July 2013 The Problem Insurance companies could turn away the 129 million Americans with pre-existing conditions Premiums had more than doubled over the last decade, while insurance company profits

More information

American Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA)

American Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA) American Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA) This Fact Sheet reflects the Final Ruling published by the Department of Health and Human

More information

A Consumer s Guide to the Affordable Care Act

A Consumer s Guide to the Affordable Care Act A Consumer s Guide to the Affordable Care Act The Affordable Care Act was designed to help make health care affordable for everyone. This guide will help you understand how the ACA affects individuals

More information

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions.

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions. Informational Series Glossary of Health Insurance & Medical Terminology How to use this glossary This glossary has many commonly used terms, but isn t a full list. These glossary terms and definitions

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

Find health care options that meet your needs and fit your budget.

Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. January 2015 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

David Lyons Founding Director and Chief Executive Officer

David Lyons Founding Director and Chief Executive Officer The New Health Insurance Marketplace Changes Impacting Small Employers and the SHOP Opportunity David Lyons Founding Director and Chief Executive Officer CoOportunity Health 10/1/2013 1 Why the Change?

More information

Affordable Care Act FAQs

Affordable Care Act FAQs Note: This material is not intended to serve as legal advice and only constitutes Delta Dental s opinion on the subject matter contained herein based on its own review of available guidance. Delta Dental

More information

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 HEALTHCARE.GOV Affordable Care Act Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 Joanne Corte Grossi, MIPP Regional Director U.S. Department of Health

More information

Health Insurance Marketplace 101 1

Health Insurance Marketplace 101 1 Affordable Care Act Coverage Accomplishments May 2013 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through 2012 received $5.7 billion in prescription

More information

The Healthcare Law April 19, 2010

The Healthcare Law April 19, 2010 The Healthcare Law April 19, 2010 This healthcare bill, recently made law, is a comprehensive overhaul that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system.

More information

Health Insurance Marketplace

Health Insurance Marketplace Health Insurance Marketplace & Arkansas Health Connector Published by the City of Pine Bluff, Human Resources Department ** Federal Mandate ** The Affordable Care Act, a new healthcare law, requires that

More information

TO UNDERSTANDING THE AFFORDABLE CARE ACT

TO UNDERSTANDING THE AFFORDABLE CARE ACT 3 STEPS TO UNDERSTANDING THE AFFORDABLE CARE ACT What s Inside Step 1: What Understand what you re buying 4 Step 2: How How can you buy health insurance? 20 STEPS TO UNDERSTANDING THE AFFORDABLE CARE ACT

More information

ESTIMATES OF SOURCES OF HEALTH INSURANCE IN CALIFORNIA, 2016

ESTIMATES OF SOURCES OF HEALTH INSURANCE IN CALIFORNIA, 2016 ESTIMATES OF SOURCES OF HEALTH INSURANCE IN CALIFORNIA, 2016 The California Health Benefits Review Program (CHBRP) responds to requests from the California Legislature to evaluate relevant medical effectiveness

More information

PPACA, COMPLIANCE & THE USA MARKET

PPACA, COMPLIANCE & THE USA MARKET PPACA, COMPLIANCE & THE USA MARKET INTRODUCTION The USA healthcare market is the largest in the world followed by Switzerland and Germany It consists of broad services offered by various hospitals, physicians,

More information

Medicare taxes on higher income families $318. Cadillac tax on high-cost plans $111. Employer mandate $106

Medicare taxes on higher income families $318. Cadillac tax on high-cost plans $111. Employer mandate $106 ACA Changes Created new way of counting Medicaid income Removed asset tests for some Medicaid groups Increased Medicaid income levels for children Raised age limit for coverage of children who age-out

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

Final Rule on Essential Health Benefits, Actuarial Value, Accreditation. February 26, 2013

Final Rule on Essential Health Benefits, Actuarial Value, Accreditation. February 26, 2013 Final Rule on Essential Health Benefits, Actuarial Value, Accreditation February 26, 2013 Prepared by ACP s Health Policy and Regulatory Affairs Department On February 20, 2013, the Department of Health

More information

The Affordable Care Act: Overview & Impact on Adult Immunizations

The Affordable Care Act: Overview & Impact on Adult Immunizations The Affordable Care Act: Overview & Impact on Adult Immunizations Adult Immunization Leadership Summit February 1, 2013 Barbara Flye, Senior Health Policy Advisor Office of the Insurance Commissioner 1

More information

The Affordable Care Act: What Does It Mean for Self-Employed Individuals in Agriculture and Small Business?

The Affordable Care Act: What Does It Mean for Self-Employed Individuals in Agriculture and Small Business? FIRM Team Fact Sheet 13-03 Available at http://firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan State University Extension October 2013 The Patient Protection and Affordable

More information

Affordable Care Act: Key Provisions for People with MS

Affordable Care Act: Key Provisions for People with MS Affordable Care Act: Key Provisions for People with MS October 2013 Why reform healthcare? By 2008, 15% of the U.S. population, or approximately 47 million Americans, lacked health insurance Documented

More information

Health Insurance Exchange

Health Insurance Exchange Health Insurance Exchange Lynn A. Blewett, Ph.D. Professor, Division of Health Policy and Management, University of Minnesota School of Public Health Director, State Health Access Data Assistance Center

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update State of Nebraska s Health Insurance Exchange A Presentation to Advocacy Groups August 2012 TODAY'S AGENDA Section 1: Overview of Health Insurance Exchanges Section

More information

Exchanges and the ACA What You Need to Know for 2014

Exchanges and the ACA What You Need to Know for 2014 Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute

More information

The Affordable Care Act and People with Disabilities

The Affordable Care Act and People with Disabilities The Affordable Care Act and People with Disabilities The Arc of Texas envisions a world where people with disabilities are included in their communities and neighborhoods and where quality supports and

More information

Health Insurance Marketplaces

Health Insurance Marketplaces Health Insurance Marketplaces 2013 Zywave, Inc. All rights reserved. Presented by Employer Flexible What is Health Care Reform? The Affordable Care Act (ACA) was enacted in March 2010. Biggest overhaul

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department The Affordable Care Act What Happens Now? Kansas Society of CPAs June 5, 2013 Linda J. Sheppard, Special Counsel & Director of Health Care Policy and Analysis 2010 Affordable

More information

The Health Benefit Exchange and the Commercial Insurance Market

The Health Benefit Exchange and the Commercial Insurance Market The Health Benefit Exchange and the Commercial Insurance Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges, that

More information