Blue Cross of Idaho is pleased that healthcare reform is in the national spotlight. We fully support changes that lower the cost of care and make health insurance more affordable and available for all Americans.
To achieve comprehensive and lasting healthcare reform, all healthcare stakeholders -- consumers, employers, doctors, hospitals, insurers and the government -- need to educate themselves on how far these new laws and regulations reach, and then work together to improve quality, rein in costs and extend coverage to all Americans.
Please use the resources listed below to gain as much knowledge and insight as possible about healthcare reform so you understand what’s going on in the present, and better plan for the future.
As part of the ongoing healthcare reform changes, the U.S. Departments of Health and Human Services, Labor and Treasury issued a new regulation on June 14, 2010, where existing plans are designated with "grandfathered" or "non-grandfathered" status based on certain criteria. Grandfathered plans are exempt from certain healthcare reform provisions. If you make any changes to your coverage, you may lose your grandfather status, and your coverage will need to reflect all the new changes required by healthcare reform.
Be aware that if you make changes to your healthcare plan after June 14, 2010, you may lose grandfathered status. Although certain changes that improve or expand the coverage you have won't cause you to lose your grandfather status, if you make any changes to reduce your benefits, such as increase your deductible or copayments, you will lose your grandfather status, which could cause an increase to your premium and change your benefits.
Before making a decision to change plans, review your current plan and determine if the benefits of keeping your grandfathered healthcare coverage outweigh the benefits and costs of a new plan.
For more information on the changes you can and can't make under the grandfather rule, read this PDF fact sheet from the U.S. Department of Health and Human Services.
Blue Cross Blue Shield Association Healthcare Reform Summaries
While most healthcare reform changes take effect in 2014, some changes go into effect well before that time. The Near Term Insurance Market Reforms PDF document summarizes the key actions taking effect in 2010 and 2011 that affect the private health insurance market.
Major Insurance Market Reforms
The PDF document Major Insurance Market Reforms is an overview of the long-term, more substantial changes healthcare reform places on the insurance industry.
Health Insurance Exchanges
This portion of healthcare reform attempts to appeal to individuals and small businesses by injecting some level of retail competition in the private healthcare insurance market. Read the PDF document Health Insurance Exchanges for details on what health insurance companies need to do to comply with this portion of the act.
The Patient Protection and Affordable Care Act (PPACA) includes a provision that allows children up to age 26 to become a dependent on their parent's health insurance regardless of the child's marital, financial, student or residential status.
On August 20, 2010, we mailed a letter to all of our individual members notifying them of this change in the dependent age requirement since federal regulations require us to notify all policyholders, regardless of age. As an example, if a child of age four is covered separately by his or her own policy, that child would receive a dependent age letter. We realize this may cause confusion, but our interpretation of the federal regulation meant we could apply no specific age cutoff for these letters, so we sent them to all policyholders, regardless of age.
In June, we mailed letters to policyholders notifying them that we were implementing this change in dependent age coverage beginning on June, 1. We made this change ahead of the September 23 deadline required by the government to protect our members from a potential coverage gap caused by the dependent age limit prior to September 23. This most recent letter serves as a reminder that the first effective date for enrollment for children up to age 26 is October 1.