I would love to be able to answer all of the questions about health reform, but no one can. The Patient Protection and Affordable Care Act (PPACA) contains an abundance of requirements that are awaiting definition. Federal agencies have been tasked with the requirement to establish guidelines and regulations for insurance companies, providers, and employers, and the need to create alternatives for individuals and families who do not have any coverage.
Wait and See, But Don’t Just Wait
Employers will have to hold off on communicating some specifics while guidelines are being written — but this does not mean that benefits planning should be put on hold. For January 1 renewal dates, a calendar should be created before the summer that includes timeframes for renewal and review of quotes.
Add these items to the list of questions for your broker to include the potential affect of PPACA:
- When will the plan exclude pre-existing conditions for children?
- On what date do lifetime coverage limits end?
- How are preventive care services covered?
- Is there plan language that needs to be removed that allows the insurance provider to rescind coverage?
Once you get clear answers about the effective date of any changes mandated by the new law take advantage of the communications opportunity. Don’t hide the fact that a one million dollar lifetime maximum will be eliminated as of January 1, 2011. Spread good benefits news whenever you can. If you are not getting answers don’t let the conversation slide for six months, keep pressing. If a broker seems entirely clueless or never responds it’s probably a good time to shop for a new adviser.
Never let potential confusion hold up a bidding process. You can always make changes but if you start late it will be tough to catch up and you may make decisions without all of the best available information.
Take Advantage of the Tax Credit
If you employ equivalent of fewer than 25 full time employees and provide benefits run the numbers to see if you qualify for the new small business tax credit. If you are not providing benefits but are considering a plan for 2011 the potential for a tax credit should be included in any research.
Write Down Frequently Asked Questions
Make a list of repeated questions to create your own frequently asked questions. These will include some you can respond to now; “Do I have to sign up for company health benefits if I am covered under my spouse’s plan?” The answer is, “No there is nothing in the law that requires employees to sign up for employer provided coverage.” Keep track of the inquiries that still need clarification for continued communication. There may be many situations when you respond, “I don’t know.” It’s best to do this without whining about the complexity of the law and potential regulations, negative responses will only add to frustration and anxiety.
Feel free to submit your own questions here and I will address them as information and guidance is issued.