7 Things About Obamacare Compliance that Credit Unions Need to Know
This week the nation is expected to hear the U.S. Supreme Court’s decision regarding the Patient Protection and Affordable Care Act, but that doesn’t mean credit unions can afford to simply wait and see.
According to Brad Pricer, human resources process leader at CUNA Mutual Group who has been helping credit unions and leagues navigate healthcare reform, credit unions have plenty of compliance concerns to address.
GRANDFATHERED PLAN STATUS
A grandfathered health plan is one that was in existence when health care reform was enacted on March 23, 2010. Grandfathered plans are exempt from some of the health care reform requirements. A plan’s grandfathered status will continue to affect its compliance obligations from year to year.
Beginning Jan. 1, 2014, group health plans will no longer be able to impose annual limits on the value of essential health benefits. However, until then, certain minimum annual limits are permitted. Unless your plan received a waiver of the annual limit requirements, you should confirm that any annual limit included in your plan is set at least as high as the following amounts for each applicable plan year:
SUMMARY OF BENEFITS AND COVERAGE
Plans and insurance issuers must provide a Summary of Benefits and Coverage to participants and beneficiaries.
60-DAY NOTICE OF PLAN CHANGES
WOMEN’S PREVENTIVE CARE GUIDELINES
Effective for plan years starting on or after Aug. 1, 2012, non-grandfathered plans must cover specific preventive health services for women with no cost sharing. These services include well-woman visits, STD screening and contraceptives. Exceptions to contraceptive requirements apply to religious employers.
MEDICAL LOSS RATIO REBATES
Fully insured plans may receive rebates in August 2012 if they qualify for a rebate from their issuers due to the medical loss ratio rules requiring insurance companies to spend a certain percentage of premium dollars on health care. The rebates must be used for the benefit of the plan’s enrollees, which may include reducing enrollees’ premium payments.