Despite heavy discussion and debate, the health care bill has been signed into law. It’s been more than a year since President Obama signed the bill into law, and although much of the law doesn’t go into effect for another several years (in 2014), there are some aspects that have an immediate impact on your business.
Keeping up to date on health care reform is integral to your business.
Understanding the health care reform law and its ramifications is essential to your business. Change too late, and you could end up receiving heavy fines or penalties. Jump the gun, and you could incur unnecessary cost for your business.
To help you understand what is “hot” in health care reform right now, we’ve identified three areas of confusion for both employees and employers:
- The Affordable Care Act – Part of health care reform, the Affordable Care Act eliminates copays and co-insurance for certain types of preventative care (when using an in-network provider). Your employees may be asking you, though, why their annual health exams, or other medical costs, haven’t been covered. Common tests and screenings, like blood pressure tests, colonoscopies and mammograms are also typically covered. And since it’s cold and flu season, you may also note that many immunizations are also covered. But, while these are typically covered, there are a few things to note. Specifically, if your health insurance plan was started before the bill was signed, your health care plan may be grandfathered out of the requirement. This exemption will last until your plan is significantly changed by your employer, or if certain aspects of your payments are changed. Another exemption – if your preventative care visit turns into a “sick” visit (if your doctor notices something and treats it during your visit), you may be charged. Confusion over these exemptions can be avoided by asking doctors when something is done that will result in a charge.
- Pre-Existing Conditions. The reform law will require health insurance companies to charge both healthy and sick people the same prices – eliminating extra fees for people with pre-existing conditions. But, this does not go into effect until 2014. Until 2014, though, the government is trying to help people with pre-existing conditions get by, both by excluding kids from pre-existing conditions clauses, and by providing subsidized programs in each state, called Pre-Existing Condition Insurance Plans.
- The “Doughnut Hole.” Medicare prescription coverage has a bit of a gap. Once the spending on your prescriptions surpasses $2,840, patients must pay out of pocket until costs reach $6,448. The laws have changed to eliminate this hole; however, the elimination will take time. Patients who fell into the gap may have received a one-time payment of $250 to help bridge the gap; however, this year there will not be any checks. Instead, patients will receive a 50% discount on brand-name prescription drugs purchased while in the hole. Generic drugs will be discounted by 7%. This cost differential will occur right at the pharmacy, and will not require forms or submissions.
Understanding the health care reform bill can have a significant impact on your bottom line as businesses continue to adjust and prepare for its full ramifications. Here at Masiello Employment Services, we’ll do our part to keep you updated on the latest news, changes and adjustments that could have an effect. And if you’re looking for experienced temporary or permanent professionals in Vermont, New Hampshire or Massachusetts, contact us today!
