Health Insurance Market Reforms under Obamacare

The Patient Protection and Affordable Act (PPACA), or Obamacare, sets out a number of provisions for health insurance market reforms. Having been set in motion in March 2010; the PPACA sets out health insurance market reforms that are being implemented in stages from dates commencing generally from January 1, 2014.

PPACA's health insurance market reforms are aimed at health insurance standards and group health plans. These reforms set out dates for the implementation of these reforms. They also prescribe penalties for noncompliance with these reforms.

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What kinds of market reforms are needed?

The health insurance market reforms suggested by PPACA are almost singularly for group health plans. A group health plan is defined as one in which the employer makes a contribution into expenses accruing from the employee's health insurance plans. When an employer chooses to bring an employee's health plan under her coverage; the employer has to mandatorily comply with the provisions of the health insurance market reforms.

Areas of the health insurance market reforms

These are the essential areas in which the health insurance market reforms are to be applied:

Removal of lifetime and annual limits on essential health benefits

One of the primary provisions of the health insurance market reforms under PPACA is that it prohibits both lifetime and annual limits on essential health benefits, which were allowed some dollar limits prior to enactment of Obamacare.

Preventive health services

An area of preventive health services that has undergone an amendment under the health insurance market reforms is that of no-cost sharing. Accordingly, employer plans are to offer preventive health services without requiring the employee to share the burden for this part of the plan.

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The three-month waiting period

The health insurance market reforms don't require a waiting period of over 90 days. A waiting period is the period that has to pass by the time the employee can take part in a plan.

Extending coverage on dependents

The Obamacare health insurance market reforms offers coverage on children who are dependents of health insurance for those aged up to 26 years, whether they are married or unmarried.

Health insurance market reforms relating to Summary of Benefits and Coverage (SBC)

Finally, the ACA health insurance market reforms make it mandatory for employers to provide an SBC to its employees who are covered under ACA. This is a short description of the details of the health plan.

Penalties under health insurance market reforms

In order to ensure strict compliance, the health insurance market reforms fix a rather steep penalty of $100 a day per employee on an employer who does not comply with its provisions.