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New health reforms benefitting consumers begin

September 23, 2010

Consumer Reports Health Helps Consumers Prepare For Rollout of Consumer Potections Under Health Reform

Free Guide Explains New Options Available to Consumers, Interprets the Fine Print

YONKERS, NY — To help consumers prepare for the September 23rd rollout of the first major marketplace reforms under the new health reform law, Consumer Reports Health is providing a free online guide at www.ConsumerReportsHealth.org on September 16th at 6 am Eastern. A free PDF in English and Spanish is also be available for downloading.
“”There are many meaningful reforms here that, while not perfect, will help millions of consumers get a fairer shake when they buy and use health insurance,” said Jim Guest, president and CEO of Consumers Union, the nonprofit publisher of Consumer Reports.
According to Guest, the law’s biggest impact will fall on health insurers who will be required to abide by the new rules of the road set forth by the law signed on March 23, 2010. “One change we helped push into health-reform law will compel insurers to explain in plain English what’s covered and what’s not covered and consumers’ rights to appeal their decisions,” said Guest.
The online guide available at www.ConsumerReportsHealth.org provides a timeline for the major provisions that will affect consumers. Two major changes that will apply to all health insurance plans in the individual and small business markets include a ban on the practice of canceling coverage when people get sick and a ban on annual and lifetime coverage limits. “The ban on annual and lifetime caps is big news for people with chronic conditions that are expensive to treat. Lifetime caps will be banned when your plan comes up for renewal, which for many people happens in January, 2011. Annual limits will be phased out through 2014,” said Guest.
Here are some highlights for consumers. More details are available online at www.ConsumerReportsHealth.org:
If you’re insured through your job: Most consumer protections will kick in at the official beginning of your plan year. Many employer based plans start in January but some start later. Also, consumers will start hearing the terms “grandfathered” and “non-grandfathered.” The former refers to plans that existed when the healthcare reform law was signed six months ago. The Consumer Reports Health Guide explains how grand-fathering will impact consumers in greater detail.
If you’re under 26: A key provision in the health reform law allows you to look forward to high school or college graduation without worrying about getting kicked off your parents’ health insurance plan. The law says that health insurance plans must allow adult children to stay on their parents’ plans until their 26th birthday. The new requirement takes effect when the next plan year starts. Some insurers and companies voluntarily started offering young-adult coverage earlier than the new plan year. Parents should check with their plan administrator to find out the exact renewal date.
If you buy health insurance on your own: Individual health insurance is the hardest kind to buy because consumers can’t rely on the expertise of an employer, union, or association to screen out bad plans or policies. As of September 23rd, health insurers can’t cancel your coverage if you get sick; set lifetime limits on coverage; put annual dollar limits on coverage (phased in over three years); deny coverage to children under age 19 with pre-existing conditions; or impose barriers to emergency care. In its healthcare guide, Consumer Reports Health provides advice for buying insurance on your own and urges vigilance against health insurance scams, suggesting ways to avoid “junk” insurance plans propagated by scam artists.
If you have sick children: Under the new health reform law, children can’t be denied coverage for pre-existing conditions. Parents may benefit from this provision if they have a child under the age of 19 with a medical condition. This is effective for plans beginning on or after September 23, 2010. For many people, that will be in January, 2011. Grandfathering can be tricky here—the new provision applies to all existing employer plans, but only “non-grandfathered” individual plans. It’s best to contact your plan administrator to find out how this provision will impact your plan.
Tildy La Farge: 914-378-2436
David Butler: 202-462-6262
Michael McCauley: 415-431-6747, ext 126