07/02/2010
Group administrators for groups 2 - 99 notified of changes to benefits and premium
We're making several modifications to coverage for groups 2 - 99 to ensure compliance with provisions of the Patient Protection and Affordable Care Act (PPACA).
Beginning June 30th, letters were sent to group administrators of groups renewing October 1 that are currently on Innova®, Engage®, ActivateSM or HSA Healthplan 2.0SM products outlining changes that will become effective upon the group's renewal:
- "Adult children" will be eligible to be covered up to age 26, regardless of marital status, student status or financial dependency;
- Pre-existing condition exclusions will not be applied for enrollees under age 19. Individuals also cannot be denied enrollment due to a pre-existing condition;
- Preventive services will be covered at 100% of the allowed amount with no deductible and no copayment;
- The overall lifetime dollar limit on essential benefits will be removed; and
- Any overall annual dollar limit on essential benefits will be modified if necessary to comply with guidance from the U.S. Department of Health and Human Services.
Because these changes include expansion of coverage and benefits, medical costs are expected to rise as a result. Group administrators are also being notified that the group's premium will increase upon renewal. The group's renewal contract will contain more specific information about the benefit and premium changes. These 90-day advance-notice letters will be mailed each month through September 2011 renewals. Letters are only going to the group administrators, not the subscribers.
These changes may prompt questions and concerns from your clients. We appreciate your assistance in helping your clients understand these changes.
If you have any questions, please talk to your Regence Sales contact.
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