What You Need To Know About Health Care Reform

<Insert Date.> <Insert Your Company Name or Logo.>

Health Care Reform Key Facts

• March 23, 2010 - President Obama signed the Affordable Care Act.

A central goal of the ACA is to significantly reduce the number of uninsured by providing affordable coverage options through Medicaid and new Health Insurance Marketplaces. The law requires most people to maintain a minimum level of health insurance coverage beginning in 2014.

• Oct. 1, 2013 – Health Insurance Marketplaces open.

• Jan. 1, 2014 – Coverage begins.

What is a Health Insurance Marketplace?

• An online marketplace where individuals may:• Shop for health insurance. • Compare benefits and prices.• Enroll in a plan.

• There will be two types marketplaces in the US:1. Public– The Health Insurance Marketplace

facilitated by state and/or federal government. (Tax Credits and Subsidies available for qualified individuals.)

2. Private–marketplaces facilitated by private companies.

• State marketplaces will be accessible at https://www.healthcare.gov/marketplace/individual/

Who can use the Health Insurance Marketplace?

Bronze: plan pays 60% of “essential health benefits”

Silver: plan pays 70% of “essential health benefits”

Gold: plan pays 80% of “essential health benefits”

Platinum: plan pays 90% of “essential health benefits”

The Health Insurance Marketplace will offer 4 coverage levels

Benchmark

Low income consumers may be eligible for subsidies to assist with premium expenses and out-of-pocket expenses.

Plans must include “Essential Health Benefits”

• Ambulatory patient services• Emergency services• Hospitalization• Maternity and newborn care• Mental health and substance abuse disorder services,

including behavioral health treatment• Prescription drugs• Rehabilitative and habilitative services and devices• Laboratory services• Preventive and wellness services and chronic disease

management• Pediatric services, including oral and vision care

Plans must provide “Preventive Care” at no cost

You will not have to pay a copayment, co-insurance, or deductible to receive certain preventive health care:

• Blood pressure, diabetes, and cholesterol tests • Many cancer screenings, including mammograms and

colonoscopies • Counseling on such topics as quitting smoking, losing weight,

eating healthfully, treating depression and reducing alcohol use • Regular well-baby and well-child visits, from birth to age 21 • Routine vaccinations against diseases such as measles, polio or

meningitis • Counseling, screenings and vaccines to ensure healthy

pregnancies • Women’s wellness and pre-natal visits• Flu and pneumonia shots

Additional changes to health care plans …

• Guaranteed Issue and Renewal• Plans cannot deny coverage based on “pre-existing”

conditions.• Plans cannot exclude “pre-existing” conditions.• Plans cannot charge a higher premium for “pre-

existing” conditions.

For us at <insert company name>, this means…

• Our company will offer the following major medical benefits:• <Insert benefit and vendor details>• Open Enrollment begins: <Insert date>• Costs: <Insert cost details>

• Our company will offer the following voluntary benefits:• <Insert benefit and vendor details>• Open Enrollment begins: <Insert date>• Costs: <Insert cost details>

Slide Option 1: Employer Offering Major Medical Benefits

For us at <insert company name>, this means…

• While our company will not offer major medical benefits, you will have access to the Health Insurance Marketplace. • Open Enrollment begins: October 1, 2013• Visit: http://www.MNSure.org

• Our company will offer the following supplemental benefits:• <Insert benefit and vendor details>• Open Enrollment begins: <Insert date>• Costs: <Insert cost details>

Slide Option 2: Employer NOT Offering Major Medical Benefits

Healthcare.gov http://www.healthcare.gov/ Kaiser on Health Care Reform http://kff.org/health-reform/ U.S. Small Business Administration/Health Care

http://www.sba.gov/healthcare/ Aflac Healthcare Reform Resources

http://www.aflac.com/healthcare_reform/default.aspx

For more information…

Questions